Title 388 WAC — Social and Health Services, Department of

Chapter 388-01 Public records—Disclosure.

Wash. Admin. Code § 388-01-005 What is the purpose of this chapter?

The purpose of this chapter is to ensure compliance by the department of social and health services with the provisions of the Public Records Act, chapter 42.56 RCW.

History

Statutory Authority: RCW 42.56.040. WSR 23-19-028, amended and recodified as § 388-01-005, filed 9/12/23, effective 10/13/23
WSR 18-05-021, § 388-01-010, filed 2/9/18, effective 3/12/18. Statutory Authority: RCW 42.17.250 and 34.05.220. WSR 99-15-065, § 388-01-010, filed 7/19/99, effective 8/19/99.

Wash. Admin. Code § 388-01-010 Definitions.

The following definitions apply to this chapter:

(1) "Authorization" means a detailed document that gives DSHS permission to use or disclose confidential information and records for specified purposes and within a designated time frame.

(2) "Business days" means Monday through Friday, excluding legal holidays.

(3) "Client" means a person who receives services or benefits from DSHS. Clients include but are not limited to, consumers, recipients, applicants, residents of DSHS facilities or institutions, patients, parents receiving support enforcement services, persons who previously received services or benefits, and persons applying for benefits or services.

(4) "DSHS" means the department of social and health services.

(5) "Public records coordinator" means a person designated to respond to public records requests within an organizational unit or who are appointed as responsible for a local office, unit, region, program, or facility.

(6) "Public records officer" means the person designated as the public records officer for the DSHS under RCW 42.56.580. The DSHS public records officer has primary responsibility for management, oversight, and monitoring of DSHS's public records request process.

(7) "Redact" means deleting or marking out exempt information from a public record.

(8) "Third party notice" means notifying affected persons or entities of a public records request to allow the opportunity to enjoin disclosure of the records under RCW 42.56.540.

History

Statutory Authority: RCW 42.56.040. WSR 23-19-028, amended and recodified as § 388-01-010, filed 9/12/23, effective 10/13/23
WSR 18-05-021, § 388-01-005, filed 2/9/18, effective 3/12/18.

Wash. Admin. Code § 388-01-015 Does any provision in this title create a cause of action?

Except where otherwise provided, no provision in Title 388 WAC:

(1) Creates or is intended to create any right or cause of action;

(2) Adds to or intends to add to any existing right or cause of action; or

(3) Compels the establishment of any program or special entitlement.

Reviser's note: The permanent filing 23-19-028 contained no amendments to this section.

Wash. Admin. Code § 388-01-020 How is DSHS organized?

DSHS is organized into administrations which direct the provision of food and cash assistance, long-term care, vocational rehabilitation, services for people with intellectual and developmental disabilities, and behavioral health treatment for people in state-operated psychiatric hospitals as well as those with criminal justice involvement, and waiting to receive competency evaluation and restoration services. DSHS contracts with local government, private, and nonprofit contractors to deliver these services, and operates over 140 field offices and 12 state-run facilities throughout Washington.

DSHS's current organizational structure can be located at the following link: https://www.dshs.wa.gov/office-of-the-secretary/organizational-chart.

History

Statutory Authority: RCW 42.56.040. WSR 23-19-028, § 388-01-020, filed 9/12/23, effective 10/13/23. Statutory Authority: RCW 42.56.040 and chapter 42.56 RCW. WSR 19-02-018, § 388-01-020, filed 12/21/18, effective 1/21/19. Statutory Authority: RCW 42.56.040. WSR 18-05-021, § 388-01-020, filed 2/9/18, effective 3/12/18. Statutory Authority: RCW 42.17.250 and 34.05.220. WSR 99-15-065, § 388-01-020, filed 7/19/99, effective 8/19/99.

Wash. Admin. Code § 388-01-030 What public records are available?

(1) DSHS prepares and maintains public records that relate to the programs it administers. All records DSHS uses to conduct business are public records.

DSHS public records may include documents, audio and video recordings, pictures, email, and electronic data.

(2) DSHS public records are available to the public unless a law exempts them from disclosure. Some DSHS records are confidential and not available to everyone. Records exempt from public disclosure are listed under chapter 42.56 RCW, WAC 388-01-120, and other federal and state laws applicable to DSHS.

(3) Clients, or someone authorized to act for a client, may access confidential records about the client that are exempt from disclosure to the public unless specifically prohibited by law.

(4) Upon request, DSHS may provide access to records such as rules, policies, indexes, interpretive statements, pamphlets, forms, and other publications at cost under WAC 388-01-180 without using the public records request process.

History

Statutory Authority: RCW 42.56.040. WSR 23-19-028, § 388-01-030, filed 9/12/23, effective 10/13/23. Statutory Authority: RCW 42.56.040 and chapter 42.56 RCW. WSR 19-02-018, § 388-01-030, filed 12/21/18, effective 1/21/19. Statutory Authority: RCW 42.56.040. WSR 18-05-021, § 388-01-030, filed 2/9/18, effective 3/12/18. Statutory Authority: RCW 41.17.020 [ 42.17.250], 41.17.260 [ 42.17.260], and 41.17.300 [ 42.17.300]. WSR 03-17-014, § 388-01-030, filed 8/12/03, effective 9/12/03. Statutory Authority: RCW 42.17.250 and 34.05.220. WSR 99-15-065, § 388-01-030, filed 7/19/99, effective 8/19/99.

Wash. Admin. Code § 388-01-060 How may an individual request a public record?

(1) An individual may request a public record verbally or in writing from the DSHS public records officer using the following contact information:

DSHS public records officer

Office of information governance

P.O. Box 45135

Olympia WA 98504-5135

Telephone: (360) 902-8484

Fax: (360) 902-7855

Email: DSHSPublicDisclosure@dshs.wa.gov.

DSHS prefers that all public record requests be in writing on the "request for DSHS records" form, DSHS 17-041. Individuals may locate this form on the DSHS website at https://www.dshs.wa.gov/office-of-the-secretary/forms or request it from the DSHS public records officer.

(2) If an individual does not use the DSHS form, the written public record request should include the following information:

(a) The requester's name, organization, mailing address, telephone number, fax number, and email address;

(b) The date of the request;

(d) The email or mailing address where DSHS should send copies of the records, or if the requester wants to inspect the record at DSHS; and

(e) The requester's signature.

(3) An individual may fill out a record request at a DSHS office or send it by regular mail, email, or fax to the public records officer.

(4) Requests by third parties for confidential client records must be accompanied by a valid authorization as set forth in WAC 388-01-150.

(5) DSHS may ask an individual requesting a public record for personal identification when the law makes a record disclosable to a specific person.

(6) DSHS may deny a "bot" request, which is one of multiple requests from a requester within a 24-hour period, if responding to multiple requests would cause excessive interference with other essential DSHS functions.

History

Statutory Authority: RCW 42.56.040. WSR 23-19-028, § 388-01-060, filed 9/12/23, effective 10/13/23. Statutory Authority: RCW 42.56.040 and chapter 42.56 RCW. WSR 19-02-018, § 388-01-060, filed 12/21/18, effective 1/21/19. Statutory Authority: RCW 42.56.040. WSR 18-05-021, § 388-01-060, filed 2/9/18, effective 3/12/18. Statutory Authority: RCW 42.17.250 and 34.05.220. WSR 99-15-065, § 388-01-060, filed 7/19/99, effective 8/19/99.

Wash. Admin. Code § 388-01-070 When may a public record be inspected?

(1) Individuals may inspect public records during DSHS office hours. The office hours are 8:00 a.m. to noon and 1:00 p.m. to 5:00 p.m., Monday through Friday, excluding legal holidays. Contact the public records coordinator in the appropriate office to arrange a time to inspect the public record.

(2) In order to preserve the record or prevent interference in the performance of departmental duties, DSHS reserves the right to restrict an individual's ability to inspect or copy public records. This does not prevent DSHS from providing copies of the public record by mail or email.

Reviser's note: The permanent filing 23-19-028 contained no amendments to this section.

Wash. Admin. Code § 388-01-080 Does DSHS charge for inspecting or providing public records?

(1) There is no fee for inspecting public records.

(2) Pursuant to RCW 42.56.120 (2)(b), DSHS does not calculate the actual costs for copying records because to do so would be unduly burdensome for the following reasons:

(a) DSHS does not have the resources to conduct a study to determine all of its actual copying costs; and

(b) To conduct such a study would interfere with other essential agency functions.

(3) DSHS may do one or more of the following:

(a) Charge for copies of records according to the default fees in RCW 42.56.120 (2)(b), (c) and (d);

(b) Charge for customized services pursuant to RCW 42.56.120(3);

(d) Enter into an alternative fee agreement with a requester under RCW 42.56.120(4).

(e) Charge for an advanced deposit of 10% of the estimated fees, including a customized service charge, as allowable under RCW 42.56.120(4).

(4) Responsive records may be provided in installments as allowable under RCW 42.56.120(4). Each installment must be either paid for or inspected prior to fulfilling the remainder of the request.

(5) Payment must be made by check or money order to the department of social and health services.

(6) The department will close a request as abandoned when the requester fails within 30 days to pay for a request, or an installment, or for the required 10% deposit.

(7) DSHS may waive copying fees in one or more of the following circumstances:

(a) Clients or someone having a valid authorization or court order to act for a client receiving the first copy of their client file;

(b) Producing records assists in managing a program;

(d) Fees totaling less than $2.00.

History

Statutory Authority: RCW 42.56.040. WSR 23-19-028, § 388-01-080, filed 9/12/23, effective 10/13/23
WSR 18-05-021, § 388-01-080, filed 2/9/18, effective 3/12/18. Statutory Authority: RCW 42.17.250 and 34.05.220. WSR 99-15-065, § 388-01-080, filed 7/19/99, effective 8/19/99.

Wash. Admin. Code § 388-01-090 When and how must DSHS respond to a public record request?

(1) Within five business days after DSHS receives a public record request, DSHS must:

(a) Produce responsive public records;

(b) Acknowledge receipt of the request and provide an estimated date for first response;

(d) Seek clarification of an unclear request; or

(e) Deny the request in writing, noting the reason(s) for denial.

(2) DSHS may produce records in installments, as appropriate.

(3) A request received after office hours will be considered to have been received on the following business day.

History

Statutory Authority: RCW 42.56.040. WSR 23-19-028, § 388-01-090, filed 9/12/23, effective 10/13/23
WSR 18-05-021, § 388-01-090, filed 2/9/18, effective 3/12/18. Statutory Authority: RCW 42.17.250 and 34.05.220. WSR 99-15-065, § 388-01-090, filed 7/19/99, effective 8/19/99.

Wash. Admin. Code § 388-01-100 When may DSHS need to extend the time to respond to a public record request?

(1) DSHS may extend its estimated response time to:

(a) Locate and gather responsive records;

(b) Notify an individual or organization identified in the records or affected by the request;

(d) Contact the requester to clarify the intent, scope, or specifics of the request.

(2) If a requester does not clarify an unclear request under subsection (1)(d) of this section, DSHS does not have to respond to the unclear parts of the request.

History

Statutory Authority: RCW 42.56.040. WSR 23-19-028, § 388-01-100, filed 9/12/23, effective 10/13/23
WSR 18-05-021, § 388-01-100, filed 2/9/18, effective 3/12/18. Statutory Authority: RCW 42.17.250 and 34.05.220. WSR 99-15-065, § 388-01-100, filed 7/19/99, effective 8/19/99.

Wash. Admin. Code § 388-01-110 What if a requester disputes production time estimates?

If a requester thinks DSHS's time estimate for producing records under chapter 42.56 RCW is unreasonable, the requester may:

(1) Petition the public records coordinator to reduce the time estimate; or

(2) File a lawsuit in superior court under RCW 42.56.550(2).

Reviser's note: The permanent filing 23-19-028 contained no amendments to this section.

Wash. Admin. Code § 388-01-120 What if the public record contains information that is exempt from public disclosure?

(1) Public records and information may be exempt from disclosure or production under chapter 42.56 RCW or other state or federal laws. Commonly applicable exemptions include, but are not limited to, the following:

(a) Under RCW 42.56.230(1), personal information in files maintained for welfare recipients and patients or clients of public institutions or public health agencies. Personal information includes, but is not limited to:

(i) Names;

(ii) Telephone numbers;

(iii) Fax numbers;

(iv) Email addresses;

(v) Social Security numbers;

(vi) Medical record numbers;

(vii) Health plan beneficiary numbers;

(viii) Account numbers;

(ix) Certificate or license numbers;

(x) Vehicle identifiers and serial numbers, including license plate numbers;

(xi) Device identifiers and serial numbers;

(xii) Web universal resource locators (URLs);

(xiii) Internet protocol (IP) address numbers;

(xiv) Biometric identifiers, including finger and voice prints;

(xv) Full face photographic images and any comparable images;

(xvi) Any other unique identifying number, characteristic, or code;

(xvii) All geographic subdivisions smaller than a state, including street address, mailing address, city, county, precinct, geocodes, and zip code, except for the initial three digits of a zip code; and

(xviii) All elements of dates (except year) for dates directly related to an individual, including birth date, admission date, discharge date, date of death.

(b) Under RCW 74.04.060 and related federal laws, information and records about applicants and recipients of public assistance and other services provided and received under Title 74 RCW.

(c) Under chapter 13.50 RCW and related federal laws, information and records about juvenile offender and child welfare cases.

(d) Under chapter 26.23 RCW and related federal laws, information and records about child support enforcement.

(e) Under chapter 26.33 RCW and related federal laws, information and records about adoption.

(f) Under chapter 70.02 RCW and related federal laws, protected health care information and medical records.

(g) Under RCW 74.34.095, information and records about alleged abandonment, abuse, financial exploitation, or neglect of a vulnerable adult.

(h) Under RCW 42.56.230(3), personal information in files maintained for DSHS employees or elected officials to the extent that disclosure would violate their right to privacy.

(i) Under RCW 42.56.250, the following information from personnel records, public employment related records, volunteer rosters, or included in any mailing list of employees or volunteers of any public agency:

(A) Residential addresses;

(B) Residential phone numbers;

(D) Personal email addresses;

(E) Social Security numbers;

(F) Driver's license numbers;

(G) Identicard numbers;

(H) Personal demographic details;

(I) Photographs and month and year of birth, except the news media shall have access to the photographs and full dates of birth;

(J) Emergency contact information; and

(K) Names, dates of birth, residential addresses, residential telephone numbers, personal wireless telephone numbers, personal email addresses, social security numbers, and emergency contact information of dependents of employees or volunteers of a public agency.

(j) Under RCW 42.56.640 and 43.17.410, sensitive personal information of vulnerable individuals and in-home caregivers for vulnerable populations, except as allowed under subsection (3) of this section.

(2) If the requested public record contains information that is exempt from public disclosure, DSHS may:

(a) As appropriate, release the nonexempt portion, explaining what exemptions apply to redacted portions of the record;

(b) As appropriate, deny release of the entire record, sending a written explanation and citing the exemption that applies to the denial; or

(c) Neither confirm or deny the existence of the requested records and provide the legal basis for confidentiality as if the responsive records existed, when a denial would reveal information that is confidential and must not be disclosed.

(3) Sensitive personal information under subsection (1)(j) of this section may be disclosed or produced if DSHS determines that the requester:

(a) Meets the criteria under RCW 42.56.645; and

(b) Has complied with any procedures developed by DSHS to protect the confidentiality of the information.

History

Statutory Authority: RCW 42.56.040. WSR 23-19-028, § 388-01-120, filed 9/12/23, effective 10/13/23
WSR 18-05-021, § 388-01-120, filed 2/9/18, effective 3/12/18. Statutory Authority: RCW 42.17.250 and 34.05.220. WSR 99-15-065, § 388-01-120, filed 7/19/99, effective 8/19/99.

Wash. Admin. Code § 388-01-130 What are a requester's options if DSHS denies a public record request?

(1) After DSHS takes final action to deny all or a portion of a public record request, a requester may do any one or more of the following:

(a) Petition for agency review by the denying public records coordinator or an approved designee. The written request must specifically refer to the written statement by the public records coordinator that constituted or accompanied the denial.

(b) Ask the office of the attorney general to review the public record request.

(i) Send a copy of the denied public record request and the DSHS written denial to:

Office of the attorney general

Public records review

P.O. Box 40100

Olympia WA 98504-0100.

(ii) The office of the attorney general will review the request and DSHS denial. The office of the attorney general issues a written opinion as to whether the requested public record is excluded from disclosure.

(c) File a lawsuit for judicial review under the Public Records Act in superior court in the county where the public record is located.

(2) "Final action" occurs when DSHS indicates that it will not provide responsive records. When DSHS produces installments of records, final action occurs when DSHS produces its last installment or indicates that it will not reconsider a denial. Before DSHS produces its last installment, DSHS may cure deficiencies within prior installments. DSHS encourages requesters to contact the public records coordinator with questions or concerns about installments prior to final action.

History

Statutory Authority: RCW 42.56.040. WSR 23-19-028, § 388-01-130, filed 9/12/23, effective 10/13/23
WSR 18-05-021, § 388-01-130, filed 2/9/18, effective 3/12/18. Statutory Authority: RCW 42.17.250 and 34.05.220. WSR 99-15-065, § 388-01-130, filed 7/19/99, effective 8/19/99.

Wash. Admin. Code § 388-01-140 If a public record identifies or pertains to an individual or organization, other than the requester, is that individual or organization notified?

(1) If records responsive to a public records request identify or pertain directly to an individual or organization other than the requester, DSHS may notify the named individual or organization about the request.

(2) DSHS's third party notice may include:

(a) A copy of the original request;

(b) If appropriate, the records that identify or pertain to the third party;

(d) A statement that the third party may prevent release of the record by agreement or by bringing a lawsuit and getting an injunction against DSHS and the requester under RCW 42.56.540 prior to the intended release date.

(3) DSHS may inform the requester that:

(a) A third party has been notified of the request;

(b) DSHS provided the third party with a due date for objecting to disclosure; and

(c) In the absence of an agreement with the requester, the third party may bring a lawsuit against the requester and DSHS under RCW 42.56.540 to stop disclosure.

Reviser's note: The permanent filing 23-19-028 contained no amendments to this section.

Wash. Admin. Code § 388-01-150 May a third party request a client's record?

(1) A third party, such as a DSHS client's attorney or lay representative, may access confidential records about a DSHS client with a valid authorization.

(2) The authorization should:

(a) Identify the client;

(b) Identify the individual(s) or organization(s) authorized to receive the records;

(d) Identify the record(s) that the client wants DSHS to release;

(e) State the date the authorization expires or an expiration event that relates to the client or the purpose of the use of disclosure;

(f) State the reason for disclosure;

(g) State the right to revoke;

(h) State the potential for redisclosure;

(i) As appropriate, include specific language authorizing DSHS to release any one or more of the following to the requester: substance use disorder records, HIV or STD records, or mental health records; and

(j) Include a dated verified signature of the individual with legal authority to authorize the release of records.

(3) DSHS may ask for additional proof to verify the third party's authority to access confidential records.

(4) In general, a parent may access confidential records about a child under age 18. But a child must consent to disclosure of the following confidential records:

(a) At any age, birth control or abortion records (see RCW 9.02.100);

(b) If over age 13, substance use disorder or mental health records (see RCW 71.34.530);

(d) If over age 18, all client records held by DSHS.

(5) Legal guardians authorized by court order to act on behalf of a client are not considered to be a third party request.

History

Statutory Authority: RCW 42.56.040. WSR 23-19-028, § 388-01-150, filed 9/12/23, effective 10/13/23
WSR 18-05-021, § 388-01-150, filed 2/9/18, effective 3/12/18. Statutory Authority: RCW 42.17.250 and 34.05.220. WSR 99-15-065, § 388-01-150, filed 7/19/99, effective 8/19/99.

Wash. Admin. Code § 388-01-160 Is DSHS required to create public records for requesters?

(1) DSHS is only required to provide access to existing, identifiable public records in its possession at the time of the request (see RCW 42.56.080).

(2) DSHS is not required to collect information to create a public record that does not exist at the time the public record request is received.

Reviser's note: The permanent filing 23-19-028 contained no amendments to this section.

Wash. Admin. Code § 388-01-170 May DSHS release information or public records outside of the Public Records Act?

(1) A request for information is not a Public Records Act request.

(2) A request to access records under authority other than the Public Records Act is not a Public Records Act request, including but not limited to the following examples:

(a) Requests by employees and labor unions to access employment records under collective bargaining agreements;

(b) Requests by qualified individuals and organizations to access confidential juvenile offender and child welfare records under chapter 13.50 RCW and related federal laws;

(c) Requests by qualified individuals or organizations to access confidential child support enforcement records under chapter 26.23 RCW and related federal laws;

(d) Requests by qualified individuals or organizations to access confidential adoption records under RCW 26.33.340;

(e) Requests for public access to confidential child welfare records under RCW 74.13.500 through 74.13.525;

(f) Requests by qualified individuals and organizations to access confidential health care information and medical records under chapter 70.02 RCW and related federal laws;

(g) Requests for records pursuant to a contract; and

(h) A legal subpoena or court order for DSHS records.

History

Statutory Authority: RCW 49.12.250. WSR 26-10-075, s 388-01-170, filed 5/5/26, effective 6/5/26. Statutory Authority: RCW 42.56.040. WSR 23-19-028, § 388-01-170, filed 9/12/23, effective 10/13/23
WSR 18-05-021, § 388-01-170, filed 2/9/18, effective 3/12/18. Statutory Authority: RCW 42.17.250 and 34.05.220. WSR 99-15-065, § 388-01-170, filed 7/19/99, effective 8/19/99.

Wash. Admin. Code § 388-01-180 Who should an individual contact to review or get a copy of an interpretive or policy statement index?

DSHS issues administrative policy statements that apply to the whole department. Administrations may issue policies and interpretive statements that relate to their own programs. (See RCW 34.05.010.)

(1) To receive a copy of a DSHS administrative policy, send a written request to:

Office of justice and civil rights

Rules and policies assistance unit

P.O. Box 45850

Olympia WA 98504-5850.

(2) To receive a copy or review a specific administration's policies or interpretive statements, send a written request to the administration.

History

Statutory Authority: RCW 42.56.040. WSR 23-19-028, § 388-01-180, filed 9/12/23, effective 10/13/23
WSR 18-05-021, § 388-01-180, filed 2/9/18, effective 3/12/18. Statutory Authority: RCW 42.17.250 and 34.05.220. WSR 99-15-065, § 388-01-180, filed 7/19/99, effective 8/19/99.

Wash. Admin. Code § 388-01-190 How can an individual get an index of DSHS significant decisions?

(1) The DSHS board of appeals reviews and selects orders and creates an index of significant decisions that substantially affect DSHS performance (see RCW 42.56.070).

(2) The index:

(a) Is divided into program categories;

(b) Contains a copy or synopsis of the order; and

(3) An individual can view the index on the boards of appeals website at https://www.dshs.wa.gov/office-of-the-secretary/board-appeals or inspect or request a copy by contacting the board of appeals at:

Board of appeals

1115 Washington Street S.E.

Olympia WA 98504-5803

Telephone: (360) 664-6100

Fax: (360) 664-6187

Mailing address:

Board of appeals

P.O. Box 45803

Olympia WA 98504-5803.

(4) An individual may ask the board of appeals to index an order as a significant decision by sending a written request with a copy of the order to the mailing address.

History

Statutory Authority: RCW 42.56.040. WSR 23-19-028, § 388-01-190, filed 9/12/23, effective 10/13/23
WSR 18-05-021, § 388-01-190, filed 2/9/18, effective 3/12/18. Statutory Authority: RCW 42.17.250 and 34.05.220. WSR 99-15-065, § 388-01-190, filed 7/19/99, effective 8/19/99.

Wash. Admin. Code § 388-01-200 How may an individual file a petition for declaratory order by DSHS?

An individual may file a petition for declaratory order by DSHS as follows:

(1) Read the information on declaratory orders in RCW 34.05.240 and WAC 10-08-250, 10-08-251, and 10-08-252; and

(2) File the petition with the DSHS rules and policies assistance unit at:

DSHS Rules and policies assistance unit

P.O. Box 45850

Olympia WA 98504-5850.

History

Statutory Authority: RCW 42.56.040. WSR 23-19-028, § 388-01-200, filed 9/12/23, effective 10/13/23
WSR 18-05-021, § 388-01-200, filed 2/9/18, effective 3/12/18. Statutory Authority: RCW 42.17.250 and 34.05.220. WSR 99-15-065, § 388-01-200, filed 7/19/99, effective 8/19/99.

Chapter 388-02 DSHS hearing rules.

Wash. Admin. Code § 388-02-0005 What is the purpose and scope of this chapter?

This chapter describes the general procedures that apply to the resolution of disputes between you and the various programs within the department of social and health services (DSHS). The rules of this chapter are intended to supplement for DSHS both the Administrative Procedure Act (APA), chapter 34.05 RCW, and the model rules, chapter 10-08 WAC, adopted by the office of administrative hearings (OAH).

(1) This chapter:

(a) Establishes rules encouraging informal dispute resolution between DSHS and persons or entities who disagree with its actions;

(b) Regulates all hearings involving DSHS; and

(2) Nothing in this chapter is intended to affect the constitutional rights of any person or to limit or change additional requirements imposed by statute or other rule. Other laws or rules determine if you have a hearing right, including the APA and DSHS program rules or laws.

(3) Specific DSHS program hearing rules prevail over the rules in this chapter.

(4) Rules encouraging informal dispute resolution between the health care authority and persons or entities who disagree with its actions, and regulating hearings for the medical services programs established under chapter 74.09 RCW are governed by chapter 182-526 WAC.

History

Statutory Authority: RCW 34.05.020. WSR 13-05-028, § 388-02-0005, filed 2/12/13, effective 3/15/13. Statutory Authority: RCW 74.09.741 and 34.05.020. WSR 12-05-043, § 388-02-0005, filed 2/10/12, effective 2/25/12. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0005, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0010 What definitions apply to this chapter?

The following definitions apply to this chapter:

"Administrative law judge (ALJ)" means an impartial decision-maker who is an attorney and presides at an administrative hearing. The office of administrative hearings (OAH), which is a state agency, employs the ALJs. ALJs are not department employees or department representatives.

"BOA" means the board of appeals.

"Business days" means all days except Saturdays, Sundays and legal holidays.

"Calendar days" means all days including Saturdays, Sundays and legal holidays.

"Date of the department action" means the date when the department's decision is effective.

"Deliver" means giving a document to someone in person.

"Department" means the department of social and health services.

"Documents" means papers, letters, writings, or other printed or written items.

"DSHS" means the department of social and health services.

"DSHS or department representative" means an employee of the department, a department contractor, or an assistant attorney general authorized to represent the department in an administrative hearing. Department representatives include, but are not limited to, claims officers and administrative hearing coordinators.

"Final order" means an order that is the final department decision.

"Hearing" means a proceeding before an ALJ or review judge that gives a party an opportunity to be heard in disputes about department programs. For purposes of this chapter, hearings include administrative hearings, adjudicative proceedings, and any other similar term referenced under chapter 34.05 RCW, the Administrative Procedure Act, Title 388 of the Washington Administrative Code (WAC), chapter 10-08 WAC, or other law.

"Initial order" is a hearing decision made by an ALJ that may be reviewed by a BOA review judge at either party's request.

"Judicial review" means a superior court's review of a final order.

"Mail" means placing a document in the mail with the proper postage.

"OAH" means the office of administrative hearings, a separate state agency from the department.

"Party" means:

(1) The department or DSHS; or

(2) A person or entity:

(a) Named in a department action;

(b) To whom a department action is directed; or

"Prehearing conference" means a proceeding scheduled and conducted by an ALJ or review judge in preparation for a hearing.

"Prehearing meeting" means an informal voluntary meeting that may be held before any prehearing conference or hearing.

"Program" means a department organizational unit and the services that it provides, including services provided by department staff and through contracts with providers. Organizational units include, but are not limited to, administrations and divisions.

"Record" means the official documentation of the hearing process. The record includes recordings or transcripts, admitted exhibits, decisions, briefs, notices, orders, and other filed documents.

"Review" means a review judge evaluating initial orders entered by an ALJ and making the final agency decision as provided by RCW 34.05.464, or issuing final orders.

"Review judge" means a decision-maker with expertise in department rules who is an attorney and serves as the reviewing officer under RCW 34.05.464. In some cases, review judges conduct hearings and enter final orders. In other cases, they review initial orders and may make changes to correct any errors in an ALJ's initial order. After reviewing initial orders or conducting hearings, review judges enter final orders. Review judges are employed by the department, are located in the board of appeals (BOA), and are not part of the department program involved in the review. See WAC 388-02-0600 for information on the authority of a review judge.

"Rule" means a state regulation. Rules are found in the Washington Administrative Code (WAC).

"Should" means that an action is recommended but not required.

"Stay" means an order temporarily halting the department decision or action.

"You" means any individual or entity that has a right to be involved with the department hearing process, which includes a party or a party's representative. "You" does not include the department or its representative.

History

Statutory Authority: RCW 34.05.310(4) [34.05.020]. WSR 12-10-036, § 388-02-0010, filed 4/26/12, effective 5/27/12. Statutory Authority: RCW 34.05.020, 34.05.220. WSR 11-04-074, § 388-02-0010, filed 1/31/11, effective 3/3/11. Statutory Authority: RCW 34.05.020, 34.05.220, 42 C.F.R. 431.10 (e)(3), 45 C.F.R. 205.100 (b)(3), chapter 34.05 RCW, Parts IV and V. WSR 08-21-144, § 388-02-0010, filed 10/21/08, effective 11/21/08. Statutory Authority: RCW 34.05.020, chapter 34.05 RCW, Parts IV and V, 2002 c 371 § 211. WSR 02-21-061, § 388-02-0010, filed 10/15/02, effective 11/15/02. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0010, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0015 How do the terms in the Administrative Procedure Act (APA) compare to this chapter?

To improve clarity and understanding, the rules in this chapter may use different words than the APA or the model rules. Following is a list of terms used in those laws and the terms as used in these rules:

| Chapter 34.05 RCW Chapter 10-08 WAC | Chapter 388-02 WAC | | --- | --- | | Adjudicative proceeding | Different terms are used to refer to different stages of the hearing process, and may include prehearing meeting, prehearing conference, hearing, review, reconsideration, and the entire hearing process | | Agency | DSHS | | Application for adjudicative proceeding | Request a hearing | | Enter | Make, send | | Presiding officer | ALJ | | Reviewing officer | Review judge |

History

Statutory Authority: RCW 34.05.020, 34.05.220, and 34.05.353. WSR 25-21-040, s 388-02-0015, filed 10/9/25, effective 11/9/25. Statutory Authority: RCW 34.05.020, chapter 34.05 RCW, Parts IV and V, 2002 c 371 § 211. WSR 02-21-061, § 388-02-0015, filed 10/15/02, effective 11/15/02. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0015, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0020 What does good cause mean?

(1) Good cause is a substantial reason or legal justification for failing to appear, to act, or respond to an action. To show good cause, the ALJ must find that a party had a good reason for what they did or did not do, using the provisions of Superior Court Civil Rule 60 as a guideline.

(2) Good cause may include, but is not limited to, the following examples.

(a) You ignored a notice because you were in the hospital or were otherwise prevented from responding; or

(b) You could not respond to the notice because it was written in a language that you did not understand.

(3) For purposes of public assistance cases, good cause has the same meaning as described in RCW 74.08.080. Good cause for not requesting a hearing before the deadline may include, but is not limited to: Military deployment, medical reasons, housing instability, language barriers, or domestic violence.

History

Statutory Authority: RCW 34.05.220, 43.17.060, 43.20A.075, and 74.08.080(2). WSR 24-06-040, § 388-02-0020, filed 2/29/24, effective 4/1/24. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0020, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0025 Where is the office of administrative hearings located?

(1) The office of administrative hearings (OAH) headquarters location is:

(a) Office of Administrative Hearings

2420 Bristol Court SW

P.O. Box 42488

Olympia WA 98504-2488

(360) 407-2700

(360) 664-8721 (fax)

(b) The headquarters office is open from 8:00 a.m. to 5:00 p.m. Monday through Friday, except legal holidays.

(2) OAH field offices are at the following locations:

(a) Olympia

Office of Administrative Hearings

2420 Bristol Court SW

P.O. Box 42489

Olympia, WA 98504-2489

fax: (360) 586-6563

(b) Seattle

Office of Administrative Hearings

Closed to the public, see the call center for contact information

fax: (206) 587-5135

Office of Administrative Hearings

16201 E. Indiana Avenue, Suite 3000

Spokane Valley, WA 99216

(509) 742-5747

fax: (509) 456-3980 & (509) 456-3997

(d)Tacoma

Office of Administrative Hearings

4301 S. Pine St, Suite 200

Tacoma, WA 98409

(253) 476-6888

Effective 11/18/2024, open by appointment only

fax (253) 593-2200

(3) You should contact the call center, under subsection (2) of this section, if you do not know the correct field office.

Call center telephone: (360) 407-2700

Toll free: (800) 583-8271

Call center is open from 7:00 a.m. to 5:00 p.m. Monday through Friday, except legal holidays.

(4) You can obtain further hearing information at the OAH website: www.oah.wa.gov.

History

Statutory Authority: RCW 34.05.020, 34.05.220, and 34.05.353. WSR 25-21-040, s 388-02-0025, filed 10/9/25, effective 11/9/25. Statutory Authority: RCW 34.05.020 and 34.05.353. WSR 15-23-048, § 388-02-0025, filed 11/12/15, effective 12/13/15
WSR 14-11-094, § 388-02-0025, filed 5/21/14, effective 6/21/14. Statutory Authority: RCW 34.05.020, 34.05.220. WSR 11-04-074, § 388-02-0025, filed 1/31/11, effective 3/3/11. Statutory Authority: RCW 34.05.353. WSR 09-05-032, § 388-02-0025, filed 2/11/09, effective 3/14/09. Statutory Authority: RCW 34.05.020 and chapter 34.05 RCW, Parts IV and V. WSR 05-22-076, § 388-02-0025, filed 10/31/05, effective 12/1/05. Statutory Authority: RCW 34.05.020, chapter 34.05 RCW, Parts IV and V, 2002 c 371 § 211. WSR 02-21-061, § 388-02-0025, filed 10/15/02, effective 11/15/02. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0025, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0030 How do I contact the board of appeals?

(1) The information included in this section is current at this time of rule adoption, but may change. Current information and additional contact information are available on the department's internet site, in person at the board of appeals office, or by a telephone call to the board of appeal's main public number.

| Department of Social and Health Services Board of Appeals | | | --- | --- | | Location | Office Building 2 (OB-2) First Floor Information 1115 Washington Street SE Olympia, WA | | Mailing address | P.O. Box 45803 Olympia, WA 98504-5803 | | Telephone | (360) 664-6100 | | Fax | (360) 664-6187 | | Toll free | 1-877-351-0002 | | Internet website | https://www.dshs.wa.gov/office-of-the-secretary/board-appeals |

History

Statutory Authority: RCW 34.05.020, 34.05.220, and 34.05.353. WSR 25-21-040, s 388-02-0030, filed 10/9/25, effective 11/9/25. Statutory Authority: RCW 34.05.020, 34.05.220. WSR 11-04-074, § 388-02-0030, filed 1/31/11, effective 3/3/11. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0030, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0035 How are days counted when calculating deadlines for the hearing process?

(1) When counting days to find out when a hearing deadline ends under DSHS rules or statutes:

(a) Do not include the day of the action, notice, or order. For example, if a hearing decision is mailed on Tuesday and you have twenty-one days to request a review, start counting the days with Wednesday.

(b) If the last day of the period ends on a Saturday, Sunday or legal holiday, the deadline is the next business day.

(c) For periods of seven days or less, count only business days. For example, if you have seven days to respond to a review request that was mailed to you on Friday, May 10, the response period ends on Tuesday, May 21.

(d) For periods over seven days, count every day, including Saturdays, Sundays, and legal holidays.

(2) The deadline ends at 5:00 p.m. on the last day.

(3) If you miss a deadline, you may lose your right to a hearing or appeal of a decision.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0035, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0037 When must the OAH reschedule a proceeding based on the amount of notice required?

Any party may request that the proceeding be rescheduled and OAH must reschedule if:

(1) A rule requires the OAH to provide notice of a proceeding; and

(2) The OAH does not provide the amount of notice required.

History

Statutory Authority: RCW 34.05.020, 34.05.220. WSR 11-04-074, § 388-02-0037, filed 1/31/11, effective 3/3/11.

Wash. Admin. Code § 388-02-0038 When may the OAH shorten the amount of notice required to the parties of a proceeding?

The ALJ and the parties may agree to shorten the amount of notice required by any rule.

History

Statutory Authority: RCW 34.05.020, 34.05.220. WSR 11-04-074, § 388-02-0038, filed 1/31/11, effective 3/3/11.

Wash. Admin. Code § 388-02-0040 How do parties send documents?

(1) When the rules in this chapter or in other law asks a party to send copies of documents to other parties, the party must mail or deliver copies to the DSHS representative and to all other parties or their representatives.

(2) When sending documents to OAH or BOA, you must mail or deliver the documents to one of the locations listed in WAC 388-02-0025(2) for OAH or in WAC 388-02-0030 for BOA.

(3) When sending documents to your assigned field office, you may use the address listed at the top of your notice of hearing. If a field office has not been assigned, all written communication about your hearing must be sent to the OAH Olympia field office which sends the communication to the correct office.

(4) Documents may be sent by giving them to someone in person, placing them in the mail with proper postage, or by fax or email if the party mails a copy on the same day.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0040, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0045 What is service?

Service gives the party notice. When a document is given to the party, the party is considered served with official notice of the contents of the document.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0045, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0050 How does a party serve someone?

Unless otherwise stated in law, a party may serve someone by:

(1) Personal service (hand delivery);

(2) First class, registered, or certified mail;

(3) Fax if the party mails a copy of the document the same day;

(4) Commercial delivery service; or

(5) Legal messenger service.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0050, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0055 When must a party serve someone?

A party must serve all other parties and their representatives whenever the party files a pleading, brief or other document with OAH or BOA, or when required by law.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0055, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0060 When is service complete?

Service is complete when:

(1) Personal service is made;

(2) Mail is properly stamped, addressed and deposited in the United States mail;

(3) Fax produces proof of transmission;

(4) A parcel is delivered to a commercial delivery service with charges prepaid; or

(5) A parcel is delivered to a legal messenger service with charges prepaid.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0060, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0065 How does a party prove service?

A party may prove service by providing any of the following:

(1) A sworn statement;

(2) The certified mail receipt signed by the recipient;

(3) An affidavit or certificate of mailing;

(4) A signed receipt from the person who accepted the commercial delivery service or legal messenger service package; or

(5) Proof of fax transmission.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0065, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0070 What is filing?

(1) Filing is the act of delivering documents to OAH or BOA.

(2) The date of filing is the date documents are received by OAH or BOA.

(3) Filing is complete when the documents are received by OAH or BOA during office hours.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0070, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0075 How does a party file documents?

(1) A party may file documents by delivering them to OAH or BOA by:

(a) Personal service (hand delivery);

(b) First class, registered, or certified mail;

(d) Commercial delivery service; or

(e) Legal messenger service.

(2) Any party may file documents with OAH by secure email. The BOA does not accept electronic submission except by fax.

History

Statutory Authority: RCW 43.17.060, 43.20A.550, 34.05.020, 34.05.350 and Proclamation by the Governor 20-05. WSR 20-22-096, § 388-02-0075, filed 11/3/20, effective 12/4/20. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0075, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0080 What are your options for resolving a dispute with DSHS?

(1) If you disagree with a DSHS decision or action, you have several options for resolving your dispute, which may include the following:

(a) Any special prehearing alternative or administrative process offered by the program;

(b) Prehearing meeting;

(d) Hearing.

(2) Because you have a limited time to request a hearing, you must request a hearing within the deadline on the notice of DSHS action to preserve your hearing right.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0080, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0085 Do you have a right to a hearing?

(1) You have a right to a hearing only if a law or DSHS rule gives you that right. If you are not sure, you should request a hearing to protect your right.

(2) Some DSHS programs may require you to go through an informal administrative process before you can request or have a hearing. The notice of DSHS action sent to you should include information about this requirement if it applies.

(3) You have a limited time to request a hearing. The deadline for your request varies by the DSHS program involved. You should submit your request right away to protect your right to a hearing, even if you are also trying to resolve your dispute informally. For public assistance cases, if an applicant or recipient does not file a request for a hearing within 90 calendar days after receiving notice of an aggrieving decision, the request may still be filed within one year of the aggrieving decision upon a showing of good cause. For purposes of public assistance cases, as defined in RCW 74.08.080, good cause for not requesting a hearing before the deadline may include, but is not limited to: military deployment, medical reasons, housing instability, language barriers, or domestic violence.

(4) If you request a hearing, one is scheduled.

(5) If DSHS or the ALJ questions your right to a hearing, the ALJ decides whether you have that right.

(6) If the ALJ decides you do not have a right to a hearing, your request is dismissed.

(7) If the ALJ decides you do have a right to a hearing, the hearing proceeds.

History

Statutory Authority: RCW 34.05.220, 43.17.060, 43.20A.075, and 74.08.080(2). WSR 24-06-040, § 388-02-0085, filed 2/29/24, effective 4/1/24. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0085, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0090 Who may request a hearing?

Either you or your representative may request a hearing.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0090, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0095 What if you have questions about requesting a hearing?

If you have questions about how, when, and where to request a hearing, you should:

(1) Contact the DSHS program involved, OAH, or BOA;

(2) Review the notice sent to you of the DSHS action or decision; or

(3) Review the applicable law or DSHS rule.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0095, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0100 How do you request a hearing?

(1) You may request a hearing in writing or orally, depending upon which program is involved. The DSHS notice and applicable laws and rules should tell you whether the request must be in writing or may be made orally.

(2) If you are allowed to make an oral request, you may do so to a DSHS or OAH employee in person or by telephone or voice mail.

(3) You may send a written request by mail, delivery service, personal service, or by fax if you mail a copy the same day. You should send written requests to the location on the notice or to OAH at the location specified in WAC 388-02-0025(2).

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0100, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0105 What information do you give when requesting a hearing?

(1) Your hearing request must contain enough information to identify you and the DSHS action. You should include:

(a) Your name, address, and telephone number;

(b) A brief explanation of why you disagree with the DSHS action;

(c) Your client identification or case number, contract number, or any other information that identifies your case or the program involved; and

(d) Any assistance you need, including a foreign or sign language interpreter or any other accommodation for a disability.

(2) You should also refer to a program's specific rules or the notice to see if additional information is required in your request.

(3) OAH may not be able to process your hearing request if it cannot identify or locate you and determine the DSHS action involved.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0105, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0110 What happens after you request a hearing?

(1) After you request a hearing, the OAH sends the parties a notice containing the hearing date, time, and place. This document is called the notice of hearing. The parties may also receive a written notice of a prehearing conference. You may receive a notice of a prehearing conference either before or after receiving the notice of the hearing.

(2) Before your hearing is held:

(a) The department may contact you and try to resolve your dispute; and

(b) You are encouraged to contact the department and try to resolve your dispute.

(3) If you do not appear for your hearing, an ALJ may enter an order of default or an order dismissing your hearing according to WAC 388-02-0285.

History

Statutory Authority: RCW 34.05.020, 34.05.220. WSR 11-04-074, § 388-02-0110, filed 1/31/11, effective 3/3/11. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0110, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0115 May you withdraw your hearing request?

(1) You may withdraw your hearing request for any reason and at any time by contacting DSHS or OAH in writing or orally with the ALJ and the other parties. After your request for withdrawal is received, your hearing is cancelled and OAH sends an order dismissing the hearing. If you withdraw your request you may not be able to request another hearing on the same DSHS action.

(2) If you withdraw your hearing request, you may only set aside the dismissal according to WAC 388-02-0290.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0115, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0120 Do you have the right to an interpreter in the hearing process?

If you need an interpreter because you or any of your witnesses are a person with limited English proficiency, OAH will provide an interpreter at no cost to you.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0120, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0125 What definitions apply to limited-English-proficient (LEP) parties?

The following definitions apply to LEP parties:

"Hearing impaired person" means a person who, because of a hearing or speech impairment, cannot readily speak, understand or communicate in spoken language.

"Intermediary interpreter" means an interpreter who:

(1) Is a certified deaf interpreter (CDI); and

(2) Is able to assist in providing an accurate interpretation between spoken and sign language or between types of sign language by acting as an intermediary between a hearing impaired person and a qualified interpreter.

"Limited-English-proficient (LEP)" includes limited English speaking persons or other persons unable to communicate in spoken English because of a hearing impairment.

"Limited-English-speaking (LES) person" means a person who, because of non-English speaking cultural background or disability, cannot readily speak or understand the English language.

"Qualified interpreter" includes qualified interpreters for a limited English-speaking person or a person with a hearing impairment.

"Qualified interpreter for a limited-English-speaking person" means a person who is readily able to interpret or translate spoken and written English communications to and from a limited English-speaking person. If an interpreter is court certified, the interpreter is considered qualified.

"Qualified interpreter for a person with a hearing impairment" means a visual language interpreter who is certified by the registry of interpreters for the deaf or National Association of the Deaf and is readily able to interpret or translate spoken communications to and from a hearing impaired person.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0125, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0130 What requirements apply to notices for limited-English-speaking parties?

If OAH is notified that you are a limited-English-speaking person, all hearing notices, decisions, and orders for you must:

(1) Be written in your primary language; or

(2) Include a statement in your primary language:

(a) Indicating the importance of the notice; and

(b) Telling you how to get help in understanding the notice and responding to it.

History

Statutory Authority: RCW 34.05.020, 34.05.220, and 34.05.353. WSR 25-21-040, s 388-02-0130, filed 10/9/25, effective 11/9/25. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0130, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0135 What requirements apply to interpreters?

(1) OAH must provide a qualified interpreter to assist any person who:

(a) Has limited-English proficiency; and

(b) Is a party or witness in a hearing.

(2) OAH may hire or contract with persons to interpret at hearings.

(3) Relatives of any party and DSHS employees may not be used as interpreters.

(4) The ALJ must determine, at the beginning of the hearing, if an interpreter can accurately interpret all communication for the person requesting the service. To do so, the ALJ considers the interpreter's:

(a) Ability to meet the needs of the hearing impaired person or limited English speaking person;

(b) Education, certification, and experience;

(d) Ability to be impartial.

(5) The parties or their representatives may question the interpreter's qualifications and ability to be impartial.

(6) If at any time before or during the hearing the interpreter does not provide accurate and effective communication, the ALJ must provide another interpreter.

History

Statutory Authority: RCW 34.05.020, 34.05.220, and 34.05.353. WSR 25-21-040, s 388-02-0135, filed 10/9/25, effective 11/9/25. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0135, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0140 May you waive interpreter services?

(1) If you are limited English proficient, you may ask to waive interpreter services.

(2) You must make your request in writing or through a qualified interpreter on the record.

(3) The ALJ must determine if your waiver has been knowingly and voluntarily made.

(4) You may withdraw your waiver at any time before or during the hearing.

(5) You may ask that the interpreter be retained on standby for the duration of the hearing to provide interpreter services if the need arises.

History

Statutory Authority: RCW 34.05.020, 34.05.220, and 34.05.353. WSR 25-21-040, s 388-02-0140, filed 10/9/25, effective 11/9/25. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0140, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0145 What requirements apply to the use of interpreters?

(1) Interpreters must:

(a) Use the interpretive mode that the parties, the hearing impaired person the interpreter and the ALJ consider the most accurate and effective;

(b) Interpret statements made by the parties and the ALJ;

(d) Not comment on the hearing or give legal advice.

(2) The ALJ must allow enough time for all interpretations to be made and understood.

(3) The ALJ may video tape a hearing and use it as the official transcript for hearings involving a hearing impaired person.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0145, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0150 What requirements apply to hearing decisions involving limited-English-speaking parties?

(1) When an interpreter is used at a hearing, the ALJ must explain that the decision is written in English but that a party using an interpreter may contact the interpreter for an oral translation of the decision at no cost to you.

(2) Interpreters must provide a telephone number where they can be reached. This number must be attached to any decision or order mailed to the parties.

(3) OAH or BOA must mail a copy of a decision or order to the interpreter for use in oral translation.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0150, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0155 Who represents you during the hearing process?

(1) You may represent yourself or have anyone represent you, except a DSHS employee.

(2) Your representative may be a friend, relative, community advocate, attorney, or paralegal.

(3) You should inform DSHS or OAH of your representatives name, address, and telephone number.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0155, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0157 How does a party appear?

(1) If you are going to represent yourself, you should provide the ALJ and other parties with your name, address, and telephone number.

(2) If you are represented, your representative should provide the ALJ and other parties with the representative's name, address, and telephone number.

(3) The presiding officer may require your representative to file a written notice of appearance or to provide documentation that you have authorized the representative to appear on your behalf. In cases involving confidential information, your representative must file a signed written release of information on department form 17-063.

(4) If your representative is an attorney admitted to practice in this state, your attorney must file a written notice of appearance, and must file a notice of withdrawal upon withdrawal of representation.

(5) If you or your representative have put in a written notice of appearance, the ALJ should call the telephone number on the notice of appearance if you or your representative do not appear by calling in with a telephone number before a hearing (including a prehearing).

History

Statutory Authority: RCW 34.05.020, 34.05.220. WSR 11-04-074, § 388-02-0157, filed 1/31/11, effective 3/3/11.

Wash. Admin. Code § 388-02-0160 If a DSHS employee cannot represent you, can they assist you during the hearing process?

Although DSHS employees cannot represent you during the hearing process, they may assist you by:

(1) Acting as a witness;

(2) Referring you to community legal resources;

(3) Helping you get nonconfidential information; or

(4) Informing you about or providing copies of the relevant laws or rules.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0160, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0165 What if you would like to be represented by an attorney but you cannot afford one?

(1) Neither DSHS nor OAH will pay for an attorney.

(2) If you want an attorney to represent you and cannot afford one, community resources may be available to assist you. These legal services may be free or available at a reduced cost. DSHS or OAH can tell you who to contact for legal assistance.

(3) Information about legal assistance can also be found at www.oah.wa.gov.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0165, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0170 Who represents DSHS during the hearing?

(1) A DSHS employee, DSHS contractor, or the office of the attorney general represents DSHS during the hearing. The DSHS representative may or may not be an attorney.

(2) An ALJ is independent and does not represent DSHS or any other party.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0170, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0175 What is a prehearing meeting?

(1) A prehearing meeting is an informal meeting with a DSHS representative that may be held before any prehearing conference or hearing.

(2) A DSHS representative may contact you before the scheduled hearing to arrange a prehearing meeting. You may also contact DSHS to request a prehearing meeting.

(3) A prehearing meeting is voluntary. You are not required to request one and you are not required to participate in one.

(4) The prehearing meeting includes you and/or your representative, the DSHS representative, and any other party. An ALJ does not attend a prehearing meeting.

(5) The prehearing meeting gives the parties an opportunity to:

(a) Clarify issues;

(b) Exchange documents and witness statements;

(d) Ask questions about the hearing process and the laws and rules that apply.

(6) A prehearing meeting may be held or information exchanged:

(a) In person;

(b) By telephone conference call;

(d) Any combination of the above that is agreeable to the parties.

(7) If a prehearing conference is required by the program or rule, a prehearing meeting may not be an option available to you.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0175, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0180 What happens during a prehearing meeting?

During a prehearing meeting:

(1) A DSHS representative:

(a) Explains the role of the DSHS representative in the hearing process;

(b) Explains how a hearing is conducted and the relevant laws and rules that apply;

(d) Responds to your questions about the hearing process;

(e) Identifies accommodation and safety issues;

(f) Distributes copies of the DSHS documents to be presented during the hearing;

(g) Provides, upon request, copies of relevant laws and rules;

(h) Identifies additional documents or evidence you may want or be required to present during the hearing;

(i) Tells you how to obtain documents from your file;

(j) Clarifies the issues; and

(k) Attempts to settle the dispute, if possible.

(2) You should explain your position and provide documents that relate to your case. You also have the right to consult legal resources.

(3) You and the DSHS representative may enter into written agreements or stipulations, including agreements that settle your dispute.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0180, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0185 What happens after a prehearing meeting?

(1) If you and DSHS resolve the dispute during the prehearing meeting and put it in writing or present the agreement to an ALJ, your agreement may be legally enforceable.

(2) Any agreements or stipulations made at the prehearing meeting must be presented to an ALJ before or during the hearing, if you want the ALJ to consider the agreement.

(3) If all of your issues are not resolved in the prehearing meeting, you may request a prehearing conference before an ALJ or go to your scheduled hearing. The ALJ may also order a prehearing conference.

(4) You may withdraw your hearing request at any time if DSHS agrees to some action that resolves your dispute, or for any other reason. If you withdraw your hearing request, the hearing is not held and the ALJ sends a written order of dismissal.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0185, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0190 What happens if you do not participate in a prehearing meeting?

You are not required to participate in a prehearing meeting. If you do not participate, it does not affect your right to a hearing.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0190, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0195 What is a prehearing conference?

(1) A prehearing conference is a formal proceeding conducted on the record by an ALJ to prepare for a hearing. The ALJ must record the prehearing conference using audio recording equipment (such as a digital recorder or tape recorder).

(2) An ALJ may conduct the prehearing conference in person, by telephone conference call, or in any other manner acceptable to the parties. Your attendance is mandatory.

(3) You may lose the right to participate during the hearing if you do not attend the prehearing conference.

History

Statutory Authority: RCW 34.05.020, 34.05.220. WSR 11-04-074, § 388-02-0195, filed 1/31/11, effective 3/3/11. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0195, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0197 When is a prehearing conference scheduled?

(1) The ALJ may require a prehearing conference. Any party may request a prehearing conference.

(2) The ALJ must grant the first request for a prehearing conference if it is received by the OAH at least seven business days before the scheduled hearing date.

(3) The ALJ may grant untimely or additional requests for prehearing conferences.

(4) If the parties do not agree to a continuance, the OAH and/or the ALJ must set a prehearing conference to decide whether there is good cause to grant or deny the continuance.

(5) The OAH must schedule prehearing conferences for all cases which concern actions of the following department programs:

(a) Adult protective services; and

(b) The division of residential care services.

History

Statutory Authority: RCW 34.05.020, 34.05.220. WSR 11-04-074, § 388-02-0197, filed 1/31/11, effective 3/3/11.

Wash. Admin. Code § 388-02-0200 What happens during a prehearing conference?

During a prehearing conference the parties and the ALJ may:

(1) Simplify or clarify the issues to be decided during the hearing;

(2) Agree to the date, time, and place of the hearing;

(3) Identify accommodation and safety issues;

(4) Agree to postpone the hearing;

(5) Allow the parties to make changes in their own documents, including the DSHS notice or the hearing request;

(6) Agree to facts and documents to be entered during the hearing;

(7) Set a deadline to exchange names and phone numbers of witnesses and documents before the hearing;

(8) Schedule additional prehearing conferences;

(9) Resolve the dispute;

(10) Consider granting a stay if authorized by law or DSHS rule; or

(11) Determine any other procedural issues raised by the parties.

History

Statutory Authority: RCW 34.05.020, 34.05.220, and 34.05.353. WSR 25-21-040, s 388-02-0200, filed 10/9/25, effective 11/9/25. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0200, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0205 What happens after a prehearing conference?

(1) After the prehearing conference ends, the ALJ must enter a written prehearing order describing:

(a) The actions taken;

(b) Any changes to the documents;

(d) Any ruling of the ALJ.

(2) The ALJ must send the prehearing order to the parties at least fourteen calendar days before the scheduled hearing, except a hearing may still occur as allowed under WAC 388-02-0280(5). The parties and the ALJ may agree to a shorter time period.

(3) A party may object to the prehearing order by notifying the ALJ in writing within ten days after the mailing date of the order. The ALJ must issue a ruling on the objection.

(4) If no objection is made to the prehearing order, the order determines how the hearing is conducted, including whether the hearing will be in person or held by telephone conference or other means, unless the ALJ changes the order for good cause.

(5) The ALJ may take further appropriate actions to address other concerns.

History

Statutory Authority: RCW 34.05.020, 34.05.220. WSR 11-04-074, § 388-02-0205, filed 1/31/11, effective 3/3/11. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0205, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0210 What happens if a party does not attend a prehearing conference?

(1) All parties are required to attend a prehearing conference.

(2) If you do not attend, you may not be allowed to participate in the hearing. The ALJ may dismiss your hearing request or enter an order of default against you.

History

Statutory Authority: RCW 34.05.020, 34.05.220. WSR 11-04-074, § 388-02-0210, filed 1/31/11, effective 3/3/11. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0210, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0215 What is the authority of the ALJ?

(1) The ALJ must hear and decide the issues de novo (anew) based on what is presented during the hearing.

(2) As needed, the ALJ may:

(a) Determine the order for presenting evidence;

(b) Issue subpoenas or orders directing witnesses to appear or bring documents;

(d) Rule on an offer of proof made to admit evidence;

(e) Admit relevant evidence;

(f) Impartially question witnesses to develop the record;

(g) Call additional witnesses and request exhibits to complete the record;

(h) Give the parties an opportunity to cross-examine witnesses or present more evidence against the witnesses or exhibits;

(i) Keep order during the hearing;

(j) Allow or require oral or written argument and set the deadlines for the parties to submit argument or evidence;

(k) Permit others to attend, photograph or electronically record hearings, but may place conditions to preserve confidentiality or prevent disruption;

(l) Allow a party to waive rights given by chapters 34.05 RCW or 388-02 WAC, unless another law prevents it;

(m) Decide whether a party has a right to a hearing;

(n) Issue protective orders;

(o) Consider granting a stay if authorized by law or DSHS rule; and

(p) Take any other action necessary and authorized under these or other rules.

(3) The ALJ administers oaths or affirmations and takes testimony.

(4) The ALJ enters initial or final orders as provided for in WAC 388-02-0217.

History

Statutory Authority: RCW 34.05.020, 34.05.220, 42 C.F.R. 431.10 (e)(3), 45 C.F.R. 205.100 (b)(3), chapter 34.05 RCW, Parts IV and V. WSR 08-21-144, § 388-02-0215, filed 10/21/08, effective 11/21/08. Statutory Authority: RCW 34.05.020, 34.05.220 and chapter 34.05 RCW, Parts IV and V. WSR 06-16-008, § 388-02-0215, filed 7/20/06, effective 8/20/06. Statutory Authority: RCW 34.05.020 and chapter 34.05 RCW, Parts IV and V. WSR 05-02-018, § 388-02-0215, filed 12/27/04, effective 1/27/05
WSR 03-13-046, § 388-02-0215, filed 6/11/03, effective 7/12/03. Statutory Authority: RCW 34.05.020, chapter 34.05 RCW, Parts IV and V, 2002 c 371, § 211. WSR 02-21-061, § 388-02-0215, filed 10/15/02, effective 11/15/02. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0215, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0216 Is the authority of the administrative law judge and the review judge limited?

The authority of the ALJ and the review judge is limited to those powers conferred (granted) by statute or rule. The ALJ and the review judge do not have any inherent or common law powers.

History

Statutory Authority: RCW 34.05.020, 34.05.220. WSR 11-04-074, § 388-02-0216, filed 1/31/11, effective 3/3/11.

Wash. Admin. Code § 388-02-0217 When do ALJs conduct the hearing and enter the hearing decision as an initial order or a final order?

(1) As provided for in WAC 388-02-0218, ALJs do not conduct hearings involving cases brought by contractors for the delivery of nursing facility services under WAC 388-96-904(5).

(2) ALJs conduct the hearing and enter the hearing decision as a final order only in cases pertaining to:

(a) Eligibility for the following programs:

(i) Food assistance;

(ii) General assistance, except for general assistance expedited medicaid (GAX);

(iii) Refugee assistance; or

(iv) Telephone assistance.

(b) Child support under chapter 388-14A WAC, except for cases relating to parent address disclosure under WAC 388-14A-2114 through 388-14A-2140 or claims of good cause for not cooperating with the division of child support under WAC 388-14A-2040 through 388-14A-2075 and WAC 388-422-0020;

(d) Juvenile rehabilitation cost reimbursement under chapter 388-720 WAC;

(e) Vocational rehabilitation services under chapter 388-891 WAC; or

(f) Vendor overpayments, except for provider overpayment cases where the hearing is requested by a provider under chapter 388-502 or 388-502A WAC.

(3) ALJs conduct the hearing and enter the hearing decision as an initial order in all other cases.

History

Statutory Authority: RCW 34.05.020, 34.05.220, 42 C.F.R. 431.10 (e)(3), 45 C.F.R. 205.100 (b)(3), chapter 34.05 RCW, Parts IV and V. WSR 08-21-144, § 388-02-0217, filed 10/21/08, effective 11/21/08.

Wash. Admin. Code § 388-02-0220 What rules and laws must an ALJ and review judge apply when conducting a hearing or making a decision?

(1) ALJs and review judges must first apply the department rules adopted in the Washington Administrative Code.

(2) If no department rule applies, the ALJ or review judge must decide the issue according to the best legal authority and reasoning available, including federal and Washington state constitutions, statutes, regulations, and court decisions.

(3) When applying program rules regarding the substantive rights and responsibilities of the parties (such as eligibility for services, benefits, or a license), the ALJ and review judge must apply the program rules in effect on the date of the department action, unless otherwise required by other rule or law. If the department amends its notice of the action, the ALJ and review judge must apply the rules in effect on the date the action was taken, unless otherwise required by other rule or law.

(4) When applying program rules regarding the procedural rights and responsibilities of the parties, the ALJ and review judge must apply the rules that are in effect on the date the procedure is followed.

(5) Program rules determine the amount of time the department has to process your application for services, benefits, or a license.

(6) The ALJ and review judge must apply the rules in this chapter beginning on the date each rule is effective and in accordance with subsection (3) of this section.

(7) The rules in this chapter apply to disputes between you and the department of social and health services.

History

Statutory Authority: RCW 34.05.020, 34.05.220, and 34.05.353. WSR 25-21-040, s 388-02-0220, filed 10/9/25, effective 11/9/25. Statutory Authority: RCW 34.05.310(4) [ 34.05.020]. WSR 12-10-036, § 388-02-0220, filed 4/26/12, effective 5/27/12. Statutory Authority: RCW 34.05.020, 34.05.220. WSR 11-04-074, § 388-02-0220, filed 1/31/11, effective 3/3/11. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0220, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0221 How is the index of significant decisions used?

(1) A final order may be relied on, used, or cited as precedent by a party if the final order has been indexed in the department index of significant decisions.

(2) The department index of significant decisions is available to the public at www.dshs.wa.gov/boa. For information on how to obtain a copy of the index, see WAC 388-01-190.

(3) If a precedential published decision entered by the Court of Appeals or the Supreme Court reverses an indexed board of appeals final order, that order will be removed from the index of significant decisions.

History

Statutory Authority: RCW 34.05.020, 34.05.220. WSR 11-04-074, § 388-02-0221, filed 1/31/11, effective 3/3/11.

Wash. Admin. Code § 388-02-0225 May an ALJ or review judge decide that a DSHS rule is invalid?

(1) Neither an ALJ nor a review judge may decide that a DSHS rule is invalid or unenforceable. Only a court may decide this issue.

(2) If the validity of a DSHS rule is raised during the hearing, the ALJ or review judge may allow argument for court review.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0225, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0230 When is the ALJ assigned to the hearing?

The OAH assigns an ALJ at least five business days before the hearing. A party may ask which ALJ is assigned to the hearing by calling or writing the OAH field office listed on the notice of hearing. If requested by a party, the OAH must send the name of the assigned ALJ to the party by email or in writing at least five business days before the party's scheduled hearing date. For division of child support cases, the OAH will only be required to assign an ALJ at least five days before the hearing if such a request is specifically made by one of the parties.

History

Statutory Authority: RCW 34.05.020, 34.05.220. WSR 11-04-074, § 388-02-0230, filed 1/31/11, effective 3/3/11. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0230, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0235 May a party request a different judge?

A party may file a motion of prejudice against an ALJ under RCW 34.12.050. A party may also request that an ALJ or review judge be disqualified under RCW 34.05.425.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0235, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0240 How does a party file a motion of prejudice?

(1) A party may request a different ALJ by sending a written motion of prejudice to the OAH before the ALJ rules on a discretionary issue in the case, admits evidence, or takes testimony. A motion of prejudice must include an affidavit or statement that a party does not believe that the ALJ can hear the case fairly.

(2) Rulings that are not considered discretionary rulings for purposes of this section include but are not limited to those:

(a) Granting or denying a request for a continuance; and

(b) Granting or denying a request for a prehearing conference.

(3) A party must send the written motion of prejudice to the chief ALJ at the OAH headquarters identified in WAC 388-02-0025(1) and must send a copy to the OAH field office where the ALJ is assigned.

(4) A party may make an oral motion of prejudice at the beginning of the hearing before the ALJ rules on a discretionary issue in the case, admits evidence, or takes testimony if:

(a) The OAH did not assign an ALJ at least five business days before the date of the hearing; or

(b) The OAH changed the assigned ALJ within five business days of the date of the hearing.

(5) The first request for a different ALJ is automatically granted. The chief ALJ or a designee grants or denies any later requests.

History

Statutory Authority: RCW 34.05.020, 34.05.220. WSR 11-04-074, § 388-02-0240, filed 1/31/11, effective 3/3/11. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0240, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0245 May an ALJ or review judge be disqualified?

(1) An ALJ or review judge may be disqualified for bias, prejudice, or conflict of interest, or if one of the parties or a party's representative has an ex parte contact with the ALJ or review judge.

(2) Ex parte contact means a written or oral communication with the ALJ or review judge about something related to the hearing when the other parties are not present. Procedural questions are not considered an ex parte contact. Examples of procedural questions include clarifying the hearing date, time, location, or asking for directions to the hearing location.

(3) To ask to disqualify an ALJ or review judge a party must send a written petition for disqualification. A petition for disqualification is a written explanation to request assignment of a different ALJ or review judge. A party must promptly make the petition upon discovery of possible bias, conflict of interest, or an ex parte contact.

(4) A party must send or deliver the petition to the ALJ or review judge assigned to the case. That ALJ or review judge must decide whether to grant or deny the petition and must state the facts and reasons for the decision.

History

Statutory Authority: RCW 34.05.020, 34.05.220, and 34.05.353. WSR 25-21-040, s 388-02-0245, filed 10/9/25, effective 11/9/25. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0245, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0250 What happens after you request a hearing, and when must the OAH provide notice of the hearing and prehearing conference?

(1) The OAH must send a copy of your hearing request to the department, unless the OAH received your hearing request from the department. The OAH should send it to the department within four business days of the OAH receiving your request.

(2) The OAH must send a notice of hearing to all parties and their representatives at least fourteen calendar days before the hearing date. The OAH must provide notice of seven or more business days if the case is about child support under chapter 388-14A WAC.

(3) If the OAH schedules a prehearing conference, the OAH must send a notice of prehearing conference to the parties and their representatives at least seven business days before the date of the prehearing conference except:

(a) The OAH and/or an ALJ may convert a scheduled hearing into a prehearing conference and provide less than seven business days notice of the prehearing conference; and

(b) The OAH may give less than seven business days notice if the only purpose of the prehearing conference is to consider whether there is good cause to grant a continuance under WAC 388-02-0280 (3)(b).

(4) The OAH and/or the ALJ must reschedule the hearing if necessary to comply with the notice requirements in this section.

(5) If the ALJ denies a continuance after a prehearing conference, the hearing may proceed on the scheduled hearing date, but the ALJ must still issue a written order regarding the denial of the continuance.

(6) You may ask for a prehearing meeting even after you have requested a hearing.

History

Statutory Authority: RCW 34.05.020, 34.05.220. WSR 11-04-074, § 388-02-0250, filed 1/31/11, effective 3/3/11. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0250, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0255 What information must OAH include in the notice of hearing?

(1) A notice of hearing is a written notice that must include:

(a) The names of all parties who receive the notice and, if known, the names and addresses of their representatives;

(b) The name, mailing address, and telephone number of the ALJ, if known;

(d) The legal authority and jurisdiction for the hearing; and

(e) The date of the hearing request.

(2) OAH also sends you information with your notice of hearing telling you the following:

(a) If you fail to attend or participate in a prehearing conference or a hearing, you may lose your right to a hearing. Then the ALJ may send:

(i) An order of default against you; or

(ii) An order dismissing the hearing.

(b) If you need a qualified interpreter because you or any of your witnesses are persons with limited English proficiency, OAH will provide an interpreter at no cost to you.

(d) How to indicate any special needs for yourself or your witnesses, including the need for an interpreter in a primary language or for sensory impairments.

(e) How to contact OAH if a party has a safety concern.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0255, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0260 May the department amend a notice?

(1) The ALJ must allow the department to amend (change) the notice of a department action before or during the hearing to match the evidence and facts.

(2) The department must put the change in writing and give a copy to the ALJ and all parties.

(3) The ALJ must offer to continue (postpone) the hearing to give the parties more time to prepare or present evidence or argument if there is a significant change from the earlier department notice.

(4) If the ALJ grants a continuance, the OAH must send, a new hearing notice at least fourteen calendar days before the hearing date. The OAH must provide notice of seven or more business days if the case is about child support under chapter 388-14A WAC.

History

Statutory Authority: RCW 34.05.020, 34.05.220. WSR 11-04-074, § 388-02-0260, filed 1/31/11, effective 3/3/11. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0260, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0265 May you amend your hearing request?

(1) The ALJ may allow you to amend your hearing request before or during the hearing.

(2) The ALJ must offer to continue (postpone) the hearing to give the other parties more time to prepare or present evidence or argument if there is a significant change in the hearing request.

(3) If the ALJ grants a continuance, the OAH must send a new hearing notice at least fourteen calendar days before the hearing date. The OAH must provide notice of seven or more business days if the case is about child support under chapter 388-14A WAC.

History

Statutory Authority: RCW 34.05.020, 34.05.220. WSR 11-04-074, § 388-02-0265, filed 1/31/11, effective 3/3/11. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0265, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0270 Must you tell DSHS and OAH when your mailing address changes?

(1) You must tell DSHS and OAH, as soon as possible, when your mailing address changes.

(2) If you do not notify DSHS and OAH of a change in your mailing address and they continue to send notices and other important papers to your last known mailing address, the ALJ may assume that you received the documents.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0270, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0275 What is a continuance?

A continuance is a change in the date or time of a prehearing conference, hearing or the deadline for other action.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0275, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0280 Who may request a continuance?

(1) Any party may request a continuance either orally or in writing.

(2) Before contacting the ALJ to request a continuance, a party should contact the other parties, if possible, to find out if they will agree to a continuance. If you are unable to contact the parties, the OAH or the department must assist you in contacting them.

(3) The party making the request for a continuance must let the ALJ know whether the other parties agreed to the continuance.

(a) If the parties agree to a continuance, the ALJ must grant it unless the ALJ finds that good cause for a continuance does not exist.

(b) If the parties do not agree to a continuance, the ALJ must set a prehearing conference to decide whether there is good cause to grant or deny the continuance. The prehearing conference will be scheduled as required by WAC 388-02-0197 and 388-02-0250.

(4) If the ALJ grants a continuance, the OAH must send a new hearing notice at least fourteen calendar days before the new hearing date. The OAH must provide notice of seven or more business days if the case is about child support under chapter 388-14A WAC.

(5) If the ALJ denies the continuance, the ALJ will proceed with the hearing on the date the hearing is scheduled, but must still issue a written order regarding the denial of the continuance.

History

Statutory Authority: RCW 34.05.020, 34.05.220. WSR 11-04-074, § 388-02-0280, filed 1/31/11, effective 3/3/11. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0280, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0285 What is an order of dismissal?

(1) An order of dismissal is an order sent by the ALJ to end the hearing. The order is made because the party who requested the hearing withdrew the request, failed to appear, or refused to participate, resulting in a default.

(2) If your hearing is dismissed because you did not appear or refused to participate, the DSHS decision stands.

(3) If the hearing is dismissed due to a written agreement between the parties, the parties must follow the agreement.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0285, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0290 If your hearing is dismissed, may you request another hearing?

(1) If the ALJ sends an order dismissing your hearing, you may ask that the ALJ vacate (set aside) the order of dismissal.

(2) If the order of dismissal is vacated, your hearing is reinstated, which means you get another opportunity to have a hearing on your initial request for hearing.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0290, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0295 Where do you send a request to vacate an order of dismissal?

You must send your request to vacate an order of dismissal to BOA or OAH. You should specify in your request why the order of dismissal should be vacated. BOA forwards any request received to OAH to schedule a hearing. OAH sends you a notice of the hearing on the request to vacate the order of dismissal.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0295, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0300 What is the deadline for vacating an order of dismissal?

(1) You must send your request to vacate an order to OAH or BOA twenty-one calendar days after the date the order of dismissal was mailed to you. If no request is received within that deadline, the dismissal order becomes a final order.

(2) You may make a late request to vacate the order of dismissal for up to one year after it was mailed but you must show good cause according to WAC 388-02-0020 for the late request to be accepted and the dismissal to be vacated.

(3) If you ask to vacate more than one year after the order was mailed, the ALJ may vacate the order of dismissal if the DSHS representative and any other party agrees to waive (excuse) the deadline.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0300, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0305 How does an ALJ vacate an order of dismissal?

(1) If your request was received more than twenty-one days, but less than one year after the dismissal order was mailed, the ALJ first must decide if you have good cause according to WAC 388-02-0020.

(2) If your request was timely or you show good cause for missing the deadline, the ALJ will receive evidence and argument at a hearing from the parties on whether the order of dismissal should be vacated.

(3) The ALJ vacates an order of dismissal and reinstates the hearing if you show good cause or if the DSHS representative agrees to waive the deadline. You will then be allowed to present your case about your original request for hearing, either at the same time or at a later date if a continuance is granted.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0305, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0310 May a party request a stay of DSHS action?

A party may request that an ALJ or review judge stay (stop) a DSHS action until there is a decision entered by the ALJ or review judge. An ALJ or review judge decides whether to grant the stay.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0310, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0315 May a party require witnesses to testify or provide documents?

A party may require witnesses to testify or provide documents by issuing a subpoena. A subpoena is an order to appear at a certain time and place to give testimony, or to provide books, documents, or other items.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0315, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0320 Who may prepare a subpoena?

(1) ALJs, DSHS, and attorneys for the parties may prepare subpoenas. If an attorney does not represent you, you may ask the ALJ to prepare a subpoena on your behalf. The ALJ may schedule a hearing to decide whether to issue a subpoena.

(2) An ALJ may deny a request for a subpoena. For example, an ALJ may deny a request for a subpoena when the ALJ determines that a witness has no actual knowledge regarding the facts or that the documents are not relevant.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0320, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0325 How is a subpoena served?

(1) Any person who is at least eighteen years old and not a party to the hearing may serve a subpoena.

(2) Service of a subpoena is complete when the server:

(a) Gives the witness a copy of the subpoena; or

(b) Leaves a copy at the residence of the witness with a person over the age of eighteen.

(3) To prove that a subpoena was served on a witness, the person serving the subpoena must sign a written, dated statement including:

(a) Who was served with the subpoena;

(b) When the subpoena was served;

(d) The name, age, and address of the person who served the subpoena.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0325, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0330 May the ALJ quash a subpoena?

(1) A party may request that an ALJ quash (set aside) or change the subpoena request at any time before the deadline given in the subpoena.

(2) An ALJ may set aside or change a subpoena if it is unreasonable.

(3) Witnesses with safety or accommodation concerns should contact OAH.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0330, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0335 Do you have to pay for a subpoena?

There is no cost to prepare a subpoena, but you may have to pay for:

(1) Serving a subpoena;

(2) Complying with a subpoena; and

(3) Witness fees according to RCW 34.05.446(7).

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0335, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0340 How is your hearing held?

(1) Hearings may be held in person or by telephone conference.

(2) A telephone conference hearing is where all parties appear by telephone.

(3) An in-person hearing is where you appear face-to-face with the ALJ and the other parties appear either in person or by telephone.

(4) Whether a hearing is held in person or by telephone conference, the parties have the right to see all documents, hear all testimony and question all witnesses.

(5) Parties and their witnesses may appear in person or by telephone conference. The ALJ may require parties and/or their witnesses to appear in person if the ALJ determines there is a compelling reason, and the compelling reason is stated in a hearing notice or prehearing order.

(6) After a telephone conference hearing begins, the ALJ may stop, reschedule, and convert the hearing to an in-person hearing if the ALJ determines there is a compelling reason to do so.

History

Statutory Authority: RCW 34.05.020, 34.05.220. WSR 11-04-074, § 388-02-0340, filed 1/31/11, effective 3/3/11. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0340, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0345 Is an ALJ present at your hearing?

(1) If your hearing is scheduled as an in-person hearing, an ALJ is physically or visually present.

(2) If your hearing is scheduled as a telephone conference, an ALJ is present by telephone.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0345, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0350 Is your hearing recorded?

The ALJ must record the entire hearing using audio recording equipment (such as a digital recorder or a tape recorder).

History

Statutory Authority: RCW 34.05.020, 34.05.220. WSR 11-04-074, § 388-02-0350, filed 1/31/11, effective 3/3/11. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0350, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0355 Who may attend your hearing?

(1) All parties and their representatives may attend the hearing.

(2) Witnesses may be excluded from the hearing if the ALJ finds good cause.

(3) The ALJ may also exclude other persons from all or part of the hearing.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0355, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0360 May a party convert how a hearing is held?

(1) The parties have the right to request that:

(a) A hearing format be converted (changed) to an in-person hearing or a telephone conference; or

(b) A witness appear in person or by telephone conference. The OAH must advise you of the right to request a change in how a witness appears.

(2) Except as provided in subsection (4) of this section, a party requesting a change in how a hearing is held must show a compelling reason. A party must also show a compelling reason to change the way a witness appears (in-person or by telephone conference). Some examples of compelling reasons are:

(a) A party does not speak or understand English well.

(b) A party wants to present a significant number of documents during the hearing.

(c) A party does not believe that one of the witnesses or another party is credible, and wants the ALJ to have the opportunity to see the testimony.

(d) A party has a disability or communication barrier that affects their ability to present their case.

(e) A party believes that the personal safety of someone involved in the hearing process is at risk.

(3) A compelling reason to convert how a hearing is held can be overcome by a compelling reason not to convert how a hearing is held.

(4) In public assistance cases, a party has the right to request that a hearing be changed without showing a compelling reason to the ALJ. Public assistance programs include:

(a) Temporary assistance for needy families (TANF);

(b) Working connections child care;

(d) Medical assistance;

(e) Food assistance; and

(f) Refugee assistance.

History

Statutory Authority: RCW 34.05.020, 34.05.220. WSR 11-04-074, § 388-02-0360, filed 1/31/11, effective 3/3/11. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0360, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0365 How does a party convert how a hearing is held or how the witnesses or parties appear?

(1) If a party wants to convert the hearing or change how their witnesses or other parties appear, the party must contact OAH to request the change.

(2) The ALJ may schedule a prehearing conference to determine if the request should be granted.

(3) If the ALJ grants the request, the ALJ reschedules the hearing or changes how the witness or party appears.

(4) If the ALJ denies the request, the ALJ must issue a written order that includes findings of fact supporting why the request was denied.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0365, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0370 How are documents submitted for a telephone conference?

(1) When a hearing is conducted by telephone, an ALJ may order the parties to provide the hearing documents at least five days before the hearing, so all parties have an opportunity to view them during the hearing.

(2) DSHS may be able to help you copy and send your documents to the ALJ and any other parties.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0370, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0375 What happens at your hearing?

At your hearing:

(1) The ALJ:

(a) Explains your rights;

(b) Marks and admits or rejects exhibits;

(d) Explains that a decision is mailed after the hearing;

(e) Notifies the parties of appeal rights;

(f) May keep the record open for a time after the hearing if needed to receive more evidence or argument; and

(g) May take actions as authorized according to WAC 388-02-0215.

(2) The parties may:

(a) Make opening statements to explain the issues;

(b) Offer evidence to prove their positions, including oral or written statements of witnesses;

(d) Give closing arguments about what the evidence shows and what laws apply.

(3) At the end of the hearing if the ALJ does not allow more time to send in evidence, the record is closed.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0375, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0380 What is a group hearing?

(1) A group hearing may be held when two or more parties request a hearing about similar issues.

(2) Hearings may be combined at the request of the parties or the ALJ.

(3) All parties participating in a group hearing may have their own representative.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0380, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0385 May a party withdraw from a group hearing?

(1) A party may withdraw from a group hearing by asking the ALJ for a separate hearing.

(2) If a party asks to withdraw from a group hearing before the ALJ makes a discretionary ruling or the hearing begins, the ALJ must give the party a separate hearing.

(3) If a party later shows good cause, the ALJ may give the party a separate hearing at any time during the hearing process.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0385, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0387 How may you request that a hearing be consolidated or severed when multiple agencies are parties to the proceeding?

The following requirements apply only to adjudicative proceedings in which an applicant or recipient of medical services programs set forth in chapter 74.09 RCW seeks review of decisions made by more than one agency.

(1) When you file a single application for an adjudicative proceeding seeking review of decisions by more than one agency, this review shall be conducted initially in one adjudicative proceeding. The administrative law judge (ALJ) may sever the proceeding into multiple proceedings on the motion of any of the parties, when:

(a) All parties consent to the severance; or

(b) Either party requests severance without another party's consent, and the ALJ finds there is good cause for severing the matter and that the proposed severance is not likely to prejudice the rights of an appellant who is a party to any of the severed proceedings.

(2) If there are multiple adjudicative proceedings involving common issues or parties where there is one appellant and both the health care authority and the department are parties, upon motion of any party or upon his or her own motion, the ALJ may consolidate the proceedings if he or she finds that the consolidation is not likely to prejudice the rights of the appellant who is a party to any of the consolidated proceedings.

(3) If the ALJ grants the motion to sever the hearing into multiple proceedings or consolidate multiple proceedings into a single proceeding, the ALJ will send out an order and a new notice of hearing to the appropriate parties in accordance with WAC 388-02-0250.

History

Statutory Authority: RCW 74.09.741 and 34.05.020. WSR 12-05-043, § 388-02-0387, filed 2/10/12, effective 2/25/12.

Wash. Admin. Code § 388-02-0390 What is evidence?

(1) Evidence includes documents, objects, and testimony of witnesses that parties give during the hearing to help prove their positions.

(2) Evidence may be all or parts of original documents or copies of the originals.

(3) Parties may offer statements signed by a witness under oath or affirmation as evidence, if the witness cannot appear.

(4) Testimony given with the opportunity for cross-examination by the other parties may be given more weight by the ALJ.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0390, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0395 When may the parties bring in evidence?

(1) The parties may bring evidence to any prehearing meeting, prehearing conference, or hearing, or may send in evidence before these events.

(2) The ALJ may set a deadline before the hearing for the parties to provide proposed exhibits and names of witnesses. If the parties miss the deadline, the ALJ may refuse to admit the evidence unless the parties show:

(a) They have good cause for missing the deadline; or

(b) That the other parties agree.

(3) If the ALJ gives the parties more time to submit evidence, the parties may send it in after the hearing. The ALJ may allow more time for the other parties to respond to the new evidence.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0395, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0400 What evidence may the parties present during the hearing?

The parties may bring any documents and witnesses to the hearing to support their position. However, the following provisions apply:

(1) The other parties may object to the evidence and question the witnesses;

(2) The ALJ determines whether the evidence is admitted and what weight (importance) to give it;

(3) If the ALJ does not admit the evidence the parties may make an offer of proof to show why the ALJ should admit it;

(4) To make an offer of proof a party presents evidence and argument on the record to show why the ALJ should consider the evidence; and

(5) The offer of proof preserves the argument for appeal.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0400, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0405 What is a stipulation?

(1) A stipulation is an agreement among two or more parties that certain facts or evidence is correct or authentic.

(2) If an ALJ accepts a stipulation, the ALJ must enter it into the record.

(3) A stipulation may be made before or during the hearing.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0405, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0410 After the parties agree to a stipulation, may they change or reject it?

(1) A party may change or reject a stipulation after it has been made.

(2) To change or reject a stipulation, a party must show the ALJ that:

(a) The party did not intend to make the stipulation or was mistaken when making it; and

(b) Changing or rejecting the stipulation does not harm the other parties.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0410, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0415 What are proposed exhibits?

Proposed exhibits are documents or other objects that a party wants the ALJ to consider when reaching a decision. After the document or object is accepted by the ALJ, it is admitted and becomes an exhibit.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0415, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0420 Do the parties mark and number their proposed exhibits?

(1) DSHS representatives must mark and number their proposed exhibits and provide copies to the other parties as far ahead of the hearing as possible.

(2) The ALJ may request that you mark and number your proposed exhibits before the hearing. You should bring enough copies of your proposed exhibits for all parties. If you do not bring enough copies, you must make your proposed exhibits available for copying.

(3) If you cannot afford to pay for copies of proposed exhibits, either DSHS or OAH must make the copies for you.

(4) The ALJ may require proof that you are unable to pay.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0420, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0425 Who decides whether to admit proposed exhibits into the record?

(1) The ALJ decides whether or not to admit a proposed exhibit into the record and also determines the weight (importance) of the evidence.

(2) The ALJ admits proposed exhibits into the record by marking, listing, identifying, and admitting the proposed exhibits.

(3) The ALJ may also exclude proposed exhibits from the record.

(4) The ALJ must make rulings on the record to admit or exclude exhibits.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0425, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0430 What may a party do if they disagree with an exhibit?

(1) A party may object to the authenticity or admissibility of any exhibit, or offer argument about how much weight the ALJ should give the exhibit.

(2) Even if a party agrees that a proposed exhibit is a true and authentic copy of a document, the agreement does not mean that a party agrees with:

(a) Everything in the exhibit or agrees that it should apply to the hearing;

(b) What the exhibit says; or

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0430, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0435 When should an ALJ receive proposed exhibits for a telephone hearing?

(1) Parties should send their proposed exhibits to the ALJ and the other parties at least five days before the telephone hearing. In some cases, the ALJ may require that the parties send them earlier.

(2) Sending the proposed exhibits to the ALJ before the telephone hearing allows all parties to use them during the hearing.

(3) For a telephone hearing, DSHS may help you send copies of your proposed exhibits to the ALJ and the other parties if you cannot afford to do so.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0435, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0440 What is judicial notice?

(1) Judicial notice is evidence that includes facts or standards that are generally recognized and accepted by judges, government agencies, or national associations.

(2) For example, an ALJ may take judicial notice of a calendar, a building code or a standard or practice.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0440, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0445 How does the ALJ respond to requests to take judicial notice?

(1) The ALJ may consider and admit evidence by taking judicial notice.

(2) If a party requests judicial notice, or if the ALJ intends to take judicial notice, the ALJ may ask the party to provide a copy of the document that contains the information.

(3) If judicial notice has been requested, or if the ALJ intends to take judicial notice, the ALJ must tell the parties before or during the hearing.

(4) The ALJ must give the parties time to object to judicial notice evidence.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0445, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0450 What is a witness?

(1) A witness is any person who makes statements or gives testimony that becomes evidence in a hearing.

(2) One type of witness is an expert witness. An expert witness is qualified by knowledge, experience, and education to give opinions or evidence in a specialized area.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0450, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0455 Who may be a witness?

(1) A witness may be:

(a) You or the DSHS representative; or

(b) Anyone you, the ALJ, or the DSHS representative asks to be a witness, including DSHS employees.

(2) The ALJ decides who may testify as a witness.

(3) Unless DSHS agrees, a former DSHS employee may not be an expert witness against DSHS if that employee was actively involved in the case while working for DSHS.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0455, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0460 How do witnesses testify?

All witnesses:

(1) Must affirm or take an oath to testify truthfully during the hearing.

(2) May testify in person or by telephone.

(3) May request interpreters from OAH at no cost to you.

(4) May be subpoenaed and ordered to appear according to WAC 388-02-0315.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0460, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0465 May the parties cross-examine a witness?

(1) The parties have the right to cross-examine (question) each witness.

(2) If a party has a representative, only the representative, and not the party, may question the witness.

(3) The ALJ may also question witnesses.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0465, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0470 May witnesses refuse to answer questions?

Witnesses may refuse to answer questions. However, if a witness refuses to answer, the ALJ may reject all of the related testimony of that witness.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0470, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0475 What evidence does an ALJ consider?

(1) The ALJ may only consider admitted evidence to decide the case.

(2) Admission of evidence is based upon the reasonable person standard. This standard means evidence that a reasonable person would rely on in making a decision.

(3) The ALJ may admit and consider hearsay evidence. Hearsay is a statement made outside of the hearing used to prove the truth of what is in the statement. The ALJ may only base a finding on hearsay evidence if the ALJ finds that the parties had the opportunity to question or contradict it.

(4) The ALJ may reject evidence, if it:

(a) Is not relevant;

(b) Repeats evidence already admitted; or

(5) The ALJ must reject evidence if required by law.

(6) The ALJ decides:

(a) What evidence is more credible if evidence conflicts; and

(b) The weight given to the evidence.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0475, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0480 What does burden of proof mean?

(1) Burden of proof is a party's responsibility to:

(a) Provide evidence regarding disputed facts; and

(b) Persuade the ALJ that a position is correct.

(2) To persuade the ALJ, the party who has the burden of proof must provide the amount of evidence required by WAC 388-02-0485.

History

Statutory Authority: RCW 34.05.020, 34.05.220. WSR 11-04-074, § 388-02-0480, filed 1/31/11, effective 3/3/11. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0480, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0485 What is the standard of proof?

Standard of proof refers to the amount of evidence needed to prove a party's position. Unless the rules or law states otherwise, the standard of proof in a hearing is a preponderance of the evidence. This standard means that it is more likely than not that something happened or exists.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0485, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0490 How is a position proven at hearing?

The ALJ decides if a party has met the burden of proof. The ALJ writes a decision based on the evidence presented during the hearing and consistent with the law.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0490, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0495 What is equitable estoppel?

(1) Equitable estoppel is a legal doctrine defined in case law that may only be used as a defense to prevent the department from taking some action against you, such as collecting an overpayment. Equitable estoppel may not be used to require the department to continue to provide something, such as benefits, services, or a license, or to require the department to take action contrary to a statute.

(2) There are five elements of equitable estoppel. The standard of proof is clear and convincing evidence. You must prove all of the following:

(a) The department made a statement or took an action or failed to take an action, which is inconsistent with a later claim or position by the department. For example, the department gave you money based on your application, then later tells you that you received an overpayment and wants you to pay the money back based on the same information.

(b) You reasonably relied on the department's original statement, action or failure to act. For example, you believed the department acted correctly when you received money.

(c) You will be injured to your detriment if the department is allowed to contradict the original statement, action or failure to act. For example, you did not seek help from health clinics or food banks because you were receiving benefits from the department, and you would have been eligible for these other benefits.

(d) Equitable estoppel is needed to prevent a manifest injustice. Factors to be considered in determining whether a manifest injustice would occur include, but are not limited to, whether:

(i) You cannot afford to repay the money to the department;

(ii) You gave the department timely and accurate information when required;

(iii) You did not know that the department made a mistake;

(iv) You are free from fault; and

(v) The overpayment was caused solely by a department mistake.

(e) The exercise of government functions is not impaired. For example, the use of equitable estoppel in your case will not result in circumstances that will impair department functions.

(3) If the ALJ concludes that you have proven all of the elements of equitable estoppel in subsection (2) of this section with clear and convincing evidence, the department is stopped or prevented from taking action or enforcing a claim against you.

History

Statutory Authority: RCW 34.05.020, 34.05.220. WSR 11-04-074, § 388-02-0495, filed 1/31/11, effective 3/3/11. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0495, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0500 What may an ALJ do before the record is closed?

Before the record is closed, the ALJ may:

(1) Set another hearing date;

(2) Enter orders to address limited issues if needed before writing and mailing a hearing decision to resolve all issues in the proceeding; or

(3) Give the parties more time to send in exhibits or written argument.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0500, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0505 When is the record closed?

The record is closed:

(1) At the end of the hearing if the ALJ does not allow more time to send in evidence or argument; or

(2) After the deadline for sending in evidence or argument is over.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0505, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0510 What happens when the record is closed?

No more evidence may be taken without good cause after the record is closed.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0510, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0512 What is included in the hearing record?

(1) The ALJ must produce a complete official record of the proceedings.

(2) The official record must include, if applicable:

(a) Notice of all proceedings;

(b) Any prehearing order;

(d) Evidence received or considered;

(e) A statement of matters officially noticed;

(f) Offers of proof, objections, and any resulting rulings;

(g) Proposed findings, requested orders and exceptions;

(h) A complete audio recording of the entire hearing, together with any transcript of the hearing;

(i) Any final order, initial order, or order on reconsideration; and

(j) Matters placed on the record after an ex parte communication.

History

Statutory Authority: RCW 34.05.020, 34.05.220. WSR 11-04-074, § 388-02-0512, filed 1/31/11, effective 3/3/11.

Wash. Admin. Code § 388-02-0515 What happens after the record is closed?

(1) After the record is closed, the ALJ must enter an initial or final order and send copies to the parties.

(2) The maximum time an ALJ has to send a decision is ninety calendar days after the record is closed, but many department programs have earlier deadlines. Specific program rules may set the deadlines.

(3) OAH must send the official record of the proceedings to the BOA. The record must be complete when it is sent, and include all parts required by WAC 388-02-0512.

History

Statutory Authority: RCW 34.05.020, 34.05.220. WSR 11-04-074, § 388-02-0515, filed 1/31/11, effective 3/3/11. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0515, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0520 What information must the ALJ include in the decision?

The ALJ must include the following information in the decision:

(1) Identify the hearing decision as a DSHS case;

(2) List the name and docket number of the case and the names of all parties and representatives;

(3) Find the facts used to resolve the dispute based on the hearing record;

(4) Explain why evidence is credible when the facts or conduct of a witness is in question;

(5) State the law that applies to the dispute;

(6) Apply the law to the facts of the case in the conclusions of law;

(7) Discuss the reasons for the decision based on the facts and the law;

(8) State the result and remedy ordered;

(9) Explain how to request changes in the decision and the deadlines for requesting them;

(10) State the date the decision becomes final according to WAC 388-02-0525; and

(11) Include any other information required by law or DSHS program rules.

History

Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0520, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0525 When do initial orders become final?

If no one requests review of the initial order or if a review request is dismissed, the initial order is final twenty-one calendar days after it is mailed.

History

Statutory Authority: RCW 34.05.020, chapter 34.05 RCW, Parts IV and V, 2002 c 371 § 211. WSR 02-21-061, § 388-02-0525, filed 10/15/02, effective 11/15/02. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0525, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0530 What if a party disagrees with the ALJ's decision?

(1) If a party disagrees with an ALJ's initial or final order because of a clerical error, the party may ask for a corrected decision from the ALJ as provided in WAC 388-02-0540 through 388-02-0555.

(2) If a party disagrees with an initial order and wants it changed, the party must request review by a review judge as provided in WAC 388-02-0560 through 388-02-0595.

If a party wants to stay the DSHS action until review of the initial order is completed, the party must request a stay from a review judge.

(3) Final orders entered by ALJs may not be reviewed by a review judge.

(4) If a party disagrees with an ALJ's final order, the party may request reconsideration as provided in WAC 388-02-0605 through 388-02-0635. You may also petition for judicial review of the final order as stated in WAC 388-02-0640 through 388-02-0650. You do not need to file a request for reconsideration of the final order before petitioning for judicial review. DSHS may not request judicial review of an ALJ's or review judge's final order.

History

Statutory Authority: RCW 34.05.020, 34.05.220, 42 C.F.R. 431.10 (e)(3), 45 C.F.R. 205.100 (b)(3), chapter 34.05 RCW, Parts IV and V. WSR 08-21-144, § 388-02-0530, filed 10/21/08, effective 11/21/08. Statutory Authority: RCW 34.05.020, chapter 34.05 RCW, Parts IV and V, 2002 c 371 § 211. WSR 02-21-061, § 388-02-0530, filed 10/15/02, effective 11/15/02. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0530, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0540 How are clerical errors in ALJ decisions corrected?

(1) A clerical error is a mistake that does not change the intent of the decision.

(2) The ALJ corrects clerical errors in hearing decisions by issuing a second decision referred to as a corrected decision or corrected order. Corrections may be made to initial orders and final orders.

(3) Some examples of clerical error are:

(a) Missing or incorrect words or numbers;

(b) Dates inconsistent with the decision or evidence in the record such as using May 3, 1989, instead of May 3, 1998; or

History

Statutory Authority: RCW 34.05.020, chapter 34.05 RCW, Parts IV and V, 2002 c 371 § 211. WSR 02-21-061, § 388-02-0540, filed 10/15/02, effective 11/15/02. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0540, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0545 How does a party ask for a corrected ALJ decision?

(1) A party may ask for a corrected ALJ decision by calling or writing the OAH office that held the hearing.

(2) When asking for a corrected decision, please identify the clerical error you found.

History

Statutory Authority: RCW 34.05.020, chapter 34.05 RCW, Parts IV and V, 2002 c 371 § 211. WSR 02-21-061, § 388-02-0545, filed 10/15/02, effective 11/15/02. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0545, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0550 How much time do the parties have to ask for a corrected ALJ decision?

(1) The parties must ask the ALJ for a corrected decision on or before the tenth calendar day after the order was mailed.

(2) If you ask the ALJ to correct a decision, the time period provided by this section for requesting a corrected decision of an initial order, and the time it takes the ALJ to deny the request or make a decision regarding the request for a corrected initial order, do not count against any deadline, if any, for a review judge to enter a final order.

History

Statutory Authority: RCW 34.05.020, 34.05.220, and 42 C.F.R. 431.10 (e)(3), 45 C.F.R. 205.100 (b)(3), chapter 34.05 RCW, Parts IV and V. WSR 08-21-144, § 388-02-0550, filed 10/21/08, effective 11/21/08. Statutory Authority: RCW 34.05.020, chapter 34.05 RCW, Parts IV and V, 2002 c 371 § 211. WSR 02-21-061, § 388-02-0550, filed 10/15/02, effective 11/15/02. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0550, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0555 What happens when a party requests a corrected ALJ decision?

(1) When a party requests a corrected initial or final order, the ALJ must either:

(a) Send all parties a corrected order; or

(b) Deny the request within three business days of receiving it.

(2) If the ALJ corrects an initial order and a party does not request review, the corrected initial order becomes final twenty-one calendar days after the original initial order was mailed.

(3) If the ALJ denies a request for a corrected initial order and the party still wants the hearing decision changed, the party must request review by a review judge.

(4) Requesting an ALJ to correct the initial order does not automatically extend the deadline to request review of the initial order by a review judge. When a party needs more time to request review of an initial order, the party must ask for more time to request review as permitted by WAC 388-02-0580(2).

(5) If the ALJ denies a request for a corrected final order and you still want the hearing decision changed, you must request judicial review.

History

Statutory Authority: RCW 34.05.020, 34.05.220, 42 C.F.R. 431.10 (e)(3), 45 C.F.R. 205.100 (b)(3), chapter 34.05 RCW, Parts IV and V. WSR 08-21-144, § 388-02-0555, filed 10/21/08, effective 11/21/08. Statutory Authority: RCW 34.05.020, chapter 34.05 RCW, Parts IV and V, 2002 c 371 § 211. WSR 02-21-061, § 388-02-0555, filed 10/15/02, effective 11/15/02. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0555, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0560 What is review of an initial order by a review judge?

(1) Review by a review judge is available to a party who disagrees with the ALJ's initial order.

(2) If a party wants the initial order changed, the party must request that a review judge review the initial order.

(3) If a request is made for a review judge to review an initial order, it does not mean there is another hearing conducted by a review judge.

(4) The review judge considers the request, the initial order, and the record, and may hear oral argument, before deciding if the initial order should be changed.

(5) Review judges may not review ALJ final orders.

History

Statutory Authority: RCW 34.05.020, 34.05.220, 42 C.F.R. 431.10 (e)(3), 45 C.F.R. 205.100 (b)(3), chapter 34.05 RCW, Parts IV and V. WSR 08-21-144, § 388-02-0560, filed 10/21/08, effective 11/21/08. Statutory Authority: RCW 34.05.020, chapter 34.05 RCW, Parts IV and V, 2002 c 371 § 211. WSR 02-21-061, § 388-02-0560, filed 10/15/02, effective 11/15/02. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0560, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0565 What evidence does the review judge consider in reviewing an initial order?

(1) The review judge, in most cases, only considers evidence given at the original hearing before the ALJ.

(2) The review judge may allow the parties to make oral argument when reviewing initial orders.

History

Statutory Authority: RCW 34.05.020, 34.05.220, 42 C.F.R. 431.10 (e)(3), 45 C.F.R. 205.100 (b)(3), chapter 34.05 RCW, Parts IV and V. WSR 08-21-144, § 388-02-0565, filed 10/21/08, effective 11/21/08. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0565, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0570 Who may request review of an initial order?

(1) Any party may request a review judge to review the initial order.

(2) If more than one party requests review, each request must meet the deadlines in WAC 388-02-0580.

History

Statutory Authority: RCW 34.05.020, 34.05.220, 42 C.F.R. 431.10 (e)(3), 45 C.F.R. 205.100 (b)(3), chapter 34.05 RCW, Parts IV and V. WSR 08-21-144, § 388-02-0570, filed 10/21/08, effective 11/21/08. Statutory Authority: RCW 34.05.020, chapter 34.05 RCW, Parts IV and V, 2002 c 371 § 211. WSR 02-21-061, § 388-02-0570, filed 10/15/02, effective 11/15/02. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0570, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0575 What must a party include in the review request?

A party must make the review request in writing and send it to BOA. The party should identify the:

(1) Parts of the initial order with which the party disagrees; and

(2) Evidence supporting the party's position.

History

Statutory Authority: RCW 34.05.020, 34.05.220. WSR 11-04-074, § 388-02-0575, filed 1/31/11, effective 3/3/11. Statutory Authority: RCW 34.05.020, 34.05.220, 42 C.F.R. 431.10 (e)(3), 45 C.F.R. 205.100 (b)(3), chapter 34.05 RCW, Parts IV and V. WSR 08-21-144, § 388-02-0575, filed 10/21/08, effective 11/21/08. Statutory Authority: RCW 34.05.020, chapter 34.05 RCW, Parts IV and V, 2002 c 371 § 211. WSR 02-21-061, § 388-02-0575, filed 10/15/02, effective 11/15/02. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0575, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0580 What is the deadline for requesting review by a review judge?

(1) BOA must receive the written review request on or before 5:00 p.m. on the twenty-first calendar day after the initial order was mailed. A party may submit the review request by facsimile transmission (fax). A copy of the review request should also be mailed to the BOA.

(2) A review judge may extend the deadline if a party:

(a) Asks for more time before the deadline expires; and

(b) Gives a good reason for more time.

(3) A review judge may accept a review request after the twenty-one calendar day deadline only if:

(a) The BOA receives the review request on or before the thirtieth calendar day after the deadline; and

(b) A party shows good cause for missing the deadline.

(4) If you ask a review judge to review an ALJ decision, the time period provided by this section for requesting review of an initial order, including any extensions, does not count against any deadline, if any, for a review judge to enter the final order.

History

Statutory Authority: RCW 34.05.020. WSR 12-13-083, § 388-02-0580, filed 6/19/12, effective 7/20/12. Statutory Authority: RCW 34.05.020, 34.05.220. WSR 11-04-074, § 388-02-0580, filed 1/31/11, effective 3/3/11. Statutory Authority: RCW 34.05.020, 34.05.220, 42 C.F.R. 431.10 (e)(3), 45 C.F.R. 205.100 (b)(3), chapter 34.05 RCW, Parts IV and V. WSR 08-21-144, § 388-02-0580, filed 10/21/08, effective 11/21/08. Statutory Authority: RCW 34.05.020, chapter 34.05 RCW, Parts IV and V, 2002 c 371 § 211. WSR 02-21-061, § 388-02-0580, filed 10/15/02, effective 11/15/02. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0580, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0585 Where does a party send the request for review by a review judge?

(1) A party must send the request for review of the initial order to BOA at the address given in WAC 388-02-0030. A party should also send a copy of the review request to the other parties.

(2) After receiving a party's review request, BOA sends a copy to the other parties, their representatives, and OAH. The other parties and their representatives may respond as described in WAC 388-02-0590.

History

Statutory Authority: RCW 34.05.020, 34.05.220, 42 C.F.R. 431.10 (e)(3), 45 C.F.R. 205.100 (b)(3), chapter 34.05 RCW, Parts IV and V. WSR 08-21-144, § 388-02-0585, filed 10/21/08, effective 11/21/08. Statutory Authority: RCW 34.05.020, chapter 34.05 RCW, Parts IV and V, 2002 c 371 § 211. WSR 02-21-061, § 388-02-0585, filed 10/15/02, effective 11/15/02. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0585, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0590 How does the party that is not requesting review respond to the review request?

(1) A party does not have to respond to the review request. A response is optional.

(2) If a party decides to respond, that party must send the response so that BOA receives it on or before the seventh business day after the date the other party's review request was mailed to the party by BOA.

(3) The party should send a copy of the response to all other parties or their representatives.

(4) A review judge may extend the deadline in subsection (2) of this section if a party asks for more time before the deadline to respond expires and gives a good reason.

(5) If you ask for more time to respond, the time period provided by this section for responding to the review request, including any extensions, does not count against any deadline, if any, for a review judge to enter the final order. A review judge may accept and consider a party's response even if it is received after the deadline.

History

Statutory Authority: RCW 34.05.020, 34.05.220. WSR 11-04-074, § 388-02-0590, filed 1/31/11, effective 3/3/11. Statutory Authority: RCW 34.05.020, 34.05.220, 42 C.F.R. 431.10 (e)(3), 45 C.F.R. 205.100 (b)(3), chapter 34.05 RCW, Parts IV and V. WSR 08-21-144, § 388-02-0590, filed 10/21/08, effective 11/21/08. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0590, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0595 What happens after the response deadline?

(1) After the response deadline, the record on review is closed unless there is a good reason to keep it open.

(2) A review judge is assigned to review the initial order after the record is closed. To find out which judge is assigned, call BOA.

(3) After the record is closed, the assigned review judge:

(a) Reviews the initial order; and

(b) Enters a final order that affirms, changes, dismisses or reverses the initial order; or

History

Statutory Authority: RCW 34.05.020, 34.05.220, 42 C.F.R. 431.10 (e)(3), 45 C.F.R. 205.100 (b)(3), chapter 34.05 RCW, Parts IV and V. WSR 08-21-144, § 388-02-0595, filed 10/21/08, effective 11/21/08. Statutory Authority: RCW 34.05.020, chapter 34.05 RCW, Parts IV and V, 2002 c 371 § 211. WSR 02-21-061, § 388-02-0595, filed 10/15/02, effective 11/15/02. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0595, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0600 What is the authority of the review judge?

(1) Review judges review initial orders and enter final orders. The review judge has the same decision-making authority as the ALJ. The review judge considers the entire record and decides the case de novo (anew). In reviewing findings of fact, the review judge must give due regard to the ALJ's opportunity to observe witnesses.

(2) Review judges may return (remand) cases to the OAH for further action.

(3) Review judges may not review ALJ final orders for the types of cases listed in WAC 388-02-0217(2).

(4) A review judge conducts the hearing and enters the final order in cases covered by WAC 388-02-0218.

History

Statutory Authority: RCW 34.05.020, 34.05.220. WSR 11-04-074, § 388-02-0600, filed 1/31/11, effective 3/3/11. Statutory Authority: RCW 34.05.020, 34.05.220, 42 C.F.R. 431.10 (e)(3), 45 C.F.R. 205.100 (b)(3), chapter 34.05 RCW, Parts IV and V. WSR 08-21-144, § 388-02-0600, filed 10/21/08, effective 11/21/08. Statutory Authority: RCW 34.05.020, chapter 34.05 RCW, Parts IV and V, 2002 c 371 § 211. WSR 02-21-061, § 388-02-0600, filed 10/15/02, effective 11/15/02. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0600, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0605 What if a party does not agree with a final order entered by OAH or BOA?

(1) If a party does not agree with the final order and wants it reconsidered, the party must:

(a) Ask the ALJ to reconsider the decision, if the final order was entered by an ALJ; or

(b) Ask the review judge to reconsider the decision, if the final order was entered by a review judge.

(2) The final order or the reconsideration decision is the final agency decision. If you disagree with that decision, you must petition for judicial review to change it.

(3) You may ask the court to stay or stop the DSHS action after filing the petition for judicial review.

History

Statutory Authority: RCW 34.05.020, chapter 34.05 RCW, Parts IV and V, 2002 c 371 § 211. WSR 02-21-061, § 388-02-0605, filed 10/15/02, effective 11/15/02. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0605, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0610 What is reconsideration?

(1) Reconsideration is:

(a) Asking an ALJ to reconsider a final order entered by the ALJ because the party believes the ALJ made a mistake; and

(b) Asking a review judge to reconsider a final order entered by a review judge because the party believes the review judge made a mistake.

(2) If a party asks for reconsideration of the final order, the reconsideration process must be completed before you request judicial review. However, you do not need to request reconsideration of a final order before you request judicial review.

History

Statutory Authority: RCW 34.05.020, chapter 34.05 RCW, Parts IV and V, 2002 c 371 § 211. WSR 02-21-061, § 388-02-0610, filed 10/15/02, effective 11/15/02. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0610, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0615 What must a party include in the reconsideration request?

The party must make the request in writing and clearly state why the party wants the final order reconsidered.

History

Statutory Authority: RCW 34.05.020, chapter 34.05 RCW, Parts IV and V, 2002 c 371 § 211. WSR 02-21-061, § 388-02-0615, filed 10/15/02, effective 11/15/02. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0615, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0620 What is the deadline for requesting reconsideration?

(1) If OAH entered the final order, OAH must receive a written reconsideration request on or before the tenth calendar day after the final order was mailed.

(2) If BOA entered the final order, BOA must receive a written reconsideration request on or before the tenth calendar day after the final order was mailed.

(3) If a reconsideration request is received after the deadline, the final order will not be reconsidered and the deadline to ask for superior court review continues to run.

(4) OAH or BOA may extend its deadline if a party:

(a) Asks for more time before the deadline expires; and

(b) Gives a good reason for the extension.

(5) If a party does not request reconsideration or ask for an extension within the deadline, the final order may not be reconsidered and it becomes the final agency decision.

History

Statutory Authority: RCW 34.05.020, chapter 34.05 RCW, Parts IV and V, 2002 c 371 § 211. WSR 02-21-061, § 388-02-0620, filed 10/15/02, effective 11/15/02. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0620, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0625 Where does a party send a reconsideration request?

(1) A party must send a written reconsideration request to OAH, if OAH entered the final order, or to BOA, if BOA entered the final order.

(2) After receiving a reconsideration request, OAH or BOA sends a copy to the other parties and representatives giving them time to respond.

History

Statutory Authority: RCW 34.05.020, chapter 34.05 RCW, Parts IV and V, 2002 c 371 § 211. WSR 02-21-061, § 388-02-0625, filed 10/15/02, effective 11/15/02. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0625, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0630 How does a party respond to a reconsideration request?

(1) A party does not have to respond to a request. A response is optional.

(2) If a party responds, that party must send a response to OAH, if OAH entered the final order, or to BOA, if BOA entered the final order, by or before the seventh business day after the date OAH or BOA mailed the request to the party.

(3) A party must send a copy of the response to any other party or representative.

(4) If a party needs more time to respond, OAH or BOA may extend its deadline if the party gives a good reason within the deadline in subsection (2) of this section.

History

Statutory Authority: RCW 34.05.020, chapter 34.05 RCW, Parts IV and V, 2002 c 371 § 211. WSR 02-21-061, § 388-02-0630, filed 10/15/02, effective 11/15/02. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0630, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0635 What happens after a party requests reconsideration?

(1) After OAH or BOA receives a reconsideration request, an ALJ or review judge has twenty calendar days to send a reconsideration decision unless OAH or BOA sends notice allowing more time.

(2) After OAH or BOA receives a reconsideration request, the ALJ or review judge must either:

(a) Write a reconsideration decision; or

(b) Send all parties an order denying the request.

(3) If the ALJ or review judge does not send an order or notice granting more time within twenty days of receipt of the reconsideration request, the request is denied.

History

Statutory Authority: RCW 34.05.020, chapter 34.05 RCW, Parts IV and V, 2002 c 371 § 211. WSR 02-21-061, § 388-02-0635, filed 10/15/02, effective 11/15/02. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0635, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0640 What is judicial review?

(1) Judicial review is the process of appealing a final order to a court.

(2) You may appeal a final order by filing a written petition for judicial review that meets the requirements of RCW 34.05.546. DSHS may not request judicial review.

(3) You must consult RCW 34.05.510 to 34.05.598 for further details of the judicial review process.

History

Statutory Authority: RCW 34.05.020, chapter 34.05 RCW, Parts IV and V, 2002 c 371 § 211. WSR 02-21-061, § 388-02-0640, filed 10/15/02, effective 11/15/02. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0640, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0645 When must you ask for judicial review?

(1) You must file your petition for judicial review with the superior court within thirty calendar days after OAH or BOA mails its final order.

(2) Generally, you may file a petition for judicial review only after you have completed the administrative hearing process. However, you do not need to file a request for reconsideration of a final order before requesting judicial review.

History

Statutory Authority: RCW 34.05.020, chapter 34.05 RCW, Parts IV and V, 2002 c 371 § 211. WSR 02-21-061, § 388-02-0645, filed 10/15/02, effective 11/15/02. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0645, filed 9/1/00, effective 10/2/00.

Wash. Admin. Code § 388-02-0650 How do you serve your petition for judicial review?

(1) You must file and serve the petition for judicial review of a final order within thirty days after the date it was mailed. You must file your petition for judicial review with the court. You must serve copies of your petition on DSHS, the office of the attorney general, and all other parties.

(2) To serve DSHS, you must deliver a copy of the petition to the secretary of DSHS or to BOA. You may hand deliver the petition or send it by mail that gives proof of receipt. The physical location of the secretary is:

DSHS Office of the Secretary

OB-2, 4th Floor

Mail Stop 45010

14th and Jefferson

Olympia, WA 98504-5010

The mailing address of the secretary is:

DSHS Office of the Secretary

P.O. Box 45010

Olympia, WA 98504-5010

The physical and mailing addresses for BOA are in WAC 388-02-0030.

(3) To serve the office of the attorney general and other parties, you may send a copy of the petition for judicial review by regular mail. You may send a petition to the address for the attorney of record to serve a party. You may serve the office of the attorney general by hand delivery to:

Office of the Attorney General

7141 Cleanwater Drive S.W.

Tumwater, Washington 98501

The mailing address of the attorney general is:

Office of the Attorney General

P.O. Box 40124

Olympia WA 98504-0124

History

Statutory Authority: RCW 34.05.220. WSR 06-24-072, § 388-02-0650, filed 12/4/06, effective 1/4/07. Statutory Authority: RCW 34.05.020, chapter 34.05 RCW, Parts IV and V, 2002 c 371 § 211. WSR 02-21-061, § 388-02-0650, filed 10/15/02, effective 11/15/02. Statutory Authority: RCW 34.05.020. WSR 00-18-059, § 388-02-0650, filed 9/1/00, effective 10/2/00.

Chapter 388-03 Certification of DSHS spoken language interpreters, translators, employees, and licensed agency personnel (LAPL).

Wash. Admin. Code § 388-03-010 What is the purpose of these rules?

These rules:

(1) Establish the qualifications for department certified and authorized interpreters, translators, employees, and licensed agency personnel (LAPL); and

(2) Establish the requirements and procedures for administering and evaluating the department's interpreter, translator, employee, and LAPL examinations.

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-010, filed 3/6/15, effective 4/6/15. Statutory Authority: RCW 2.43.010, 74.04.025, and 74.08.090. WSR 00-06-014, § 388-03-010, filed 2/22/00, effective 3/24/00.

Wash. Admin. Code § 388-03-020 What is the scope of these rules?

Except where stated otherwise, these rules apply to any person who:

(1) Seeks employment with the department as a bilingual employee;

(2) Wishes to provide services to the department as a contracted interpreter or translator; or

(3) Works for a nonDSHS county agency/program that contracts with the department to provide services to the department's limited English proficient (LEP) clients, also known as licensed agency personnel (LAPL).

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-020, filed 3/6/15, effective 4/6/15. Statutory Authority: RCW 2.43.010, 74.04.025, and 74.08.090. WSR 00-06-014, § 388-03-020, filed 2/22/00, effective 3/24/00.

Wash. Admin. Code § 388-03-030 What definitions are important to understanding these rules?

The following definitions are important to this chapter:

"Authorized interpreter" means a person who has met the training and language examination requirements for screened languages.

"Certified/authorized bilingual employee" means a department employee who has passed a department bilingual employee examination in either a certified or a screened language.

"Certified interpreter" means a person who has met the training requirements and has passed one or both of the following examinations:

(1) The department's social services interpreter certification examination in a certified language; or

(2) The department's medical interpreter certification examination in a certified language.

"Certified languages for interpreters" means any of the languages listed under certified languages on the official LTC website and in the official LTC examination manual.

"Certified languages for translators" means any of the languages listed under certified languages on the official LTC website and in the official LTC examination manual.

"Certified translator" means a person who has met the training requirements and has passed the department's translator certification examination in a certified language.

"Department" means the department of social and health services (DSHS).

"Employee" means a department bilingual employee whose position requires the use of bilingual skills as part of the job functions.

"Examination manual" means the language testing and certification section's professional language certification examination manual. To obtain a copy of this manual, visit the LTC website.

"Interpretation" means the process of transferring a message orally from one language into another.

"Language access provider" means, pursuant to RCW 41.56.030(10) and solely for the purpose of public employees' collective bargaining, any independent contractor who provides spoken language interpreter services for department of social and health services appointments or medicaid enrollee appointments.

"Language specialist" means a high school or above language instructor who possesses a BA or higher academic degree majoring in language/linguistics studies of any language.

"Language testing and certification (LTC)" means the section within the department that is responsible for managing the bilingual skills testing and certification of employees, LAPL, and contracted interpreters and translators.

"Licensed agency personnel (LAPL)" means an employee of a county government agency/program that contracts with the department to provide services to department clients.

"Limited-English proficient (LEP) client" means a person applying for or receiving department services, either directly or indirectly, who, because of a non-English speaking cultural background, cannot readily speak or understand the English language.

"Medical interpreter" means an interpreter who renders language interpretation services in a health care setting.

"Position cluster" means a group of DSHS jobs/positions that share the same or similar nature of job functions or responsibilities.

"Recognized interpreter" for spoken languages means a person who is certified by:

(1) The Washington state administrative office of the courts (AOC) as a court interpreter; or

(2) The Administrative Office of the United States Courts as a federal court interpreter; or

(3) A national interpreter certification body as a health care interpreter and is recognized by the department; or

(4) A nonprofit organization that uses a credible certification program to certify professional interpreters and is recognized by the department; or

(5) Another state or U.S. territory or another country whose certification program is comparable to DSHS certification and based upon similar requirements.

"Recognized translator" for spoken languages means a person who is certified by:

(1) The American Translators Association (ATA); or

(2) A nonprofit organization that uses a credible certification program to certify professional translators and is recognized by the department; or

(3) Another state or U.S. territory or another country whose certification program is comparable to DSHS certification and based upon similar requirements.

"Screened language" means any spoken language or any dialect within a spoken language that is not one of the certified languages.

"Social service interpreter" means an interpreter who renders language interpretation services in settings where human services programs are provided.

"Source language" means the language from which an interpretation and/or translation is rendered.

"Target language" means the language into which an interpretation and/or translation is rendered.

"Translation" means the process of transferring a written message from one language into another.

History

Statutory Authority: RCW 74.04.025, 74.08.090, 45 C.F.R. Section 80.3 (b)(2), Title VI of the Civil Rights Act of 1964 and Reyes vs. Thompson Consent Order. WSR 15-17-092, § 388-03-030, filed 8/18/15, effective 9/18/15. Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-030, filed 3/6/15, effective 4/6/15. Statutory Authority: RCW 2.43.010, 74.04.025, and 74.08.090. WSR 00-06-014, § 388-03-030, filed 2/22/00, effective 3/24/00.

Wash. Admin. Code § 388-03-050 What is the department's code of professional conduct for interpreters, translators, and LAPL?

The code of conduct is the professional standard established by the department for all interpreters, translators, and LAPL who provide language services to department programs and clients. Any violation of this code may disqualify a provider from providing those services. Specifically, the code addresses:

(1) Accuracy. Interpreters/translators must always express the source language message in a thorough and faithful manner. They must:

(a) Omit or add nothing;

(b) Give consideration to linguistic variations in both the source and target languages; and

(2) Cultural sensitivity-courtesy. Interpreters/translators must be culturally sensitive, and respectful of the individual(s) they serve.

(3) Confidentiality. Interpreters/translators must not divulge any information publicly or privately obtained through their assignments, including, but not limited to, information gained through access to documents or other written materials.

(4) Proficiency. Interpreters/translators must meet the minimum proficiency standard set by DSHS.

(5) Compensation. Interpreters/translators must:

(a) Not accept additional money, consideration, or favors for services reimbursed by the department. The fee schedule agreed to between the contracted language services providers and the department shall be the maximum compensation accepted.

(b) Not use the department's time, facilities, equipment or supplies for private gain or other advantage; and

(6) Nondiscrimination. Interpreters/translators must:

(a) Always be impartial and unbiased;

(b) Not discriminate on the basis of gender, disability, race, color, national origin, age, socio-economic or educational or marital status, religious or political beliefs, or sexual orientation; and

(c) Refuse or withdraw from an assignment, without threat or retaliation, if they are unable to perform the required service in an ethical manner.

(7) Self-representation. Interpreters/translators must accurately and completely represent their certifications, training, and experience.

(8) Impartiality-conflict of interest. Interpreters/translators must disclose to the department any real or perceived conflicts of interest that would affect their professional objectivity. Note: Providing interpreting or translating services to family members or friends may violate the family member or friend's right to confidentiality, constitute a conflict of interest, or violate a DSHS contract or subcontract.

(9) Professional demeanor. Interpreters/translators must be punctual, prepared, and dressed in a manner appropriate, and not distracting for the situation.

(10) Scope of practice. Interpreters/translators must not:

(a) Counsel, refer, give advice, or express personal opinions to the individuals for whom they are interpreting/translating;

(b) Engage in activities with clients that are not directly related to providing interpreting and/or translating services to DSHS;

(c) Have unsupervised access to DSHS clients, including but not limited to phoning clients directly, other than at the request of a DSHS employee;

(d) Market their services to DSHS clients, including but not limited to, arranging services or appointments for DSHS clients in order to create business for themselves; or

(e) Transport DSHS clients for any business, including social service or medical appointments.

(11) Reporting obstacles to practice. Interpreters/translators must assess at all times their ability to interpret/translate.

(a) Interpreters/translators must immediately notify the parties if they have any reservations about their competency or ability to remain impartial and offer to withdraw without threat or retaliation;

(b) Interpreters/translators must immediately withdraw from encounters they perceive as a violation of this code.

(12) Professional development. As specified in WAC 388-03-160, interpreters/translators are expected to continually develop their skills and knowledge through:

(a) Professional interpreter/translator training;

(b) Continuing education; and

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-050, filed 3/6/15, effective 4/6/15. Statutory Authority: RCW 2.43.010, 74.04.025, and 74.08.090. WSR 00-06-014, § 388-03-050, filed 2/22/00, effective 3/24/00.

Wash. Admin. Code § 388-03-060 What is the responsibility of the language testing and certification (LTC) section in certifying and authorizing interpreters, translators, employees, and LAPL?

Language testing and certification (LTC) is the section within DSHS responsible for:

(1) Establishing and publishing systems, methods, and procedures for certifying, screening and/or evaluating the interpretation and/or translation skills of employees, LAPL, interpreters and translators who work with department clients, employees, and service providers;

(2) Ensuring that certified/authorized interpreters, translators, employees, and LAPL are aware of DSHS's code of professional conduct for interpreters, translators, and LAPL;

(3) Overseeing that the test development process is empirically sound, the test instruments are valid and reliable, and the test administration procedures and test evaluation criteria are consistent with the standards established by the department;

(4) Coordinating and managing precertification/authorization training requirements, postcertification/authorization continuing education requirements, and coordinating the decertification process for interpreters/translators; and

(5) Maintaining the online interpreter database for public access.

History

Statutory Authority: RCW 74.04.025, 74.08.090, 45 C.F.R. Section 80.3 (b)(2), Title VI of the Civil Rights Act of 1964 and Reyes vs. Thompson Consent Order. WSR 15-17-092, § 388-03-060, filed 8/18/15, effective 9/18/15. Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-060, filed 3/6/15, effective 4/6/15. Statutory Authority: RCW 2.43.010, 74.04.025, and 74.08.090. WSR 00-06-014, § 388-03-060, filed 2/22/00, effective 3/24/00.

Wash. Admin. Code § 388-03-110 What requirements apply to persons providing language services to DSHS clients?

(1) Any department staff member serving in a bilingual capacity must pass a bilingual skills examination.

(2) Any candidate seeking employment with the department in a position that requires bilingual skills must pass a bilingual skills examination.

(3) Any employee of a non-DSHS county agency/program that contracts with the department to provide services to the department's limited English proficient (LEP) clients (also known as licensed agency personnel) must pass a bilingual skills examination.

(4) Any candidate wishing to provide language services to the department's LEP clients as a contracted interpreter or translator must meet the training requirements and pass a bilingual skills examination.

(5) Interpreters can be certified or authorized by the department as:

(a) Social services interpreters; and/or

(b) Medical interpreters.

(6) Translators can be certified by the department in any of the certified languages.

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-110, filed 3/6/15, effective 4/6/15. Statutory Authority: RCW 2.43.010, 74.04.025, and 74.08.090. WSR 00-06-014, § 388-03-110, filed 2/22/00, effective 3/24/00.

Wash. Admin. Code § 388-03-112 When am I considered certified or authorized?

(1) For department employees, candidates for bilingual positions, and LAPL, you are considered certified or authorized once you have passed the required bilingual skills examination for your position cluster. Information regarding position clusters and their respective required examination can be found on the DSHS HRD website.

(2) For medical and social service interpreters in certified languages, you are considered certified once you have taken the required two-hour minimum DSHS interpreter/translator orientation training in the medical field for medical interpreters and/or in the social service field for social service interpreters and the required two-hour minimum interpreter/translator professional ethics training, and you have passed the required written and oral examination for interpreters. If you pass the required examination before you complete the required trainings, your certificate will not be issued to you until you complete the required trainings.

(3) For medical and social service interpreters in screened languages, you are considered authorized once you have taken the required two-hour minimum DSHS interpreter/translator orientation training in the medical field for medical interpreters and/or in the social service field for social service interpreters and the required two-hour minimum interpreter/translator professional ethics training, and you have passed the required written and oral examination. Instead of a certificate, an authorization letter will be issued to you. If you pass the required examination before you complete the required trainings, your authorization letter will not be issued to you until you complete the required trainings.

(4) For document translators in certified languages, you are considered certified once you have taken the required two-hour minimum DSHS interpreter/translator orientation training in the social service field and the required two-hour minimum interpreter/translator professional ethics training, and you have passed the required document translation examination for translators. If you pass the required examination before you complete the required trainings, your certificate will not be issued to you until you complete the required trainings.

(5) Your certificate/authorization letter will be mailed to you within a month from the date you complete your required trainings and pass all examination requirements, whichever is later. It is your responsibility to:

(a) Check the accuracy of the information presented on your certificate/authorization letter;

(b) Inform the LTC section of any change of your name, phone number, email address, or mailing address;

(d) Contact the LTC section if your certificate/authorization letter is not received within the normal time frame.

(6) Your certification/authorization status may be denied/revoked if it is proven that you have committed any of the acts listed in WAC 388-03-170.

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-112, filed 3/6/15, effective 4/6/15. Statutory Authority: RCW 2.43.010, 74.04.025, and 74.08.090. WSR 00-06-014, § 388-03-112, filed 2/22/00, effective 3/24/00.

Wash. Admin. Code § 388-03-114 Can I provide language services to DSHS without taking a department examination?

There are five ways that you may gain department recognition as an interpreter or translator without taking the department's certification examinations.

(1) If you are certified as an interpreter by either the Washington state administrative office of the courts or the Administrative Office of the United States Courts, the department will recognize you as a social services interpreter without requiring you to take its social service interpreter examination. However, you must formally submit a written request for recognition, a photocopy of your valid official certificate, and a copy of official record attesting to your completion of the required minimum DSHS interpreter/translator orientation and interpreter/translator professional ethics trainings to the entity you contract with for your language services.

(2) If you are certified as an interpreter by either the Certification Commission for Healthcare Interpreters (CCHI) or the National Board of Certification for the Medical Interpreters (NBCMI), the department will recognize you as a medical interpreter without requiring you to take its medical interpreter examination. However, you must formally submit a written request for recognition, a photocopy of your valid official certificate, and a copy of official record attesting to your completion of the required minimum DSHS interpreter/translator orientation and interpreter/translator professional ethics trainings to the entity you contract with for your language services.

(3) If you are certified as a translator by the American Translators Association (ATA), the department will recognize you as a translator without requiring you to take its translator examination. However, you must formally submit a written request for recognition, a photocopy of your valid official certificate, and a copy of official record attesting to your completion of the required minimum DSHS interpreter/translator orientation and interpreter/translator professional ethics trainings to the entity you contract with for your language services.

(4) If you are certified as an interpreter or translator by another state or U.S. territory or another country that is comparable to DSHS certification and based upon similar requirements, the department may recognize your certification. In your written request for DSHS recognition, you must submit a photocopy of your valid official certificate and a copy of the official examination manual containing descriptions of the test development process, the scope of the examination, the knowledge and skills to be evaluated, the test validation approach and related statistics, the evaluation criteria, and the passing benchmark. Your request must be submitted to LTC. LTC will evaluate all requests on a case-by-case basis. If LTC determines that your certification meets DSHS certification requirements, a recognition letter will be issued to you, which you will submit with your written request and a copy of your valid official certificate, and a copy of the official record attesting to your completion of the required minimum DSHS interpreter/translator orientation and interpreter/translator professional ethics trainings to the entity you contract with for your language services.

(5) If you are certified as an interpreter or translator by a nonprofit organization that uses a credible certification program and is recognized by the department, the department may recognize your certification. In your written request for DSHS recognition, you must submit a photocopy of your valid official certificate and a copy of the official examination manual containing descriptions of the test development process, the scope of the examination, the knowledge and skills to be evaluated, the test validation approach and related statistics, the evaluation criteria, and the passing benchmark. Your request must be submitted to LTC. LTC will evaluate all requests on a case-by-case basis. If LTC determines that your certification meets DSHS certification requirements, a recognition letter will be issued to you, which you will submit with your written request and a copy of your valid official certificate, and a copy of official record attesting to your completion of the required minimum DSHS interpreter/translator orientation and interpreter/translator professional ethics trainings to the entity you contract with for your language services.

(6) DSHS does not recognize any academic interpreter/translator degrees/certificates or training courses as substitutes for its certification/authorization examination requirements.

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, 45 C.F.R. Section 80.3 (b)(2), and Reyes vs. Thompson Consent Order. WSR 16-04-021, § 388-03-114, filed 1/22/16, effective 2/22/16. Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-114, filed 3/6/15, effective 4/6/15. Statutory Authority: RCW 2.43.010, 74.04.025, and 74.08.090. WSR 00-06-014, § 388-03-114, filed 2/22/00, effective 3/24/00.

Wash. Admin. Code § 388-03-115 Who determines if my request for examination exemption is "sufficiently documented"?

The department determines if your request is sufficiently documented (except for WAC 388-03-114 (1), (2) and (3)). It may request further proof of your qualification. In all cases, the department's decision regarding the sufficiency of your documentation is final.

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-115, filed 3/6/15, effective 4/6/15. Statutory Authority: RCW 2.43.010, 74.04.025, and 74.08.090. WSR 00-06-014, § 388-03-115, filed 2/22/00, effective 3/24/00.

Wash. Admin. Code § 388-03-116 What if my certification documents are in a foreign language?

(1) All documents submitted to LTC in a foreign language must be accompanied by an accurate translation into English by a qualified translator other than the holder of the certificate.

(2) Each translated document must bear the affidavit of the translator, sworn to before a notary public, certifying that the:

(a) Translator is competent in both the language of the document and the English language; and

(b) Translation is an accurate and complete translation of the foreign language original.

(3) Applicants must pay all costs related to translating any documents relevant to their request for department recognition.

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-116, filed 3/6/15, effective 4/6/15. Statutory Authority: RCW 2.43.010, 74.04.025, and 74.08.090. WSR 00-06-014, § 388-03-116, filed 2/22/00, effective 3/24/00.

Wash. Admin. Code § 388-03-117 What happens to my request for department recognition as an interpreter/translator?

When LTC receives your written request for recognition and the required documentation of your qualification, it will:

(1) Process your request as expeditiously as possible; and

(2) If approved, issue you a letter of recognition; or

(3) If not approved, issue you a letter explaining the reason why your request was not approved.

(4) These procedures do not apply to WAC 388-03-114 (1), (2) and (3).

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-117, filed 3/6/15, effective 4/6/15. Statutory Authority: RCW 2.43.010, 74.04.025, and 74.08.090. WSR 00-06-014, § 388-03-117, filed 2/22/00, effective 3/24/00.

Wash. Admin. Code § 388-03-118 Does the department maintain lists of certified/authorized interpreters and translators?

(1) To enable contracted agencies and department programs to locate and contact certified and/or authorized interpreters and translators, the department maintains lists of certified interpreters, certified translators, and authorized interpreters.

(2) These lists are published and updated regularly to include newly certified and authorized interpreters/translators.

(3) Any interpreter or translator who considers certain information on the list to be confidential, such as physical address and telephone numbers, can request to have such information removed. The request must be made in writing and you must mail or email it to LTC. However, LTC will provide details regarding interpreters to the extent required by RCW 41.56.510(4).

(4) Only contracted interpreters and translators are included for online search.

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-118, filed 3/6/15, effective 4/6/15. Statutory Authority: RCW 2.43.010, 74.04.025, and 74.08.090. WSR 00-06-014, § 388-03-118, filed 2/22/00, effective 3/24/00.

Wash. Admin. Code § 388-03-120 Who can take the department's interpreter/translator certification and screening examinations?

(1) You are eligible to take any DSHS interpreter/translator certification or screening examination if you are eighteen years of age or older with a high school diploma (or GED) or higher academic degree(s), or its equivalent from another country, and:

(a) Currently employed by DSHS in a bilingual position; or

(b) Selected for an interview for a DSHS position with bilingual requirements; or

(d) Wishing to work through contracted agencies as a social service and/or medical interpreter, or a translator.

(2) Screening tests will not substitute for or be substituted by any certified language tests.

(3) LTC provides reasonable accommodations for individuals who have one or more documented disabilities within the meaning of the Americans with Disabilities Act (ADA) of 1990 and/or Washington's law against discrimination (WLAD). If you have a documented disability covered under the ADA and/or WLAD and require test accommodations, you must:

(a) Submit a copy of a qualified medical professional's statement specifying your disability and the specific accommodation required in completing a paper-and-pencil written test and an oral test using audio materials; and

(b) In the special instructions box of the test sign-up form, specify your special needs such as special equipment or the amount of extra time required in completing any of the tests. LTC will request and verify supporting documents for your special accommodation. The appointment date and time you selected through online scheduling may need to be adjusted or rescheduled depending on what is required to accommodate your situation.

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-120, filed 3/6/15, effective 4/6/15. Statutory Authority: RCW 2.43.010, 74.04.025, and 74.08.090. WSR 00-06-014, § 388-03-120, filed 2/22/00, effective 3/24/00.

Wash. Admin. Code § 388-03-122 What type of test is given by the department to certify and authorize persons providing language services to DSHS clients?

(1) Certification examinations evaluate bilingual proficiency and interpretation/translation skills by comparing your proficiency and skills to minimum competency standards.

(2) Minimum competency standards are determined by the nature of the work involved and by experienced practicing interpreters/translators, bilingual professionals, and language specialists.

(3) Five different types of tests are used to evaluate the bilingual proficiency and interpretation/translation skills of the following categories of people:

(a) Department employees and employment candidates with bilingual assignments (employee test);

(b) Social services interpreters providing oral interpretation services to department social service programs (social services interpreter test);

(d) Medical interpreters providing interpretation services to department clients in medical settings (medical interpreter test); and

(e) Licensed agency personnel (LAPL) whose agency is providing contracted services to the department (LAPL test).

(4) For a list of the specific types of examinations and languages tested (and other important testing information), see the most recent edition of the "professional language certification examination manual" published on the LTC website.

(5) Examinations for interpreters include written and oral components. To satisfy testing requirements, an interpreter must pass both the written and oral test components.

(6) Examinations for DSHS bilingual positions and LAPL usually include written and oral components and these can be taken on the same day if the test schedule allows it.

(7) Examinations for translators include only a written document translation component.

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-122, filed 3/6/15, effective 4/6/15. Statutory Authority: RCW 2.43.010, 74.04.025, and 74.08.090. WSR 00-06-014, § 388-03-122, filed 2/22/00, effective 3/24/00.

Wash. Admin. Code § 388-03-123 What is a screening examination?

(1) A screening examination is an examination administered by the department to candidates who wish to become "authorized interpreters." Authorized interpreters are individuals who speak a language or a dialect within a language that is not one of the certified languages.

(2) The scope of a screening examination is narrower than that of a certified language examination. Screening examinations assess a candidate's English and target language skills but the broader, more comprehensive type of assessment used for certified languages examination is not possible due to limited department resources.

(3) Screening examinations are available for social services interpreters and medical interpreters.

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-123, filed 3/6/15, effective 4/6/15. Statutory Authority: RCW 2.43.010, 74.04.025, and 74.08.090. WSR 00-06-014, § 388-03-123, filed 2/22/00, effective 3/24/00.

Wash. Admin. Code § 388-03-125 How do I register for a certification or screening examination if I am not a department employee or an applicant for a bilingual position with the department?

You must do the following:

(1) Read the examination manual and other related information on the LTC website. The LTC website can be accessed from any private or public computer with internet access.

(2) Follow the instructions on the LTC website to register for a test of your choice online. You need to have a valid email address and a valid credit card or debit card to register for a test.

(3) You will receive an email appointment confirmation instantaneously after you complete the online test registration process. You can access the pretest study package from the LTC website. If you did not receive your test confirmation email a few minutes after you completed the registration process, it is your responsibility to contact the LTC office.

(4) If you are only registering for the oral test or registering to retake a test, you do not need to call the LTC office. Simply follow the steps in subsections (2) and (3) of this section.

(5) Walk-in registration at a test site is not allowed under any circumstances.

(6) Telephone registration is allowed only for department employees, applicants for department bilingual positions, and LAPL.

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-125, filed 3/6/15, effective 4/6/15. Statutory Authority: RCW 2.43.010, 74.04.025, and 74.08.090. WSR 00-06-014, § 388-03-125, filed 2/22/00, effective 3/24/00.

Wash. Admin. Code § 388-03-126 What does the pretest package contain?

The pretest study package contains a study guide that includes sample test questions, sample oral exercises, a list of important terminology and the department's code of professional conduct.

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-126, filed 3/6/15, effective 4/6/15. Statutory Authority: RCW 2.43.010, 74.04.025, and 74.08.090. WSR 00-06-014, § 388-03-126, filed 2/22/00, effective 3/24/00.

Wash. Admin. Code § 388-03-130 What examination fees must I pay?

Examination fees are listed in the examination manual on the LTC website.

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-130, filed 3/6/15, effective 4/6/15. Statutory Authority: RCW 2.43.010, 74.04.025, and 74.08.090. WSR 00-06-014, § 388-03-130, filed 2/22/00, effective 3/24/00.

Wash. Admin. Code § 388-03-132 How do I pay my examination fees?

You may pay your examination fees with a credit card or debit card when you register from the LTC website.

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-132, filed 3/6/15, effective 4/6/15. Statutory Authority: RCW 2.43.010, 74.04.025, and 74.08.090. WSR 00-06-014, § 388-03-132, filed 2/22/00, effective 3/24/00.

Wash. Admin. Code § 388-03-133 Are my examination fees refundable?

(1) Examination fees are nonrefundable except in the following circumstances:

(a) If an applicant dies before taking the examination, their examination fees are refundable to their estate; or

(b) If you officially move out of Washington state before taking the examination, your examination fees can be refunded to you upon request.

(2) If you fail to attend your confirmed test session(s) because of an emergency, your test session(s) may be rescheduled upon request but your test fee will not be refunded. Rescheduling due to an emergency will be done only once and only if the emergency is properly documented. Examples of proper documentation include an official police report or a signed physician statement.

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-133, filed 3/6/15, effective 4/6/15. Statutory Authority: RCW 2.43.010, 74.04.025, and 74.08.090. WSR 00-06-014, § 388-03-133, filed 2/22/00, effective 3/24/00.

Wash. Admin. Code § 388-03-135 Where are the test locations and how frequent are the test sessions?

(1) Normally, testing for all languages is conducted in eastern and western Washington. The number of test locations and the frequency of test sessions are determined on the basis of budgetary allotment for the testing program and varying language needs of the department.

(2) Test locations can change because of scheduling factors and varying demand for testing services. Carefully read your test confirmation letter because it contains specific information on test date, test time, and test location. Current test locations and driving directions to test locations are always published on the LTC website.

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-135, filed 3/6/15, effective 4/6/15. Statutory Authority: RCW 2.43.010, 74.04.025, and 74.08.090. WSR 00-06-014, § 388-03-135, filed 2/22/00, effective 3/24/00.

Wash. Admin. Code § 388-03-136 Can I change my test appointment date and time?

(1) You may request a change in your test appointment date and time only if the request is made within ten calendar days from the date your confirmation letter is sent, otherwise LTC considers your test appointment "confirmed" and your examination fees will not be refunded.

(2) Except in bona fide emergency situations (see WAC 388-03-133(2)), you will not be allowed to reschedule your appointment free of charge if you fail to attend your confirmed test appointment. If you miss your confirmed test appointment for reasons other than an emergency, you may schedule another appointment date and time by paying the appropriate examination fee.

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-136, filed 3/6/15, effective 4/6/15.

Wash. Admin. Code § 388-03-138 What procedural requirements apply to administering certification and screening examinations?

(1) The department has a "no-comment, no-return" examination policy. Once an examination is given, it becomes the property of the department and it will not be released to anyone, including test candidates. Such property includes the test booklet, answer sheets, oral test recordings, test grading sheets, and notes taken by the candidate.

(2) The department will not discuss specific examination content, including specific test questions or answers, with test candidates or any other party. Candidates can receive general critiques of their oral test performance if they submit a written request. Generic critiques of written test performance are not available except for the employee test.

(3) Passing scores for the different examinations are established by the department based on bilingual fluency required by law, testing technicalities and the language needs of the department. Test scores will only be reported to candidates in writing. No score information will be released over the telephone to anyone, including the test candidate.

(4) All interpreter and translator candidates must follow test instructions. Failure to follow test instructions may result in an invalid test. Invalid tests will not be scored and, therefore, no test results will be reported to the candidate.

(5) If a candidate arrives late for the written test but decides to proceed with taking the test, the candidate will take the test during the remaining time allowed. The lost time resulting from their late arrival will not be made up in additional testing time.

(6) If a candidate arrives late for an oral test, they may lose their confirmed time slot. A lost time slot resulting from a late arrival will not be made up.

(7) Tests will not be rescheduled because a candidate arrives late at a testing site except in the case of a bona fide emergency. If you are too late to take the test for some reason other than an emergency, you may register for another examination by paying another test fee.

(8) No electronic devices such as laptops, tablets, electronic dictionaries, smart phones, cell phones are allowed during the written and oral test.

(9) No reference materials of any kind will be allowed during the written and oral tests. However, hard copy dictionaries are allowed for the document translator examination.

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-138, filed 3/6/15, effective 4/6/15. Statutory Authority: RCW 2.43.010, 74.04.025, and 74.08.090. WSR 00-06-014, § 388-03-138, filed 2/22/00, effective 3/24/00.

Wash. Admin. Code § 388-03-140 What if a test candidate is suspected of cheating?

If a test administrator concludes with reasonable evidence that a candidate cheated during an examination, the accused candidate may be declared ineligible indefinitely for all interpreter and translator certification/ authorization tests administered by the department. The candidate will be notified in writing about the department's decision.

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-140, filed 3/6/15, effective 4/6/15. Statutory Authority: RCW 2.43.010, 74.04.025, and 74.08.090. WSR 00-06-014, § 388-03-140, filed 2/22/00, effective 3/24/00.

Wash. Admin. Code § 388-03-142 Can I appeal the decision about my ineligibility to take any DSHS test because of cheating?

If you are notified that you are ineligible to take any DSHS test because of cheating, you have the right to appeal the decision by using the adjudicative proceeding process in chapters 34.05 RCW and 388-02 WAC.

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-142, filed 3/6/15, effective 4/6/15.

Wash. Admin. Code § 388-03-144 How do I request an adjudicative hearing about the department's decision to declare me ineligible due to cheating?

To request an adjudicative hearing, you must:

(1) File a written application for hearing with the department's board of appeals within twenty-one days of receiving the department's decision to deny you from taking any DSHS test.

(2) Your written application must include:

(a) A copy of the decision that you are contesting;

(b) A specific statement of the issue(s) and the law involved; and

(3) Your written application for hearing must be delivered to the board of appeals in person, electronically by fax or by certified mail. (See WAC 388-02-0030.)

(4) Once the board of appeals receives your written application, an adjudicative hearing will be scheduled.

(5) The adjudicative hearing will be governed by the provisions of chapters 34.05 RCW and 388-02 WAC.

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-144, filed 3/6/15, effective 4/6/15.

Wash. Admin. Code § 388-03-150 How does the department score my bilingual examinations?

(1) Depending on the nature of the test or test section, the department uses either an objective or a holistic scoring method to evaluate your examination.

(2) Please consult the examination manual for the evaluation indicators used by the department for each test or subtest.

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008 , § 388-03-150, filed 3/6/15, effective 4/6/15. Statutory Authority: RCW 2.43.010, 74.04.025, and 74.08.090. WSR 00-06-014, § 388-03-150, filed 2/22/00, effective 3/24/00.

Wash. Admin. Code § 388-03-152 When does the department mail my test scores?

Score report letters will be sent to candidates when they finish either portion (written or oral) of the test:

(1) For an interpreter written test, your scores should be available within two to four weeks from the date you took the examination.

(2) For an interpreter, employee, or LAPL oral test, your scores should be available within four to six weeks from the date you took the examination.

(3) For an employee or LAPL written test and a document translator test, your scores should be available within four to six weeks from the date you took the examination.

(4) If you wish your test scores mailed to a specific organization or individual, you must personally notify the department in writing (signature required) and provide the name and mailing address of the organization or individual to whom your score should be sent.

(5) If you do not receive your score report letter within the suggested time period, you should contact LTC via email. The LTC email address can be found on the LTC website.

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-152, filed 3/6/15, effective 4/6/15. Statutory Authority: RCW 2.43.010, 74.04.025, and 74.08.090. WSR 00-06-014, § 388-03-152, filed 2/22/00, effective 3/24/00.

Wash. Admin. Code § 388-03-153 I have passed my interpreter written test. How long is my written test score valid before I take my oral test?

If passed, your written test score is valid for two years from the date of your score report letter. If it has been more than two years since you passed your interpreter written test, you need to retake the written test and pass it before it can be applied toward your certification/authorization status.

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-153, filed 3/6/15, effective 4/6/15.

Wash. Admin. Code § 388-03-154 Can I appeal my test scores?

You have two months, from the date your test score letter is sent, to appeal your test score. Note:

(1) Your appeal must be submitted to the department's LTC program manager in writing.

(2) Your appeal will not be honored if it is filed beyond the two-month appeal period.

(3) You will not be allowed to reschedule an examination while your score is being appealed.

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-154, filed 3/6/15, effective 4/6/15. Statutory Authority: RCW 2.43.010, 74.04.025, and 74.08.090. WSR 00-06-014, § 388-03-154, filed 2/22/00, effective 3/24/00.

Wash. Admin. Code § 388-03-156 How many times can I retake a failed test?

You can retake a failed examination until you pass it. Each time you retake the test you must pay an examination fee (except for DSHS bilingual staff tests).

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-156, filed 3/6/15, effective 4/6/15. Statutory Authority: RCW 2.43.010, 74.04.025, and 74.08.090. WSR 00-06-014, § 388-03-156, filed 2/22/00, effective 3/24/00.

Wash. Admin. Code § 388-03-160 How do I maintain my certification or authorization status?

(1) If you have been certified or authorized as a department bilingual employee or LAPL, your status does not expire as long as you remain in a designated bilingual position within the position cluster for which you were certified/authorized. Otherwise:

(a) If you moved out of a designated bilingual position and do not use your bilingual skills for four consecutive years or longer, you need to retest for the position cluster you are reentering; or

(b) If you are moving into a new designated bilingual position within a new position cluster, you need to meet the test requirements for the position cluster you are entering.

(2) If you have been certified or authorized as an interpreter or translator and are not a department employee, you can maintain your certification or authorization status by:

(a) Earning a minimum of twenty credit hours of DSHS approved continuing education (CE) every four years, of which at least one credit hour per year must be in ethics training. A current list of DSHS recognized continuing education and/or professional development courses is published on the LTC website; or

(b) Retake the examination within four years from the date you were certified/authorized if you do not earn a minimum of twenty credit hours of DSHS recognized continuing education during this time frame. Once you pass all test requirements, a new certificate or authorization letter will be issued to you with a new expiration date. Your name and contact information will then be included for publication.

(c) Continuing education credits (CEC) earned before January 1, 2015 will not be accepted, even if the CEC were DSHS approved.

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, 45 C.F.R. Section 80.3 (b)(2), and Reyes vs. Thompson Consent Order. WSR 16-04-021, § 388-03-160, filed 1/22/16, effective 2/22/16. Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-160, filed 3/6/15, effective 4/6/15.

Wash. Admin. Code § 388-03-162 How does the department keep track of my continuing education credit hours?

Before your certification or authorization status expires, you need to submit proof of your CE credit hours, a signed oath to abide by the code of conduct, and a criminal background check by following the procedures on the LTC website. You should only report DSHS approved CE credits. The information you submit will be verified before it is recorded in determining the renewal of your certification or authorization status. Once renewed, a new certificate or authorization letter will be issued to you with a new expiration date. Your name and contact information will then be included for publication.

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-162, filed 3/6/15, effective 4/6/15.

Wash. Admin. Code § 388-03-164 What happens if I do not meet the requirements for maintaining my certification or authorization status?

If you do not meet the requirements as specified under WAC 388-03-160, your certification or authorization status will expire after the expiration date on your certificate or authorization letter. Your name will be removed from the list of certified or authorized interpreters/translators. Once your certification or authorization status has expired, you must meet all requirements specified under WAC 388-03-112 before it can be renewed.

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-164, filed 3/6/15, effective 4/6/15.

Wash. Admin. Code § 388-03-166 What about certificates/authorization letters issued prior to the effective date of the revised chapter 388-03 WAC?

WAC 388-03-160 applies to all certified/authorized/recognized interpreters/translators, regardless of when their certificates/authorization letters were issued. The expiration date for certificates/authorization letters is four years from the effective date of the revised chapter 388-03 WAC if the requirement of WAC 388-03-160 is not met.

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-166, filed 3/6/15, effective 4/6/15.

Wash. Admin. Code § 388-03-170 Can the department deny or revoke my certification or authorization status?

Except for current DSHS employees in designated bilingual positions, the department may deny or revoke either your certification or authorization status if it determines that you committed any of the following acts:

(1) You have not been truthful when dealing with the department; or

(2) You have violated any provision of the department's code of professional conduct that is determined to be creating major negative impacts on the department or the profession; or

(3) You have committed any act that constitutes a felony or misdemeanor related to your language service assignments; or

(4) You have committed any fraud, dishonesty, or corruption related to your language service assignments; or

(5) You continued to violate any provision of the department's code of professional conduct after receipt of notification to discontinue; or

(6) You continued to falsely or deceptively advertise your language service after receipt of notification to discontinue; or

(7) It is determined that you are grossly incompetent as a language access provider.

In making this determination, the department will consider the investigation findings by the authorized entity, or the entity that contracts with you.

Alternatively, if the department determines that you engaged in misconduct but that the misconduct is not one of the acts described above, the department will alert you to your misconduct and notify you to discontinue such misconduct.

Once you have been decertified/deauthorized due to any of the proven acts listed above, you will be ineligible indefinitely for recertification/reauthorization.

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-170, filed 3/6/15, effective 4/6/15. Statutory Authority: RCW 2.43.010, 74.04.025, and 74.08.090. WSR 00-06-014, § 388-03-170, filed 2/22/00, effective 3/24/00.

Wash. Admin. Code § 388-03-171 Can the department deny or revoke my certification or authorization status as a department bilingual employee?

The DSHS human resources division (HRD) will address issues of bilingual employees through agency administrative policy or applicable collective bargaining agreements.

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-171, filed 3/6/15, effective 4/6/15.

Wash. Admin. Code § 388-03-172 What procedures must the department follow if it denies or revokes my certification or authorization status?

Except for current DSHS employees in designated bilingual positions, if it is alleged that you have committed any of the acts listed in WAC 388-03-170, before denying or revoking your certification or authorization status, the department must:

(1) Have received an official request from the entity that contracts with you to have your certification/authorization status revoked;

(2) Have received the findings of the investigation conducted by the authorized entity or the entity that contracts with you. You must be interviewed as part of the investigation process. The findings of the investigation must include definite conclusions about the alleged violation(s);

(3) Within thirty days of receiving the official revocation request and investigation findings, send you written notification regarding the final decision of your certification or authorization status. The department's notification must be sent to you by certified mail; and

(4) Remove your name from the department's database and the published online searchable list of certified/authorized interpreters/translators, if your certification/authorization status has been revoked.

(5) If a revocation request is made by a third party while the investigation of an allegation described in subsection (2) of this section is not readily feasible, the department retains the right and authority to preliminarily deny or revoke a certification or authorization status pending completion of the investigation.

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-172, filed 3/6/15, effective 4/6/15. Statutory Authority: RCW 2.43.010, 74.04.025, and 74.08.090. WSR 00-06-014, § 388-03-172, filed 2/22/00, effective 3/24/00.

Wash. Admin. Code § 388-03-173 What is the required time frame to file a revocation request?

Any request for revocation must be officially filed with LTC within two years of the alleged occurrence of misconduct. Otherwise, the request shall be dismissed as untimely.

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-173, filed 3/6/15, effective 4/6/15.

Wash. Admin. Code § 388-03-174 Can I appeal the decision to deny or revoke my certification or authorization?

If your certification or authorization is denied or revoked, you have the right to appeal the decision by using the adjudicative proceeding process in chapters 34.05 RCW and 388-02 WAC.

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-174, filed 3/6/15, effective 4/6/15. Statutory Authority: RCW 2.43.010, 74.04.025, and 74.08.090. WSR 00-06-014, § 388-03-174, filed 2/22/00, effective 3/24/00.

Wash. Admin. Code § 388-03-176 How do I request an adjudicative hearing?

To request an adjudicative hearing, you must:

(1) File a written application for hearing with the department's board of appeals within twenty-one days of receiving the department's decision to deny or revoke your certification or authorization.

(2) Your written application must include:

(a) A copy of the decision that you are contesting; and

(b) A specific statement of the issue(s) and the law involved; and

(3) Your written application for hearing must be delivered to the board of appeals in person, electronically by fax or by certified mail. (See WAC 388-02-0030.)

(4) Once the board of appeals receives your written application, an adjudicative hearing will be scheduled.

(5) The adjudicative hearing will be governed by the provisions of chapters 34.05 RCW and 388-02 WAC.

History

Statutory Authority: RCW 74.04.025, 74.08.090, Title VI of the Civil Rights Act of 1964, and 45 C.F.R. Section 80.3 (b)(2). WSR 15-07-008, § 388-03-176, filed 3/6/15, effective 4/6/15. Statutory Authority: RCW 2.43.010, 74.04.025, and 74.08.090. WSR 00-06-014, § 388-03-176, filed 2/22/00, effective 3/24/00.

Chapter 388-04 Protection of human research subjects.

Wash. Admin. Code § 388-04-010 Purpose.

The purpose of this chapter shall be to establish rules implementing the department's policy for the protection of departmental wards, clients, and employees who serve as human subjects in research and related activities. These rules do not supersede or limit the applicability of other state and federal laws and regulations. For example, see Title 45, Part 46 of the Code of Federal Regulations.

History

WSR 99-15-021, recodified as § 388-04-010, filed 7/12/99, effective 7/12/99. Statutory Authority: RCW 43.20A.550. WSR 81-17-022 (Order 1687), § 388-10-010, filed 8/12/81.

Wash. Admin. Code § 388-04-020 Definitions.

(1) "Research" means a systematic investigation designed to develop or contribute to generalizable knowledge. Activities which meet this definition constitute "research" for purposes of these rules, whether or not they are supported or conducted under this label.

(2) "Related activities" means demonstration, service, development, and other projects that contain a research component.

(3) "Human subject" means a person about whom an investigator (whether professional or student) conducting research obtains data (a) through intervention or interaction with the person, (b) through observation of the person's behavior, or (c) from personal records and other private information sources.

History

WSR 99-15-021, recodified as § 388-04-020, filed 7/12/99, effective 7/12/99. Statutory Authority: RCW 43.20A.550. WSR 81-17-022 (Order 1687), § 388-10-020, filed 8/12/81.

Wash. Admin. Code § 388-04-030 Statement of policy.

(1) No service unit or administrative unit within the department's jurisdiction shall allow, or shall participate in, the conduct of research and related activities unless the plans or protocols for such activities have been reviewed and approved by the department of social and health services human research review board or have been specifically exempted from this review requirement by published departmental guidelines.

(2) It is the intent of the department's human subjects protection policy that review of research and related activities by the review board determine that the rights and welfare of clients, wards, and employees are adequately protected; that risks to individuals are minimized, are not unreasonable and are outweighed by the potential benefits to them or by the knowledge to be gained; and that the proposed project design and methods are adequate and appropriate in the light of stated project purposes.

History

WSR 99-15-021, recodified as § 388-04-030, filed 7/12/99, effective 7/12/99. Statutory Authority: RCW 43.20A.550. WSR 81-17-022 (Order 1687), § 388-10-030, filed 8/12/81.

Wash. Admin. Code § 388-04-040 Implementation.

(1) The department shall maintain a human research review board which shall have primary responsibility for the ethical and technical review of the use of human subjects in research and related projects conducted within the department's jurisdiction. Unfavorable review dispositions by this review board, including disapproval of proposed research, research restrictions, or special approval conditions, cannot, by federal regulation (45 C.F.R. 46.112) be removed except by the review board. Favorable review decisions by the board shall be subject to review and concurrence by appropriate departmental officials.

(2) To assure continued protection of human subjects in on-going research at the activity site, departmental service units involved in a significant number of research and related activities shall establish their own research oversight committees. These local committees shall function as extensions of the human research review board. They shall be responsible for providing ethical and procedural oversight in accordance with the review board's directions.

(3) Review of proposals requiring professional competencies beyond those represented on the human research review board shall require prior and written review consultation with at least four research experts who are competent to judge the scientific merit, benefits, and risks of the proposed research.

History

WSR 99-15-021, recodified as § 388-04-040, filed 7/12/99, effective 7/12/99. Statutory Authority: RCW 43.20A.550. WSR 81-17-022 (Order 1687), § 388-10-040, filed 8/12/81.

Wash. Admin. Code § 388-04-050 General applicability.

The department's human research review rules shall apply to all organizational units of the department. They shall apply to all research and related activities that involve departmental clients, wards, or employees as human subjects or that require disclosure of their personal records, regardless of funding source, and regardless of whether the research is conducted by a departmental employee or by a nondepartmental investigator. The rules shall apply to all research and related activities subcontracted by the department under state and federal grants and contracts to nondepartmental organizations and individuals, regardless of whether the research or related activity involves departmental clients or a nondepartmental subject population.

History

WSR 99-15-021, recodified as § 388-04-050, filed 7/12/99, effective 7/12/99. Statutory Authority: RCW 43.20A.550. WSR 81-17-022 (Order 1687), § 388-10-050, filed 8/12/81.

Wash. Admin. Code § 388-04-060 Documentation of research proposals and review dispositions.

(1) All research and related activity proposals subject to review under WAC 388-10-050 shall be submitted in writing and such proposals shall conform to the format and content guidelines published by the department.

(2) The director of the departmental unit responsible for human research review policy administration shall document in writing all review dispositions affecting research and related activity proposals submitted to the department. In the case of unfavorable dispositions, such documentation shall contain a statement of the reasons for the negative disposition.

History

WSR 99-15-021, recodified as § 388-04-060, filed 7/12/99, effective 7/12/99. Statutory Authority: RCW 43.20A.550. WSR 81-17-022 (Order 1687), § 388-10-060, filed 8/12/81.

Wash. Admin. Code § 388-04-070 Human research review guidelines.

(1) The department shall develop and publish a comprehensive set of procedural guidelines for the protection of human research subjects within its jurisdiction. These guidelines shall be at least as restrictive as the minimum requirements set forth in Title 45, Part 46 of the Code of Federal Regulations, but may be more restrictive if necessary to satisfy the protective purposes of the department's human subjects protection policy.

(2) The published guidelines shall speak at least to the following topics:

(a) Applicability;

(b) Responsibility for policy and rule implementation;

(d) Proposal format and content;

(e) Review and certification requirements;

(f) Activities exempt from review requirements;

(g) Approval and disapproval authority; appeals;

(h) Qualification requirements for investigators;

(i) Review board composition and functions;

(j) Review of ongoing research projects;

(k) Informed consent requirements;

(l) Disclosure of personal records for research purposes;

(m) Publication conditions;

(n) Provisions for adapting guidelines to the changing requirements of state and federal laws and regulations.

History

WSR 99-15-021, recodified as § 388-04-070, filed 7/12/99, effective 7/12/99. Statutory Authority: RCW 43.20A.550. WSR 81-17-022 (Order 1687), § 388-10-070, filed 8/12/81.

Chapter 388-05 Contractor billing requirements—General.

Wash. Admin. Code § 388-05-0001 What is the purpose of this chapter?

The purpose of this chapter is to establish general procedures for contractors to follow when submitting claims for payment to the department of social and health services. Additional requirements may also apply.

History

Statutory Authority: RCW 43.17.060. WSR 01-12-071, § 388-05-0001, filed 6/4/01, effective 7/5/01.

Wash. Admin. Code § 388-05-0005 What contracts does this chapter apply to?

This chapter applies to all contracts for personal or client services as defined in chapter 39.29 RCW and to all interlocal agreements governed by chapter 39.34 RCW. This chapter does not supersede WAC 388-502-0150 titled Time limits for providers to bill medical assistance administration (MAA).

History

Statutory Authority: RCW 43.17.060. WSR 01-12-071, § 388-05-0005, filed 6/4/01, effective 7/5/01.

Wash. Admin. Code § 388-05-0010 How soon does a contractor have to submit claims for payment to the department after the services are rendered?

Each contractor who is rendering authorized services to the department or its clients shall submit claims for payment, as agreed upon between the department and the contractor, no later than twelve months after the date of service. If the claims for payment are not presented within the twelve-month period there shall not be a charge against the state. The twelve-month period may be shortened by contract or regulation. The twelve-month period may be extended by contract or regulation, but only if required by applicable state or federal law or regulation. The department may grant exceptions to the twelve-month period for initial claims when billing delays are caused by either of the following:

(a) The department's certification or authorization of services for a client for a retroactive period; or

(b) The provider proves to the department's satisfaction that there are other extenuating circumstances.

This provision shall apply to all claims for payment submitted on or after the effective date.

History

Statutory Authority: RCW 43.17.060. WSR 01-12-071, § 388-05-0010, filed 6/4/01, effective 7/5/01.

Chapter 388-06 Background checks.

Wash. Admin. Code § 388-06-0030 What is the purpose of this chapter?

(1) WAC 388-06-500 through 388-06-0550 define when an applicant, long-term care worker, or service provider may have unsupervised access to vulnerable adults and children pending the results of a fingerprint-based background check required by RCW 74.39A.056 or RCW 43.43.837.

(2) WAC 388-06-0700 through 388-06-0720 describe the responsibilities of the background check central unit.

History

Statutory Authority: RCW 43.20A.710, 43.43.837, 74.08.090, 74.09.520, 74.39A.056, and 2021 c 203. WSR 22-24-058, § 388-06-0030, filed 12/1/22, effective 1/1/23. Statutory Authority: RCW 43.43.832, 43.20A.710, and 43.43.837. WSR 15-05-030, § 388-06-0030, filed 2/10/15, effective 3/13/15.

Wash. Admin. Code § 388-06-0500 What is the purpose of the 120-day provisional period?

The 120-day provisional period allows applicants, long-term care workers, and service providers to have unsupervised access to vulnerable adults and children pending the results of a fingerprint-based background check.

History

Statutory Authority: RCW 43.20A.710, 43.43.837, 74.08.090, 74.09.520, 74.39A.056, and 2021 c 203. WSR 22-24-058, § 388-06-0500, filed 12/1/22, effective 1/1/23. Statutory Authority: Chapter 43.20A RCW, RCW 72.05.440 and 74.15.030. WSR 01-15-019, § 388-06-0500, filed 7/10/01, effective 8/10/01.

Wash. Admin. Code § 388-06-0510 What definitions apply to 120-day provisional period rules?

"Applicant" has the same meaning as defined in RCW 43.43.830.

"Completed fingerprint check" means the applicant has a final fingerprint notification from the background check central unit that is not disqualifying.

"Long-term care worker" has the same meaning as defined in RCW 74.39A.009.

"Service provider" means entities, facilities, agencies, businesses, or individuals who are licensed, certified, authorized, or regulated by, receive payment from, or have contracts or agreements with, the department of social and health services or its designee, to provide services to vulnerable adults or children.

History

Statutory Authority: RCW 43.20A.710, 43.43.837, 74.08.090, 74.09.520, 74.39A.056, and 2021 c 203. WSR 22-24-058, § 388-06-0510, filed 12/1/22, effective 1/1/23. Statutory Authority: Chapter 43.20A RCW, RCW 72.05.440 and 74.15.030. WSR 01-15-019, § 388-06-0510, filed 7/10/01, effective 8/10/01.

Wash. Admin. Code § 388-06-0525 When are applicants, long-term care workers, and service providers eligible for the 120-day provisional period?

Applicants, long-term care workers, and service providers are eligible for the 120-day provisional period once they have passed a state name and date of birth background check and have scheduled their appointment to have their fingerprints taken for the fingerprint-based background check.

History

Statutory Authority: RCW 43.20A.710, 43.43.837, 74.08.090, 74.09.520, 74.39A.056, and 2021 c 203. WSR 22-24-058, § 388-06-0525, filed 12/1/22, effective 1/1/23. Statutory Authority: RCW 43.43.832, 74.15.030 and 43.43.837. WSR 14-14-026, § 388-06-0525, filed 6/24/14, effective 7/25/14. Statutory Authority: RCW 43.43.832 and 74.39A.056 as amended by 2012 c 164 and 2012 c 1. WSR 12-21-053, § 388-06-0525, filed 10/15/12, effective 12/25/12. Statutory Authority: RCW 43.43.832, 74.39A.055, 74.39A.050, 74.39A.095, 74.39A.260, 43.20A.710, and 43.43.837. WSR 10-16-083, § 388-06-0525, filed 7/30/10, effective 8/30/10. Statutory Authority: Chapter 43.20A RCW, RCW 72.05.440 and 74.15.030. WSR 01-15-019, § 388-06-0525, filed 7/10/01, effective 8/10/01.

Wash. Admin. Code § 388-06-0530 When does the 120-day provisional period begin?

The 120-day provisional period begins on the date an applicant, long-term care worker, or service provider begins providing care to a vulnerable adult or child.

History

Statutory Authority: RCW 43.20A.710, 43.43.837, 74.08.090, 74.09.520, 74.39A.056, and 2021 c 203. WSR 22-24-058, § 388-06-0530, filed 12/1/22, effective 1/1/23. Statutory Authority: Chapter 43.20A RCW, RCW 72.05.440 and 74.15.030. WSR 01-15-019, § 388-06-0530, filed 7/10/01, effective 8/10/01.

Wash. Admin. Code § 388-06-0550 How does the state of emergency declared in response to the COVID-19 pandemic affect the provisional period for applicants, long-term care workers, and service providers?

Notwithstanding WAC 388-06-0530, applicants, long-term care workers, and service providers who began providing care to vulnerable adults between November 1, 2019, and April 30, 2022, will have until August 28, 2022, to complete the fingerprint background check. Providers who begin providing care on or after May 1, 2022, are subject to the rules set forth in WAC 388-06-0525 and WAC 388-06-0530.

History

Statutory Authority: RCW 43.20A.710, 43.43.837, 74.08.090, 74.09.520, 74.39A.056, and 2021 c 203. WSR 22-24-058, § 388-06-0550, filed 12/1/22, effective 1/1/23.

Wash. Admin. Code § 388-06-0700 What definitions apply to WAC 388-06-0700 through 388-06-0810?

The following definitions apply to WAC 388-06-0700 through 388-06-0810:

"Applicant" means an employee, volunteer, student, intern, licensee, service provider, contractor, or other individual who is the subject of the background check and who will work in a position that:

(1) May have unsupervised access to vulnerable adults, the developmentally disabled, juveniles, or children; or

(2) Is designated by the department as having access to sensitive information.

"Authorized entity" means a department, administration, division, program, unit, service provider, licensee, contractor, or other public or private entity that has permission from the department to submit and receive background checks through BCCU.

"Background check central unit" or "BCCU" is the program responsible for conducting background checks for the department.

(1) BCCU is responsible for:

(a) Compiling background check information from external and internal data sources;

(b) Determining whether an applicant's background check information matches to the appropriate department list of disqualifying crimes and negative actions; and

(2) BCCU does not:

(a) Make the final hiring, contracting, placement, or licensing decision for the department or authorized entity;

(b) Determine what program, service provider, licensee, contractor, or other public or private agency qualifies as an authorized entity; or

"Background check result" means a written notification that provides information on the results of the background check process conducted for an applicant. The following are all background check results:

(1) "Disqualify result" means that BCCU has determined that the applicant's background check information has one or more items requiring automatic disqualification.

(2) "No record result" means that BCCU has determined that no background information has been reported requiring automatic disqualification or review.

(3) "Review required result" means that BCCU has determined that the applicant has one or more items of background check information, none of which require automatic disqualification.

"Certificate of restoration of opportunity" or "CROP" means a certificate obtained under chapter 9.97 RCW.

"Data sources" may include state and federal law enforcement records, state court records, agency databases, or other sources depending on the type of check conducted. More detailed information may be available on the BCCU page of the department's website or by calling the department.

"Department" means the department of social and health services.

History

Statutory Authority: RCW 9.97.020. WSR 17-19-073, § 388-06-0700, filed 9/15/17, effective 10/16/17. Statutory Authority: RCW 43.43.832, 74.39A.055, 74.39A.050, 74.39A.095, 74.39A.260, 43.20A.710, and 43.43.837. WSR 10-16-083, § 388-06-0700, filed 7/30/10, effective 8/30/10.

Wash. Admin. Code § 388-06-0710 Who may submit a background check to the background check central unit?

An authorized entity may request a background check through the background check central unit when the authorized entity has:

(1) A valid background check central unit account number;

(2) A current department background authorization form filled out and signed by the applicant; and

(3) Submitted the background check request under the applicable program requirements.

History

Statutory Authority: RCW 43.43.832, 74.39A.055, 74.39A.050, 74.39A.095, 74.39A.260, 43.20A.710, and 43.43.837. WSR 10-16-083, § 388-06-0710, filed 7/30/10, effective 8/30/10.

Wash. Admin. Code § 388-06-0720 Who receives the results of a background check conducted by the background check central unit?

(1) The background check central unit follows laws related to the release of criminal history records (chapter 10.97 and 43.43 RCW), public disclosure (chapter 42.56 RCW); and other applicable laws when releasing background information.

(2) The authorized entity who submits a background check request receives a copy of the background check results.

(3) The background check applicant may request a copy of his or her background check results.

(4) As required in RCW 74.39A.055(2), the department will share the results of state and national background checks with the Washington department of health to satisfy its certification responsibilities under chapter 18.88B RCW.

History

Statutory Authority: RCW 43.43.832, 74.39A.055, 74.39A.050, 74.39A.095, 74.39A.260, 43.20A.710, and 43.43.837. WSR 10-16-083, § 388-06-0720, filed 7/30/10, effective 8/30/10.

Wash. Admin. Code § 388-06-0800 When must BCCU include a statement about a certificate of restoration of opportunity?

(1) Except as provided for in subsections (2) through (4) of this section, BCCU must include a statement about any existing CROP in background check results for all applicants that the department is authorized to disqualify for:

(a) A license;

(b) A certificate of authority;

(d) Admission to an examination to qualify for such a license or certificate.

(2) BCCU is not required to include a statement about any existing CROP for an applicant who is exempt under chapter 9.97 RCW.

(3) BCCU is not required to include a statement about any existing CROP when BCCU issues any interim communications, including when:

(a) Requesting additional information;

(b) Notifying about an error;

(d) Requesting a thumbprint; or

(e) Any other communication that does not assess the final results of a processed background check.

(4) BCCU is not required to include a statement about any existing CROP in any no record result.

History

Statutory Authority: RCW 9.97.020. WSR 17-19-073, § 388-06-0800, filed 9/15/17, effective 10/16/17.

Wash. Admin. Code § 388-06-0810 Does a certificate of restoration of opportunity apply to any state abuse and neglect registry?

A CROP does not apply to any state abuse and neglect registry. No finding of abuse, neglect, or misappropriation of property may be removed from such registry based solely on a CROP.

History

Statutory Authority: RCW 9.97.020. WSR 17-19-073, § 388-06-0810, filed 9/15/17, effective 10/16/17.

Chapter 388-06B DSHS employee background checks.

Wash. Admin. Code § 388-06B-0010 What is the purpose of this chapter?

The purpose of this chapter is to establish standards for the department of social and health services to conduct background checks for department employees, applicants for employment, volunteers and student interns.

History

Statutory Authority: RCW 43.43.832, 43.20A.710, and 43.43.837. WSR 15-05-030, § 388-06B-0010, filed 2/10/15, effective 3/13/15.

Wash. Admin. Code § 388-06B-0020 What definitions apply to this chapter?

"Applicant" means a person who has applied for work in a department-covered position, including current employees, volunteers, students, or interns serving or working in a similarly situated position or any person who must meet state and federal background check requirements to work in a department-covered position.

"Background check central unit" means the program responsible for conducting background checks for the department of social and health services.

"Child or children" means any person under eighteen years of age.

"Department" means the department of social and health services.

"Department-covered position" means a position that has:

(1) Unsupervised access to vulnerable adults, juveniles, or children; or

(2) Access to the internal databases in the background check central unit and the division of disability determination services.

"Division of disability determination services" means the DSHS program contracted to perform medical determinations for the Social Security Administration in accordance with Social Security Administration regulations and requirements.

"DSHS" means the department of social and health services.

"Employee" means a permanent or nonpermanent department of social and health services employee who is appointed to a department-covered position for any reason including but not limited to: Transfer, promotion, demotion, elevation, layoff, reassignment, reallocation, and reversion.

"Juvenile" means a person under the age of twenty-one under the juvenile rehabilitation administration's (JRA) jurisdiction, or under the department of corrections' jurisdiction while placed in a JRA facility.

"Pending charge or pending action" means a charge or action awaiting a decision by a court or a civil adjudication proceeding. The term pending charge also includes specific types of court action where the defendant has agreed to certain conditions. Examples include a deferred prosecution or a stipulated order of continuance on an agreed condition. The department considers these types of cases on an individual case-by-case basis.

"Permanent employee" means a department employee who has successfully completed a Washington general service probationary period or Washington management service review period after appointment to a permanent position.

"Sensitive positions" means positions in the division of disability determination services and the background check central unit with access to federal databases or databases containing background check information.

"Unsupervised access" means a DSHS employee, volunteer or student intern who:

(1) Works, volunteers or serves in a setting, such as an institution, that provides residential services to vulnerable adults, juveniles and children;

(2) Works, volunteers or serves in a position where, during the course of his or her employment, the employee may transport, or visit the residence of, a vulnerable adult, juvenile or child; or

(3) Works, volunteers or serves in a position, other than one described in subsection (1) and (2) in this section, where the employee may be left alone with a vulnerable adult, juvenile or child. "Left alone" does not include the possibility of a public encounter, or public interaction.

"Vulnerable adult" means a person who is a client of the department who is:

(1) Sixty years of age or older who has the functional, mental, or physical inability to care for himself or herself; or

(2) Found incapacitated under chapter 11.88 RCW; or

(3) Developmentally disabled as defined under RCW 71A.10.020; or

(4) Admitted to any facility that is operated by the department; or

(5) Receiving services from a department contracted, authorized, certified, licensed, or individual provider, including those certified under chapter 70.96A RCW; or

(6) Receiving services through home health, hospice, or home care agencies required to be licensed under chapter 70.127 RCW; or

(7) Admitted for detoxification in a certified chemical dependency treatment facility in accordance with chapter 70.96A RCW; or

(8) A vulnerable adult as defined in chapter 74.34 RCW.

History

Statutory Authority: RCW 43.43.832, 43.20A.710, and 43.43.837. WSR 15-05-030, § 388-06B-0020, filed 2/10/15, effective 3/13/15.

Wash. Admin. Code § 388-06B-0100 Must the DSHS secretary or designee conduct background checks on all employees in department-covered positions and applicants under consideration for a covered position?

(1) The secretary of the department of social and health services or designee must conduct a background check, as authorized by statute, on all employees in covered positions; employees in sensitive positions, and applicants under final consideration for a covered position.

(2) A national fingerprint-based background check will be conducted if required by state law, federal regulations, or presidential directive.

History

Statutory Authority: RCW 43.43.832, 43.20A.710, and 43.43.837. WSR 15-05-030, § 388-06B-0100, filed 2/10/15, effective 3/13/15.

Wash. Admin. Code § 388-06B-0200 What are the DSHS secretary's responsibilities in carrying out the requirements to conduct background checks?

The DSHS secretary or designee will:

(1) Develop policies and guidelines pertaining to background checks. The department's background check policies and guidelines must minimally address the following:

(a) Process for identifying department-covered positions;

(b) Notification to employees and applicants that a background check is required for covered positions;

(d) When a character, competence, and suitability review will be required to determine if the applicant and/or employee may have unsupervised access to vulnerable adults, juveniles and children;

(e) When rechecks may be initiated;

(f) What happens when a permanent DSHS employee is denied a department-covered position because of a background check or failure to authorize a background check to include:

(i) Employment options available when a permanent employee is disqualified from holding a department covered position;

(ii) Interim measures available while exploring employment options;

(iii) Process that will be used to identify noncovered department positions; and

(iv) Specific time frame allowed for exploration of employment options prior to separation of a permanent employee.

(g) When an employee may request a review of a disqualification for employment in a covered position;

(2) Not further disseminate background check information unless authorized or required by law to do so; and

(3) Comply with public disclosure requirements and the rules of civil discovery when applicable.

History

Statutory Authority: RCW 43.43.832, 43.20A.710, and 43.43.837. WSR 15-05-030, § 388-06B-0200, filed 2/10/15, effective 3/13/15.

Wash. Admin. Code § 388-06B-0300 What information is considered in a background check conducted by DSHS and how are the results of the background check used?

(1) The background check information considered by the DSHS secretary or designee will include but is not limited to conviction records, pending charges, and civil adjudications as defined in RCW 43.43.830.

(2) The background information must be used by DSHS to determine the character, competence, and suitability of the applicant and/or employee to have unsupervised access to vulnerable adults, juveniles and children.

(3) If the applicant or employee's criminal history was reviewed in 2002 by DSHS through its background assessment review team (BART) process, and if DSHS determined the employee could remain in a covered position, the applicant or employee will not be disqualified based upon criminal history, including his or her conviction record, that was known and considered during the BART process.

(4) Background information that was the subject of a pardon, annulment, or other equivalent procedure will not disqualify an applicant and/or employee from having unsupervised access to vulnerable adults, juveniles and children.

(5) Results of a background check may be discoverable pursuant to the rules of civil discovery, or subject to disclosure pursuant to a public records request.

History

Statutory Authority: RCW 43.43.832, 43.20A.710, and 43.43.837. WSR 15-05-030, § 388-06B-0300, filed 2/10/15, effective 3/13/15.

Wash. Admin. Code § 388-06B-0400 Must an employee or applicant authorize the secretary of the department of social and health services or designee to conduct a background check and what happens if the employee or applicant does not provide authorization?

(1) An employee and/or applicant applying for or being considered for retention in a department-covered position must authorize the secretary of DSHS or designee to conduct a background check which may include fingerprinting when required by state or federal law or regulations.

(2) Failure to authorize the DSHS secretary or designee to conduct a background check shall disqualify an employee or applicant from consideration for any covered position including their current covered position.

History

Statutory Authority: RCW 43.43.832, 43.20A.710, and 43.43.837. WSR 15-05-030, § 388-06B-0400, filed 2/10/15, effective 3/13/15.

Chapter 388-14A Division of child support rules.

Wash. Admin. Code § 388-14A-1000 The DSHS division of child support is the Title IV-D child support enforcement agency for the state of Washington.

WAC 388-14A-1000

(1) The division of child support (DCS) is the part of the department of social and health services that provides child support enforcement services for the state of Washington under Title IV-D of the federal Social Security Act. DCS acts as the Washington state support registry (WSSR) under chapter 26.23 RCW.

(2) DCS is the agency referred to in federal law as "the Title IV-D agency," and performs all duties assigned to the Title IV-D agency.

(3) DCS is responsible for the statewide administration of wage withholding under Title IV-D.

(4) If your support order requires you to make payments to DCS or to WSSR, send payments to: WSSR, P.O. Box 45868, Olympia WA 98504-5868.

(5) If you want to call DCS, you can call 1-800-442-5437, or call the local DCS field office.

(6) If you want to write to DCS, you can write to P.O. Box 11520, Tacoma WA 98411-5520.

(7) You can find more information about DCS at its website. Visit https://www.dshs.wa.gov/esa/division-child-support.

History

Statutory Authority: RCW 26.18.170, 26.23.035, 26.23.110, 43.20A.550, 74.04.055, 74.08.090, 74.20.040, 74.20A.310, and 74.20A.328. WSR 26-14-086, s 388-14A-1000, filed 6/29/26, effective 7/30/26. Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-1000, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-010 and 388-14-210.

Wash. Admin. Code § 388-14A-1005 What is Washington's state plan under Title IV-D?

(1) The division of child support (DCS), on behalf of the department of social and health services of the state of Washington, has established the following provisions as the state plan (the "plan") for its child support enforcement program. This plan is authorized by Title IV-D of the Social Security Act and chapters 74.20 and 74.20A RCW. This plan covers the entire state of Washington.

(2) DCS is the organization within the state of Washington that administers the plan.

(3) DCS enters into contracts for child support enforcement and related services with:

(a) Other state agencies;

(b) Indian tribes, county prosecutors and court clerks in the state of Washington;

(c) Other states or foreign countries for action under the Uniform Interstate Family Support Act (UIFSA) and other laws to enforce or collect child support, locate noncustodial parents, or establish paternity. These contracts may include procedures for:

(i) Making referrals;

(ii) Assigning debts;

(iii) Reporting actions and activities; and

(iv) Coordinating activities under and ensuring compliance with UIFSA.

(d) Private parties;

(e) The secretary of the Department of Health and Human Services to refer and certify cases:

(i) To the federal parent locator service (FPLS);

(ii) To the secretary of the treasury for action to collect support debts; and

(iii) For action in the United States district courts to enforce support debts.

(4) DCS manages the Title IV-D plan for the state of Washington and:

(a) Oversees all activities under the plan to ensure that the program meets the standards for an efficient and effective program;

(b) Evaluates the quality and scope of services provided under the plan;

(d) Provides all services under the plan in appropriate cases, including action to locate parents, to establish paternity, and to establish, enforce and collect child support; and

(e) Assures that referrals and other communications with the Title IV-A agency (which operates the public assistance programs) and the Title IV-E agency (which operates the foster care program) meet the requirements of the Title IV-D and Title IV-A state plans.

History

Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-1005, filed 1/17/01, effective 2/17/01.

Wash. Admin. Code § 388-14A-1010 What are the other names that the division of child support has used?

(1) The division of child support (DCS) has been known by many names including:

(a) The office of support enforcement (OSE);

(b) The support enforcement division (SED);

(d) The Washington state support registry (WSSR).

(2) Some statutes and forms use one of these other names, but they all mean the division of child support.

History

Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-1010, filed 1/17/01, effective 2/17/01.

Wash. Admin. Code § 388-14A-1015 What laws regulate the actions of the division of child support?

(1) The following are the primary state and federal laws which apply to the division of child support (DCS):

(a) Title IV-D of the Social Security Act sets out the federal requirements for a state's support enforcement program.

(b) Title 45 of the Code of Federal Regulations contains the federal regulations regarding support enforcement programs.

(2) Most state statutes governing DCS are found in Title 26 RCW and chapters 74.20 and 74.20A RCW.

(3) The Washington Administrative Code (WAC) contains the state regulations regarding the Washington state support enforcement program.

History

Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-1015, filed 1/17/01, effective 2/17/01.

Wash. Admin. Code § 388-14A-1020 What definitions apply to the rules regarding child support enforcement?

For purposes of this chapter, the following definitions apply:

"Abatement" means the temporary reduction of child support obligations of an incarcerated person who is required to pay support.

"Absence of a court order" means that there is no court order either setting a support obligation for the noncustodial parent (NCP), or specifically relieving the NCP of a support obligation, for a particular child.

"Absent parent" is a term used for a noncustodial parent.

"Accessible coverage" means health care coverage which provides primary care services to the children with reasonable effort by the custodial parent.

"Accrued debt" means past-due child support which has not been paid.

"Acknowledged father" means a man who has established a father-child relationship by:

(1) Signing a valid acknowledgment of paternity under RCW 26.26.300 through 26.26.375 prior to January 1, 2019;

(a) Chapter 26.26 RCW was repealed effective January 1, 2019, under chapter 6, section 907, laws of 2018;

(b) Chapter 26.26A RCW was enacted effective January 1, 2019;

(2) Signing a valid acknowledgment of parentage under RCW 26.26A.200 through 26.26A.265 on or after January 1, 2019; or

(3) Signing a valid acknowledgment of paternity or parentage under another jurisdiction's laws.

"Acknowledged parent" means a person who, after January 1, 2019, has established a parent-child relationship by signing a valid acknowledgment of parentage under RCW 26.26A.200 through 26.26A.265.

"Adjudicated parent" means a person who has been adjudicated by a court of competent jurisdiction to be the parent of a child.

"Administrative order" means a determination, finding, decree, or order for support issued under RCW 74.20A.055, 74.20A.056, 74.20A.059, or by the agency of an Indian tribe or another state or country's agency under an administrative process, establishing the existence of a support obligation (including medical support) and ordering the payment of a set or determinable amount of money for current support, a support debt, or both. Administrative orders include:

(1) An order entered under chapter 34.05 RCW;

(2) An agreed settlement or consent order entered under WAC 388-14A-3600; and

(3) A support establishment notice which has become final by operation of law.

"Agency" means the Title IV-D provider of a state or tribe, or the central authority of another country. For the state of Washington, the Title IV-D provider is the division of child support (DCS) within the department of social and health services (DSHS).

"Agreed settlement" means an administrative order that reflects the agreement of the noncustodial parent, the custodial parent, and the division of child support. An agreed settlement does not require the approval of an administrative law judge.

"Aid" or "public assistance" means cash assistance under the temporary assistance for needy families (TANF) program, the aid to families with dependent children (AFDC) program, federally funded or state-funded foster care, and includes day care benefits and medical benefits provided to families as an alternative or supplement to TANF.

"Alternate recipient" means a child of the employee or retiree named within a support order as being entitled to coverage under an employer's group health plan.

"Annual fee" means the fee charged on never-assistance cases based on the amount of collections between October 1 and September 30 each year, required by the Federal Deficit Reduction Act of 2005 and RCW 74.20.040.

"Applicant/custodian" means a person who applies for nonassistance support enforcement services on behalf of a child or children residing in their household.

"Applicant/recipient,""applicant," or "recipient" means a person who receives public assistance on behalf of a child or children residing in their household.

"Arrears" means the debt amount owed for a period of time before the current month.

"Assistance" means cash assistance under the state program funded under Title IV-A of the federal Social Security Act.

"Assistance unit" means a cash assistance unit as defined in WAC 388-408-0005. An assistance unit is the group of people who live together and whose income or resources the department counts to decide eligibility for benefits and the amount of benefits.

"Birth costs" means medical expenses incurred by the custodial parent or the state, tribe, or country for the birth of a child.

"Birth mother" means a person who gave birth to the child and is not a genetic or gestational surrogate.

"Birth record" means a report of birth that has been filed with and registered by a state's registrar of vital statistics or equivalent agency.

"Cash medical support" means a combination of:

(1) A parent's monthly payment toward the premium paid for coverage provided by a public entity or by another parent, which represents the obligated parent's proportionate share of the premium paid, but this amount is limited to no more than 25% of the obligated parent's basic support obligation; and

(2) A parent's proportionate share of uninsured medical expenses.

"Central authority" means the agency designated by a government to facilitate support enforcement with a foreign reciprocating country (FRC) pursuant to section 459A of the federal Social Security Act.

"Child" for the purposes of this chapter, means:

(a) A person for whom a child support obligation is being established or enforced; or

(b) A dependent child as defined in RCW 74.20A.020(3); and

(c) Unless the context or the facts of a particular case clearly requires otherwise, "child" may be used interchangeably with the term "children."

"Children" for the purpose of this chapter, means more than one child, unless the context or the facts of a particular case clearly requires the term to refer to only one child.

"Conditionally assigned arrears" means those temporarily assigned arrears remaining on a case after the period of public assistance ends.

"Conference board" means a method used by the division of child support for resolving complaints regarding DCS cases and for granting exceptional or extraordinary relief from debt.

"Consent order" means a support order that reflects the agreement of the noncustodial parent, the custodial parent, and the division of child support. A consent order requires the approval of an administrative law judge.

"Controlling order" means the only order issued or, where multiple orders exist, the order determined by a tribunal to control prospective current support pursuant to the Uniform Interstate Family Support Act (UIFSA), chapter 26.21A RCW.

"Controlling order state" means the state in which the only order was issued or, where multiple orders exist, the state in which the order determined by a tribunal to control prospective current support pursuant to the UIFSA was issued.

"Country" means a foreign country (or a political subdivision thereof) declared to be a Foreign Reciprocating Country (FRC) under 42 U.S.C. 659A and any foreign country (or political subdivision thereof) with which the state has entered into a reciprocal arrangement for the establishment and enforcement of support obligations to the extent consistent with federal law pursuant to 42 U.S.C. 659A.

"Court order" means a judgment, decree, or order of a Washington state superior court, or a court of comparable jurisdiction of an Indian tribe or another state or country.

"Current support" or "current and future support" means the amount of child support which is owed for each month.

"Custodial parent" or "CP" means the person, whether a parent or not, with whom a dependent child resides the majority of the time period for which the division of child support seeks to establish or enforce a support obligation.

"Date the state assumes responsibility for the support of a dependent child on whose behalf support is sought" means the date that the TANF or AFDC program grant is effective. For purposes of this chapter, the state remains responsible for the support of a dependent child until public assistance terminates, or support enforcement services end, whichever occurs later.

"Delinquency" means failure to pay current child support when due.

"Department" means the Washington state department of social and health services (DSHS).

"Dependent child" means a person:

(1) Seventeen years of age or younger who is not self-supporting, married, or a member of the United States armed forces;

(2) Eighteen years of age or older for whom a court order requires support payments past age 18;

(3) Eighteen years of age or older, but under 19 years of age, for whom an administrative support order exists if the child is participating full-time in a secondary school program or the same level of vocational or technical training.

"Determination of parentage" means the establishment of the parent-child relationship by:

(1) A judicial proceeding;

(2) The signing of a valid acknowledgment of paternity under:

(a) RCW 26.26.300 through 26.26.375 prior to January 1, 2019;

(i) Chapter 26.26 RCW was repealed effective January 1, 2019, under chapter 6, section 907, laws of 2018;

(ii) Chapter 26.26A RCW was enacted effective January 1, 2019; or

(b) Another jurisdiction's laws dealing with the acknowledgment or affidavit of paternity or the acknowledgment of parentage; or

(3) The signing of a valid acknowledgment of parentage under RCW 26.26A.200 through 26.26A.265 on or after January 1, 2019.

"Differentiated support amount" means an amount of child support that represents a parent's support obligation for more than one child and may justifiably be divided into "per child" amounts for each child covered by the support order, based on information contained in the support order.

"Differentiated support order" means a child support order which provides a monthly amount of child support for two or more children, and either provides a specific support obligation for each child or provides enough information in the order so that the monthly amount may justifiably be divided into a "per child" amount for each child covered by the support order.

"Disbursement" means the amount of child support distributed to a case that is paid to the family, state, other child support enforcement agency in another state or foreign country, Indian tribe, or person or entity making the payment.

"Disposable earnings" means the amount of earnings remaining after the deduction of amounts required by law to be withheld.

"Distribution" means how a collection is allocated or split within a case or among multiple cases.

"Domestic partner" means a state registered domestic partner as defined in chapter 26.60 RCW.

"Earnings" means compensation paid or payable for personal service. Earnings include:

(1) Wages or salary;

(2) Commissions and bonuses;

(3) Periodic payments under pension plans, retirement programs, and insurance policies of any type;

(4) Disability payments under Title 51 RCW;

(5) Unemployment compensation under RCW 50.40.020, 50.40.050, and Title 74 RCW;

(6) Benefits under the family and medical leave insurance program under Title 50A RCW;

(7) Gains from capital, labor, or a combination of the two; and

(8) The fair value of nonmonetary compensation received in exchange for personal services.

"Employee" means a person to whom an employer is paying, owes, or anticipates paying earnings in exchange for services performed for the employer.

"Employer" means any person or organization having an employment relationship with any person. This includes:

(1) Partnerships and associations;

(2) Trusts and estates;

(3) Joint stock companies and insurance companies;

(4) Domestic and foreign corporations;

(5) The receiver or trustee in bankruptcy; and

(6) The trustee or legal representative of a deceased person.

"Employment" means personal services of whatever nature, including service in interstate commerce, performed for earnings or under any contract for personal services. Such a contract may be written or oral, express, or implied.

"Family" means the person or persons on whose behalf support is sought, which may include a custodial parent and one or more children, or one or more children in foster care placement. The family is sometimes called the assistance unit.

"Family arrears" means the amount of past-due support owed to the family, which has not been conditionally, temporarily, or permanently assigned to a state. Also called "nonassistance arrears."

"Family member" means the caretaker relative, the child or children, and any other person whose needs are considered in determining eligibility for assistance.

"Foreign order" means a court or administrative order entered by a tribunal other than one in the state of Washington, including an order entered by a tribunal in an Indian tribe or another state or country.

"Foreign reciprocating country" or "FRC" means a country which the federal government has declared to be a foreign reciprocating country, which means that the foreign country has established, or undertakes to establish, procedures for the establishment and enforcement of duties of support owed to custodial parents who are residents of the United States, and that such procedures are substantially in conformity with the standards prescribed under title IV-D of the federal Social Security Act.

"Foster care case" means a case referred to the Title IV-D agency by the Title IV-E agency, which is the department of children, youth, and families (DCYF).

"Fraud" for the purposes of vacating an agreed settlement or consent order, means:

(1) The representation of the existence or the nonexistence of a fact;

(2) The representation's materiality;

(3) The representation's falsity;

(4) The speaker's knowledge that the representation is false;

(5) The speaker's intent that the representation should be acted on by the person to whom it is made;

(6) Ignorance of the falsity on the part of the person to whom it is made;

(7) The latter's:

(a) Reliance on the truth of the representation;

(b) Right to rely on it; and

"Full support enforcement services" means the entire range of services available in a Title IV-D case.

"Good cause" for the purposes of late hearing requests and petitions to vacate orders on default means a substantial reason or legal justification for delay, including but not limited to, the grounds listed in civil rule 60. The time periods used in civil rule 60 apply to good cause determinations in this chapter.

"Head of household" means the parent or parents with whom the dependent child or children were residing at the time of placement in foster care.

"Health care costs" means medical expenses. Certain statutes in chapter 26.19 RCW refer to medical expenses as health care costs.

"Health care coverage" means fee for service, health maintenance organization, preferred provider organization, and other types of private health insurance and public health care coverage under which medical services could be provided to a dependent child or children. These services include, but are not limited to, medical and surgical care (inpatient, outpatient, physician), medical equipment (crutches, wheel-chairs, prosthesis, etc.), pharmacy products, optometric care, dental care, orthodontic care, preventive care, mental health care, and physical therapy. The term "health care coverage" includes, but is not limited to, health insurance coverage.

"Health insurance" or "health insurance coverage" is included in the definition of "health care coverage." Health insurance coverage includes any coverage under which medical services are provided by an employer or a union whether that coverage is provided through a self-insurance program, under the employee retirement income security act of 1974, a commercial insurer pursuant to chapters 48.20 and 48.21 RCW, a health care service contractor pursuant to chapter 48.44 RCW, or a health maintenance organization pursuant to chapter 48.46 RCW, and the state through chapter 41.05 RCW.

"Hearing" means an adjudicative proceeding authorized by this chapter, or chapters 26.23, 74.20, and 74.20A RCW, conducted under chapter 388-02 WAC and chapter 34.05 RCW.

"I" or "me" means the person asking the question which appears as the title of a rule.

"Incarcerated person" for purposes of abatement means a person who is totally or partially confined in a jail, prison, or correctional facility for at least six months or is serving a sentence of at least six months in a jail, prison, or correctional facility.

"Income" includes:

(1) All gains in real or personal property;

(2) Net proceeds from the sale or exchange of real or personal property;

(3) Earnings;

(4) Interest and dividends;

(5) Proceeds of insurance policies;

(6) Other periodic entitlement to money from any source; and

(7) Any other property subject to withholding for support under the laws of this state.

"Income withholding action" includes all withholding actions which DCS is authorized to take, and includes but is not limited to, the following actions:

(1) Asserting liens under RCW 74.20A.060;

(2) Serving and enforcing liens under chapter 74.20A RCW;

(3) Issuing orders to withhold and deliver under chapter 74.20A RCW;

(4) Issuing notices of payroll deduction under chapter 26.23 RCW; and

(5) Obtaining wage assignment orders under RCW 26.18.080.

"Initiating agency" or "initiating jurisdiction" means a state or Tribal IV-D agency or the central authority of another country, as defined in this rule, in which a person has applied for or is receiving services.

"Intergovernmental IV-D case" means a IV-D case in which the noncustodial parent lives or works in a different jurisdiction than the custodial parent and children that has been referred by an initiating agency to a responding agency for services. An intergovernmental IV-D case may include any combination of referrals between states, tribes, and countries. An intergovernmental IV-D case also may include cases in which a state agency is seeking only to collect support arrearages, whether owed to the family or assigned to the state.

"Locate" can mean efforts to obtain service of a support establishment notice in the manner prescribed by WAC 388-14A-3105.

"Lump sum payment" means income other than a periodic recurring payment of earnings on regular paydays and does not include reimbursement for expenses. Lump sum payment includes, but is not limited to, discretionary and nondiscretionary bonuses, commissions, performance bonuses, merit increases, safety awards, signing bonuses, moving and relocation incentive payments, holiday pay, termination pay, and severance pay. Lump sum payment also includes workers' compensation, insurance settlements, and personal injury settlements paid as replacement for wages owed.

"Medical assistance" means medical benefits under Title XIX of the federal Social Security Act provided to families as an alternative or supplement to TANF. This term includes public health care coverage, which is called apple health in Washington state.

"Medical expenses" for the purpose of establishing support obligations under RCW 26.09.105, 74.20A.055, and 74.20A.056, or for the purpose of enforcement action under chapters 26.18, 26.23, 74.20, and 74.20A RCW, including the notice of support debt and the notice of support owed, means medical costs incurred on behalf of a child, which include:

• Medical services related to a person's general health and well-being, including but not limited to, medical care, surgical care, preventive care, mental health care, and physical therapy; and

• Prescribed medical equipment and prescribed pharmacy products;

• Health care coverage, such as coverage under a health insurance plan, including the cost of premiums for coverage of a child;

• Dental, orthodontic, and optometrical costs incurred on behalf of a child; and

• Copayments and deductibles incurred on behalf of a child.

Medical expenses are sometimes also called health care costs or medical costs.

"Medical support" consists of:

(1) Health care coverage, which may be health insurance coverage or public health care coverage; and

(2) Cash medical support, which consists of:

(a) A parent's monthly payment toward the premium paid for coverage provided by a public entity or by another parent, which represents the obligated parent's proportionate share of the premium paid, but no more than 25% of the obligated parent's basic support obligation; and

(b) A parent's proportionate share of uninsured medical expenses.

"Monthly payment toward the premium" means a parent's contribution toward premiums paid for coverage provided by a public entity or by another parent, which is based on the obligated parent's proportionate share of the premium paid, but is limited to no more than 25% of the obligated parent's basic support obligation.

"National Medical Support Notice" or "NMSN" is a federally mandated form that DCS uses to enforce a health insurance support obligation; the NMSN is a notice of enrollment as described in RCW 26.18.170.

"Noncustodial parent" or "NCP" means the natural or biological parent, adoptive parent, adjudicated parent, presumed parent, responsible stepparent, or person who signed and filed an affidavit acknowledging paternity or parentage, from whom the state seeks support for a dependent child. A parent is considered to be an NCP when for the majority of the time during the period for which support is sought, the dependent child resided somewhere other than with that parent.

"Nonmedical expenses" means amounts incurred on behalf of a child which are not medical expenses as defined in this chapter. Nonmedical expenses include, but are not limited to, day care or other special childrearing expenses such as tuition and long-distance transportation costs to and from the parents for visitation purposes.

"Obligated parent" means a parent who is required under a child support order to provide medical support, which could include health care coverage or to reimburse the other parent for their share of uninsured medical expenses for a dependent child. The obligated parent could be either the NCP or the CP.

"Other ordinary expense" means an expense incurred by a parent which:

(1) Directly benefits the dependent child; and

(2) Relates to the parent's residential time or visitation with the child.

"Parent" means a person who has established a parent-child relationship under:

(1) RCW 26.26.101 prior to January 1, 2019;

(a) Chapter 26.26 RCW was repealed effective January 1, 2019, under chapter 6, section 907, laws of 2018;

(b) Chapter 26.26A RCW was enacted effective January 1, 2019;

(2) RCW 26.26A.100 on or after January 1, 2019; or

(3) Under the laws of another jurisdiction.

"Parentage" or "parent-child relationship" means the legal relationship between a child and a parent of the child. The term includes but is not limited to, the mother-child relationship and the father-child relationship.

"Participant" means an employee or retiree who is eligible for coverage under an employer group health plan.

"Pass-through" means the portion of a support collection distributed to assigned support that the state pays to a family currently receiving TANF.

"Past support" means support arrears.

"Paternity" means the legal relationship between a father and child. It is one type of parentage.

"Paternity testing" means blood testing or genetic tests of blood, tissue, or bodily fluids. This is also called genetic testing.

"Payment services only" or "PSO" means a case on which the division of child support's activities are limited to recording and distributing child support payments and maintaining case records. A PSO case is not a IV-D case.

"Permanently assigned arrears" means those arrears which the state may collect and retain up to the amount of unreimbursed assistance.

"Physical custodian" means custodial parent (CP).

"Plan administrator" means the person or entity which performs those duties specified under 29 U.S.C. 1002 (16)(A) for a health plan. If no plan administrator is specifically so designated by the plan's organizational documents, the plan's sponsor is the administrator of the plan. Sometimes an employer acts as its own plan administrator.

"Premium" means the amount paid for coverage provided by a public entity or by another parent for a child covered by a child support order. This term may also mean "cost of coverage."

"Presumed parent" means a person who, by operation of law under RCW 26.26A.115, is recognized as the parent of a child until that status is rebutted or confirmed in a judicial proceeding, or a valid denial or rescission is filed under RCW 26.26A.210 or 26.26A.235.

"Private insurance" is a term used in this chapter to refer to accessible health insurance for a child provided by a parent without the need for service of a national medical support notice, and does not include public health care coverage provided by the state.

"Proportionate share" or "proportional share" means an amount equal to a parent's percentage share of the combined monthly net income of the parents as computed on the worksheets when determining a parent's child support obligation under chapter 26.19 RCW.

"Public health care coverage" sometimes called "state purchased health care" means state-financed or federally financed medical coverage, whether or not there is an assignment of rights. For children residing in Washington state, public health care coverage is called apple health; this includes coverage through the department of social and health services or the health care authority, except for coverage under chapter 41.05 RCW. For children residing outside of Washington, this includes coverage through another state's agencies that administer state purchased health care programs.

"Putative father" includes all men who may possibly be the biological or genetic father of the child or children on whose behalf the application for assistance or support enforcement services is made.

"Reasonable efforts to locate" means any of the following actions performed by the division of child support:

(1) Mailing a support establishment notice to the noncustodial parent in the manner described in WAC 388-14A-3105;

(2) Referral to a sheriff or other server of process, or to a locate service or department employee for locate activities;

(3) Tracing activity such as:

(a) Checking local telephone directories and attempts by telephone or mail to contact the custodial parent, relatives of the noncustodial parent, past or present employers, or the post office;

(b) Contacting state agencies, unions, financial institutions, or fraternal organizations;

(c) Searching periodically for identification information recorded by other state agencies, federal agencies, credit bureaus, or other record-keeping agencies or entities; or

(d) Maintaining a case in the division of child support's automated locate program, which is a continuous search process.

(4) Referral to the state or federal parent locator service;

(5) Referral to the attorney general, prosecuting attorney, the IV-D agency of another state, or the Department of the Treasury for specific legal or collection action;

(6) Attempting to confirm the existence of and to obtain a copy of an order adjudicating paternity or parentage, or an affidavit or acknowledgment of paternity or parentage; or

(7) Conducting other actions reasonably calculated to produce information regarding the NCP's whereabouts.

"Required support obligation for the current month" means the amount set by a superior court order, tribal court order, or administrative order for support which is due in the month in question.

"Resident" means a person physically present in the state of Washington who intends to make their home in this state. A temporary absence from the state does not destroy residency once it is established.

"Residential care" means foster care, either state or federally funded.

"Residential parent" means the custodial parent (CP), or the person with whom the child resides a majority of the time.

"Responding agency" or "responding jurisdiction" means the agency that is providing services in response to a referral from an initiating agency in an intergovernmental IV-D case.

"Responsible parent" is a term sometimes used for a noncustodial parent.

"Responsible stepparent" means a stepparent who has established an in loco parentis relationship with the dependent child.

"Retained support" depending on the context in which it is used, can mean one of the following:

(1) An amount paid directly to the custodial parent by the noncustodial parent during a time when there is an open TANF grant, which the custodial parent does not immediately report or turn over to the department;

(2) A debt owed to the division of child support by anyone other than a noncustodial parent; or

(3) Amounts collected and retained by the division of child support which are applied to current or past due child support obligations which have been assigned to the state.

"Satisfaction of judgment" means payment in full of a court-ordered support obligation, or a determination that such an obligation is no longer enforceable.

"Secretary" means the secretary of the department of social and health services or the secretary's designee.

"Self-support reserve" or "self support reserve" means an amount equal to 180% of the federal poverty guideline for a one-person family.

"State" means a state or political subdivision, territory, or possession of the United States, the District of Columbia, the Commonwealth of Puerto Rico, a federally recognized Indian tribe, or a foreign country.

"Superior court order" means a judgment, decree, or order of a Washington state superior court, or of a court of comparable jurisdiction in an Indian tribe, or another state or country.

"Support debt" means support which was due under a support order but has not been paid. This includes:

(1) Delinquent support;

(2) A debt for the payment of expenses for the reasonable or necessary care, support, and maintenance including uninsured medical expenses, birth costs, child care costs, and special child rearing expenses of a dependent child or other person;

(3) A debt under RCW 74.20A.100 or 74.20A.270; or

(4) Accrued interest, fees, or penalties charged on a support debt, and attorney's fees and other litigation costs awarded in an action under Title IV-D to establish or enforce a support obligation.

"Support enforcement services" means all actions the Title IV-D agency is required to perform under Title IV-D of the Social Security Act and state law.

"Support establishment notice" means a notice and finding of financial responsibility under WAC 388-14A-3115, a notice and finding of parental responsibility under WAC 388-14A-3120, or a notice and finding of medical responsibility under WAC 388-14A-3125.

"Support money" means money paid to satisfy a support obligation, whether it is called child support, spousal support, alimony, maintenance, reimbursement for uninsured medical expenses, health care coverage, or birth costs.

"Support obligation" means the obligation to provide for the necessary care, support, and maintenance of a dependent child or other person as required by law, including health care coverage, uninsured medical expenses, birth costs, and child care or special child rearing expenses.

"Support order" means a court order, administrative order, or tribal court order which contains a determination, finding, decree, or order that sets a child support obligation (including medical support) and orders either the payment of a set or determinable amount of money for current support, a support debt, the provision of medical support, or any combination of the three. For purposes of abatement under this chapter, a support order includes the child support obligation and the obligations based on the terms of the basic child support order, such as those determined by notices of support owed.

"Temporarily assigned arrears" means those arrears which accrue prior to the family receiving assistance, for assistance applications dated on or after October 1, 1997, but before October 1, 2008. After the family terminates assistance, temporarily assigned arrears become conditionally assigned arrears.

"Temporary assistance for needy families" or "TANF" means cash assistance under the temporary assistance for needy families (TANF) program under Title IV-A of the Social Security Act.

"Title IV-A" means Title IV-A of the Social Security Act established under Title XX of the Social Security amendments and as incorporated in Title 42 U.S.C.

"Title IV-A agency" means the part of the department of social and health services that carries out the state's responsibilities under the temporary assistance for needy families (TANF) program (and the aid for dependent children (AFDC) program when it existed).

"Title IV-D" means Title IV-D of the Social Security Act established under Title XX of the Social Security amendments and as incorporated in Title 42 U.S.C.

"Title IV-D agency" or "IV-D agency" means the agency responsible for carrying out the Title IV-D plan in a state or tribe. For the state of Washington, this is the division of child support (DCS) within the department of social and health services (DSHS).

"Title IV-D case" means a case in which the division of child support provides services which qualifies for funding under the Title IV-D plan.

"Title IV-D plan" means the plan established under the conditions of Title IV-D and approved by the secretary, Department of Health and Human Services.

"Title IV-E" means Title IV-E of the Social Security Act established under Title XX of the Social Security amendments and as incorporated in Title 42 U.S.C.

"Title IV-E case" means a foster care case.

"Tribal TANF" means a temporary assistance for needy families (TANF) program run by a tribe.

"Tribunal" means a state court, tribal court, administrative agency, or quasi-judicial entity authorized to establish, enforce, or modify support orders or to determine parentage, and includes such courts, agencies, or entities in other states or countries.

"Underlying order" means an existing child support order for which DCS serves a notice of support owed under RCW 26.23.110 to determine a sum certain support obligation.

"Undifferentiated support amount" means an amount of child support that represents a parent's support obligation for more than one child which cannot justifiably be divided into "per child" amounts for each child covered by the support order.

"Undifferentiated support order" means a child support order which provides a monthly amount of child support for two or more children, but does not provide a specific support obligation for each child or does not contain enough information in either the order or the worksheets associated with the order to justify dividing the monthly amount into "per child" amounts for each child covered by the support order.

"Uninsured medical expenses" for the purpose of establishing or enforcing support obligations, means:

(1) Medical expenses not paid by insurance for medical, dental, orthodontic, prescription, and optometrical costs incurred on behalf of a child; and

(2) Premiums, copayments, or deductibles incurred on behalf of a child.

"Unreimbursed assistance" means the cumulative amount of assistance which was paid to the family and which has not been reimbursed by assigned support collections.

"Unreimbursed medical expenses" means any amounts paid by one parent for uninsured medical expenses, which that parent claims the obligated parent owes under a child support order, which percentage share is stated in the child support order itself, not just in the worksheets.

"Washington State Support Registry" or "WSSR" is the entity created under RCW 26.23.030 within the division of child support (DCS) which, among other duties, contains a central unit for the collection, accounting, and disbursement of support payments.

"We" means the division of child support, part of the department of social and health services of the state of Washington.

"You" means the reader of the rules, a member of the public, or a recipient of support enforcement services.

History

Statutory Authority: RCW 74.20.040, 74.20A.055, 74.20A.310, and 26.19.065. WSR 25-22-018, s 388-14A-1020, filed 10/24/25, effective 1/1/26. Statutory Authority: RCW 26.23.050, 74.20.040, and 74.20A.310. WSR 25-17-054, s 388-14A-1020, filed 8/14/25, effective 9/14/25. Statutory Authority: RCW 26.23.050, 26.23.110, 43.20A.550, 74.04.055, 74.04.057, 74.08.090, 74.20.040, 74.20A.055, 74.20A.056, and 74.20A.310. WSR 25-09-019, s 388-14A-1020, filed 4/7/25, effective 5/8/25. Statutory Authority: RCW 26.09.916, 74.08.090, 74.20A.055. WSR 22-02-063, § 388-14A-1020, filed 1/4/22, effective 2/4/22. Statutory Authority: Part I of 2018 c 150 and RCW 26.09.105, 26.18.170, 26.23.050, 34.05.220 (1)(a), 34.05.350(1), 74.08.090, and 74.20.040(9). WSR 19-02-017, § 388-14A-1020, filed 12/21/18, effective 1/21/19. Statutory Authority: RCW 26.23.120, 34.05.350 (1)(b), 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310 and 45 C.F.R. Parts 301.1, 302.36, 303.7, 303.11, 305.63, and 308.2. WSR 13-01-075, § 388-14A-1020, filed 12/18/12, effective 1/18/13. Statutory Authority: 2011 c 283, RCW 34.05.220, 43.20A.550, 74.04.055, 74.04.057, 74.08.090, 74.20A.055, 74.20A.056, and 74.20A.310. WSR 12-01-002, § 388-14A-1020, filed 12/7/11, effective 1/7/12. Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-1020, filed 5/19/11, effective 6/19/11. Statutory Authority: RCW 26.18.170, 26.23.035, 26.23.050, [26.23.]110, 74.20.040, 74.20A.030, [74.20A.]055, [74.20A.]056, and 74.20A.310. WSR 09-02-059, § 388-14A-1020, filed 1/5/09, effective 1/27/09. Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-1020, filed 5/29/08, effective 7/1/08. Statutory Authority: RCW 74.20A.310, 45 C.F.R. 302.31 and 302.33. WSR 06-03-120, § 388-14A-1020, filed 1/17/06, effective 2/17/06. Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.055, 74.20A.056, 74.20A.310. WSR 05-14-101, § 388-14A-1020, filed 6/30/05, effective 7/31/05. Statutory Authority: RCW 74.08.090, 74.20A.310, and 26.18.170, 42 U.S.C. 666 (a)(19), Child Support Performance and Incentives Act of 1998, 45 C.F.R. 303.31, and 45 C.F.R. 303.32. WSR 04-17-119, § 388-14A-1020, filed 8/17/04, effective 9/17/04. Statutory Authority: RCW 74.08.090, 26.23.035, 34.05.220(1), 74.20A.055, 74.20A.056. WSR 01-03-089, § 388-14A-1020, filed 1/17/01, effective 2/17/01. Formerly WAC 388-11-011 and 388-14-020.

Wash. Admin. Code § 388-14A-1025 What are the responsibilities of the division of child support?

(1) The division of child support (DCS) provides support enforcement services when:

(a) The department of social and health services pays public assistance;

(b) A former recipient of public assistance is eligible for services, as provided in WAC 388-14A-2000 (2)(c);

(i) Provides residential care (foster care) for a dependent child; and

(ii) Refers a noncustodial parent (NCP) or parents (NCPs) to DCS for DCS to provide support enforcement services for the child in residential care;

(d) A custodial parent (CP) or NCP requests nonassistance support enforcement services under RCW 74.20.040 and WAC 388-14A-2000;

(e) A support order or wage assignment order under chapter 26.18 RCW directs the NCP to make support payments through the Washington state support registry (WSSR);

(f) A support order under which there is a current support obligation for dependent children is submitted to the WSSR;

(g) A former CP requests services to collect a support debt accrued under a court or administrative support order while the child or children resided with the CP;

(h) A child support enforcement agency in another state or foreign country requests support enforcement services; or

(i) A child support agency of an Indian tribe requests support enforcement services.

(2) DCS takes action under chapters 26.09, 26.18, 26.19, 26.21A, 26.23, 26.26A, 26.26B, 74.20, and 74.20A RCW to establish, enforce, and collect child support obligations.

(a) DCS refers cases to the county prosecuting attorney or attorney general's office when judicial action is required.

(b) If DCS has referred a case to the county prosecuting attorney or attorney general's office and the CP has been granted good cause level A, DCS does not share funding under Title IV-D for any actions taken by the prosecutor or attorney general's office once DCS advises them of the good cause finding.

(3) DCS does not take action on cases where the community services office (CSO) has granted the CP good cause not to cooperate under WAC 388-422-0020, when the CSO grants "level A good cause." If the CSO grants "level B good cause," DCS proceeds to establish and enforce support obligations but does not require the CP to cooperate with DCS. WAC 388-14A-2065 and 388-14A-2070 describe the way DCS handles cases with good cause issues.

(4) DCS establishes, maintains, retains, and disposes of case records in accordance with the department's records management and retention policies and procedures adopted under chapter 40.14 RCW.

(5) DCS establishes, maintains, and monitors support payment records.

(6) DCS receives, accounts for, and distributes child support payments required under court or administrative orders for support.

(7) DCS charges and collects fees as required by federal and state law regarding the Title IV-D child support enforcement program.

(8) DCS files a satisfaction of judgment when we determine that a support obligation is either paid in full or no longer legally enforceable. WAC 388-14A-2099 describes the procedures for filing a satisfaction of judgment. WAC 388-14A-2099(4) describes how DCS determines a support obligation is satisfied or no longer legally enforceable.

(9) Based on changes in federal statutes and regulations, DCS establishes or changes the rules regarding its responsibilities when acting as either the initiating agency or responding agency in an intergovernmental child support case.

History

Statutory Authority: RCW 26.09.105, 26.18.170, 26.23.050, 26.23.110, 26.23.120, 34.05.020, 34.05.060, 74.08.090, 74.20.040, 74.20A.055, and 74.20A.056. WSR 24-15-143, § 388-14A-1025, filed 7/23/24, effective 8/23/24. Statutory Authority: RCW 26.23.120, 34.05.350 (1)(b), 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310 and 45 C.F.R. Parts 301.1, 302.36, 303.7, 303.11, 305.63, and 308.2. WSR 13-01-075, § 388-14A-1025, filed 12/18/12, effective 1/18/13. Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-1025, filed 5/29/08, effective 7/1/08. Statutory Authority: RCW 74.08.090, 74.20A.310. WSR 01-24-080, § 388-14A-1025, filed 12/3/01, effective 1/3/02. Statutory Authority: RCW 74.08.090, 45 C.F.R. 303.106. WSR 01-03-089, § 388-14A-1025, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-205.

Wash. Admin. Code § 388-14A-1030 What kinds of services can the division of child support provide?

The services provided by the division of child support include, but are not limited to the following:

(1) Receiving payments and distributing the payments (see WAC 388-14A-5000);

(2) Establishing or modifying administrative child support orders (see WAC 388-14A-3100 and 388-14A-3925);

(3) Enforcing and modifying court orders for child support or maintenance (see WAC 388-14A-3304, 388-14A-3310, and 388-14A-3900);

(4) Referral to the prosecuting attorney for establishment of parentage;

(5) Providing locate services as provided in WAC 388-14A-1035;

(6) Referral for welfare to work services in conjunction with other parts of DSHS, the employment security department (ESD), and private contractors;

(7) Cooperation with the IV-D agencies of Indian tribes and other states, and the central authorities of other countries (see WAC 388-14A-1060); and

(8) Providing any other services allowed by the state plan and applicable state and federal law.

History

Statutory Authority: RCW 26.23.050, 26.23.110, 43.20A.550, 74.04.055, 74.04.057, 74.08.090, 74.20.040, 74.20A.055, 74.20A.056, and 74.20A.310. WSR 25-09-019, s 388-14A-1030, filed 4/7/25, effective 5/8/25. Statutory Authority: RCW 26.23.120, 34.05.350 (1)(b), 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310 and 45 C.F.R. Parts 301.1, 302.36, 303.7, 303.11, 305.63, and 308.2. WSR 13-01-075, § 388-14A-1030, filed 12/18/12, effective 1/18/13. Statutory Authority: RCW 74.08.090, 34.05.310 (4)(d) and 45 C.F.R. 303.106. WSR 03-20-072, § 388-14A-1030, filed 9/29/03, effective 10/30/03. Statutory Authority: RCW 74.08.090, 45 C.F.R. 303.106. WSR 01-03-089, § 388-14A-1030, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-205.

Wash. Admin. Code § 388-14A-1035 What kinds of locate services does the division of child support provide?

The division of child support (DCS) maintains a service to locate noncustodial parents, using:

(1) All sources of information and available records in Washington or other states; and

(2) The federal parent locator service (FPLS) maintained by the federal Department of Health and Human Services.

History

Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-1035, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-350.

Wash. Admin. Code § 388-14A-1036 Who can request DCS locate services?

DCS provides locate services for:

(1) Persons receiving public assistance for the benefit of dependent children;

(2) Any agency or attorney of another state or country seeking to collect support obligations under an agreement entered into with DCS;

(3) A court which has the authority to issue an order against a noncustodial parent (NCP) for the support and maintenance of a child;

(4) The custodial parent (CP), legal guardian, attorney or agent of a child who does not receive public assistance, and has not applied for full support enforcement services;

(5) The IV-D agency of another state;

(6) The child support agency of an Indian tribe or another country; and

(7) Those persons authorized by 45 C.F.R. 303.15 to use the FPLS in connection with parental kidnaping or child custody cases.

History

Statutory Authority: RCW 26.23.120, 34.05.350 (1)(b), 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310 and 45 C.F.R. Parts 301.1, 302.36, 303.7, 303.11, 305.63, and 308.2. WSR 13-01-075, § 388-14A-1036, filed 12/18/12, effective 1/18/13. Statutory Authority: RCW 74.08.090. WSR 01-03-089, § WAC 388-14A-1036, filed 1/17/01, effective 2/17/01.

Wash. Admin. Code § 388-14A-1040 What must a request for locate services contain?

A request or referral asking the division of child support (DCS) to provide locate services must contain the following information:

(1) The name of the noncustodial parent (NCP);

(2) The NCP's Social Security number, if known;

(3) Whether the NCP is now or has been a member of the armed services;

(4) Whether the NCP is now receiving or has received any federal benefits;

(5) A request for a referral to the federal parent locator service (FPLS);

(6) A statement that the request is being made to locate a person only for one of the following purposes:

(a) Establishing parentage;

(b) Securing support; or

(7) A statement acknowledging that any information obtained from the FPLS must be kept confidential.

History

Statutory Authority: RCW 26.23.050, 26.23.110, 43.20A.550, 74.04.055, 74.04.057, 74.08.090, 74.20.040, 74.20A.055, 74.20A.056, and 74.20A.310. WSR 25-09-019, s 388-14A-1040, filed 4/7/25, effective 5/8/25. Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-1040, filed 1/17/01, effective 2/17/01.

Wash. Admin. Code § 388-14A-1045 What happens when I request locate services from the division of child support?

(1) The division of child support (DCS) makes diligent and reasonable efforts to locate the noncustodial parent (NCP), including referral to the federal parent locator service (FPLS).

(2) A request for locate services is not an application for full support enforcement services.

(3) If DCS is successful in locating the NCP, the case does not automatically convert to a full support enforcement services case, but you may apply for full services.

(4) If DCS is unsuccessful in locating the NCP using local and state resources, DCS closes the case as provided in WAC 388-14A-2080(12).

History

Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-1045, filed 1/17/01, effective 2/17/01.

Wash. Admin. Code § 388-14A-1050 The division of child support cooperates with tribes and other states and countries for support enforcement purposes.

The division of child support (DCS) cooperates with the IV-D agencies of tribes and other states and the central authorities of other countries, according to rules and policies set by the Secretary of the Department of Health and Human Services and the federal Office of Child Support Services (OCSS). Areas of cooperation include:

(1) Establishing parentage;

(2) Locating a noncustodial parent (NCP) who resides in Washington;

(3) Enforcing the support obligation of an NCP who resides in Washington but whose support order was entered by an Indian tribe or another state or country; and

(4) Any other functions required under a Title IV-D plan.

History

Statutory Authority: RCW 26.23.050, 26.23.110, 43.20A.550, 74.04.055, 74.04.057, 74.08.090, 74.20.040, 74.20A.055, 74.20A.056, and 74.20A.310. WSR 25-09-019, s 388-14A-1050, filed 4/7/25, effective 5/8/25. Statutory Authority: RCW 26.23.120, 34.05.350 (1)(b), 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310 and 45 C.F.R. Parts 301.1, 302.36, 303.7, 303.11, 305.63, and 308.2. WSR 13-01-075, § 388-14A-1050, filed 12/18/12, effective 1/18/13. Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-1050, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-360.

Wash. Admin. Code § 388-14A-1055 Can the division of child support collect support owed or assigned to another state, tribe or country?

(1) The division of child support (DCS) may, at the request of an Indian tribe or another state, collect child support which has been assigned to that tribe, state under 42 U.S.C. 608 (a)(3)(A), or another country according to the laws of that country.

(2) DCS uses the remedies in chapters 26.23, 74.20 and 74.20A RCW to collect support on behalf of another state, tribe, country or IV-D agency.

History

Statutory Authority: RCW 26.23.120, 34.05.350 (1)(b), 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310 and 45 C.F.R. Parts 301.1, 302.36, 303.7, 303.11, 305.63, and 308.2. WSR 13-01-075, § 388-14A-1055, filed 12/18/12, effective 1/18/13. Statutory Authority: RCW 26.21.016, 34.05.020, 74.08.090, 74.20.040(3), 74.20A.310. WSR 06-06-078, § 388-14A-1055, filed 2/28/06, effective 3/31/06. Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-1055, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-365.

Wash. Admin. Code § 388-14A-1060 The division of child support cooperates with courts and law enforcement.

(1) The division of child support (DCS) is authorized to enter into cooperative arrangements and written agreements including financial arrangements with the appropriate courts and law enforcement officials (including Indian tribes) to assist DCS in administering the state plan for support enforcement.

(2) These cooperative arrangements include the investigation and prosecution of fraud related to parentage and child support.

(3) DCS shares the federal funds it receives under 42 U.S.C. 655 according to the cooperative and financial agreements.

(4) Any support payments that are made by a noncustodial parent (NCP) after DCS refers a case to a court or law enforcement official must be submitted to the Washington state support registry.

History

Statutory Authority: RCW 26.23.050, 26.23.110, 43.20A.550, 74.04.055, 74.04.057, 74.08.090, 74.20.040, 74.20A.055, 74.20A.056, and 74.20A.310. WSR 25-09-019, s 388-14A-1060, filed 4/7/25, effective 5/8/25. Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-1060, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-370.

Wash. Admin. Code § 388-14A-2000 Who can receive child support enforcement services from the division of child support?

(1) The division of child support (DCS) provides payment processing and records maintenance services (called "payment services only") to parties to a court order who are not receiving a public assistance grant when:

(a) A Washington superior court order, tribal court order, administrative order, or wage assignment order under chapter 26.18 RCW directs payments through DCS or through the Washington state support registry (WSSR);

(b) The custodial parent (CP) of a dependent child or a noncustodial parent (NCP) requests payment services only, provided that:

(i) An NCP's request for payment services only may not cause a reduction of service from the level of service provided under subsection (2) of this section; and

(ii) The support obligation is set by a Washington state superior court order, tribal court order, administrative order, or wage assignment order, directing payment to DCS or to WSSR.

(2) DCS provides full support enforcement services under Title IV-D of the Social Security Act to CPs or NCPs who are not receiving a public assistance grant when:

(a) The CP or former physical custodian of a child requests support enforcement services;

(b) The NCP of a dependent child requests support enforcement services;

(c) An NCP submits a support order for inclusion in or a support payment to the WSSR, together with an application for support enforcement services;

(d) A public assistance recipient stops receiving a cash grant under the temporary assistance for needy families program;

(e) The department provides medicaid-only benefits to a CP on behalf of a dependent child, unless the recipient of the medicaid-only benefits declines support enforcement services not related to establishment of parentage, medical support establishment, or medical support enforcement;

(f) A man requests services to establish parentage alleging they are the child's biological or genetic parent; or

(g) An Indian tribe or another state or country requests services in an intergovernmental case.

(3) DCS provides payment processing, records maintenance, establishment of parentage, medical support establishment, and medical support enforcement services when a recipient of medicaid-only benefits declines support enforcement services in writing.

History

Statutory Authority: RCW 26.23.050, 26.23.110, 43.20A.550, 74.04.055, 74.04.057, 74.08.090, 74.20.040, 74.20A.055, 74.20A.056, and 74.20A.310. WSR 25-09-019, s 388-14A-2000, filed 4/7/25, effective 5/8/25. Statutory Authority: RCW 26.23.120, 34.05.350 (1)(b), 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310 and 45 C.F.R. Parts 301.1, 302.36, 303.7, 303.11, 305.63, and 308.2. WSR 13-01-075, § 388-14A-2000, filed 12/18/12, effective 1/18/13. Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-2000, filed 5/29/08, effective 7/1/08. Statutory Authority: RCW 74.08.090, 26.23.035, 34.05.220(1), 74.20A.310, 45 C.F.R. 303.106. WSR 01-03-089, § 388-14A-2000, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-205, 388-14-300, and 388-14-310.

Wash. Admin. Code § 388-14A-2005 When does an application for public assistance automatically become an application for support enforcement services?

(1) When a custodial parent (CP) or physical custodian (also called the CP) applies for or receives cash assistance on behalf of a minor child, the family authorizes the division of child support (DCS) to provide full support enforcement services to the family.

(2) These services continue until the support enforcement case is closed under WAC 388-14A-2080.

(3) The CP's public assistance application is an assignment of support rights.

(4) An application for medicaid, medical assistance, or medical benefits under Title XIX of the federal Social Security Act is an assignment of the medical support rights of anyone receiving those benefits, and the CP authorizes DCS to provide support enforcement services to the family as follows:

(a) DCS provides full support enforcement services as provided under subsection (1) of this section for a family receiving cash assistance, or under WAC 388-14A-2000 (2)(d) to a family receiving medicaid-only benefits;

(b) As set forth in WAC 388-14A-2000(3), DCS provides only payment processing, records maintenance, establishment of parentage, medical support establishment, and medical support enforcement services when a recipient of medicaid-only benefits declines full support enforcement services in writing.

(5) WAC 388-14A-2036 describes the assignment of support rights.

(6) If the community services division grants the CP good cause not to cooperate under WAC 388-422-0020, DCS does not provide services. See WAC 388-14A-2065.

History

Statutory Authority: RCW 26.23.050, 26.23.110, 43.20A.550, 74.04.055, 74.04.057, 74.08.090, 74.20.040, 74.20A.055, 74.20A.056, and 74.20A.310. WSR 25-09-019, s 388-14A-2005, filed 4/7/25, effective 5/8/25. Statutory Authority: RCW 74.20A.310, 45 C.F.R. 302.31 and 302.33. WSR 06-03-120, § 388-14A-2005, filed 1/17/06, effective 2/17/06. Statutory Authority: RCW 74.08.090, 26.23.035, 34.05.220(1), 74.20A.310, 45 C.F.R. 303.106. WSR 01-03-089, § 388-14A-2005, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-205.

Wash. Admin. Code § 388-14A-2010 Can I apply for support enforcement services if I do not receive public assistance?

(1) If you are not receiving public assistance, you can apply for support enforcement services. Your case is called a nonassistance case. A nonassistance case receives the same level of services as a case that was opened because of the payment of public assistance.

(2) Generally, the person applying for nonassistance support enforcement services is the custodial parent or former custodial parent of a child. However, the noncustodial parent may apply for services as well, as provided in WAC 388-14A-2000 (2)(b), (c) and (f).

(3) A person wishing to apply for nonassistance support enforcement services must submit a written application for support enforcement services except as provided in WAC 388-14A-2000 (2)(d); and

(a) Have or have had physical custody of the child for whom support is sought, or for whom a support debt has accrued, or be the person with whom the child resided the majority of the time for which support is sought; or

(b) Be the noncustodial parent.

(4) The applicant must:

(a) Give consent for the division of child support (DCS) to take an assignment of earnings from the noncustodial parent (NCP) if the parents are still married;

(b) Agree to send to DCS any support payments received directly from the NCP within eight days of receipt;

(d) Agree not to hire an attorney or collection agency, or apply to any other state's IV-D agency to collect the same support obligation or support debt, without notifying DCS;

(e) Complete, sign, date and submit to DCS the application form and any other required documents;

(f) Supply copies of divorce and dissolution decrees, support orders and modification orders, and any related documents affecting a support obligation;

(g) Provide a statement of the amount of support debt owed by the NCP;

(h) Include or attach a list, by date, of the support payments received from the NCP during the time period for which the CP seeks support; and

(i) Pay any applicable fee imposed by state or federal law.

(5) If someone other than the CP has legal custody of the child under a court order, the CP must affirm that:

(a) The CP has not wrongfully deprived the legal custodian of custody; and

(b) The person with legal custody has not been excused from making support payments by a court or administrative tribunal.

(6) See WAC 388-14A-2015 regarding requests for intergovernmental child support services received from a foreign reciprocating country (FRC) or from a custodial parent who is a resident of an FRC.

(7) See WAC 388-14A-7660 regarding the assessment of costs in an intergovernmental case where the initiating jurisdiction is an FRC.

History

Statutory Authority: RCW 26.23.120, 34.05.350 (1)(b), 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310 and 45 C.F.R. Parts 301.1, 302.36, 303.7, 303.11, 305.63, and 308.2. WSR 13-01-075, § 388-14A-2010, filed 12/18/12, effective 1/18/13. Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-2010, filed 5/29/08, effective 7/1/08. Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-2010, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-310.

Wash. Admin. Code § 388-14A-2015 Does DCS accept an application from someone who is not a resident of Washington state?

(1) If you are not a resident of the state of Washington but you are applying for services, you must swear or affirm that there is not an open IV-D case in another state.

(2) The division of child support (DCS) may decline the application for nonassistance support enforcement services if:

(a) DCS already has an open case for you which was opened at the request of another state; or

(b) Neither the custodial parent nor the noncustodial parent reside, work, or own any assets in the state of Washington.

(3) If you are a custodial parent residing in a foreign reciprocating country (FRC), either you or the child support agency of your country may request intergovernmental child support services from DCS. As provided under 42 U.S.C. 654 (32)(C):

(a) No formal application for services is required; and

(b) DCS does not assess costs against either the FRC or the custodial parent.

(4) See WAC 388-14A-7660 regarding costs assessed against the noncustodial parent in an intergovernmental case where the initiating jurisdiction is an FRC.

History

Statutory Authority: RCW 26.23.120, 34.05.350 (1)(b), 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310 and 45 C.F.R. Parts 301.1, 302.36, 303.7, 303.11, 305.63, and 308.2. WSR 13-01-075, § 388-14A-2015, filed 12/18/12, effective 1/18/13. Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-2015, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-310.

Wash. Admin. Code § 388-14A-2020 Can the division of child support deny my application for support enforcement services?

(1) The division of child support (DCS) may deny an application which is incomplete, contains unclear or inconsistent statements, is not supported by necessary documents, or requests services DCS cannot or does not provide.

(2) DCS may deny an application from a nonresident as provided in WAC 388-14A-2015(2).

(3) When DCS denies an application, DCS sends the applicant a written notice of denial by regular mail. The notice advises the applicant:

(a) Of the reasons for the denial; and

(b) That the applicant may request an administrative hearing to contest the denial.

History

Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-2020, filed 1/17/01, effective 2/17/01.

Wash. Admin. Code § 388-14A-2025 What services does the division of child support provide for a nonassistance support enforcement case?

(1) The division of child support (DCS) provides full support enforcement services for every IV-D case.

(2) DCS provides either full or limited nonassistance support enforcement services for recipients of medicaid-only benefits as provided in WAC 388-14A-2005(4).

(3) Some cases do not receive full support enforcement services. Nonassistance cases where DCS provides payment processing services are called payment services only (PSO) cases.

(4) In a PSO case, DCS provides only records maintenance and payment processing services if the payee under a support order does not submit an application for support enforcement services and the:

(a) Order directs support payments to DCS or to the Washington state support registry (WSSR); and

(b) The clerk of the court submitted the order under RCW 26.23.050.

(5) DCS continues to provide services without an application after a:

(a) Public assistance recipient stops receiving cash assistance; or

(b) Recipient of medicaid-only benefits becomes ineligible for medicaid-only benefits, unless the recipient declines support enforcement services or requests additional services.

(6) If you receive services as a former recipient of assistance, as described in subsection (5), you must cooperate with DCS in the same way as when you received a grant.

History

Statutory Authority: RCW 74.20A.310, 45 C.F.R. 302.31 and 302.33. WSR 06-03-120, § 388-14A-2025, filed 1/17/06, effective 2/17/06. Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-2025, filed 1/17/01, effective 2/17/01.

Wash. Admin. Code § 388-14A-2030 Do I assign my rights to support when I apply for child support enforcement services?

(1) A custodial parent applying for or receiving cash assistance on behalf of a minor child assigns the family's rights to support as provided in WAC 388-14A-2035, below.

(2) A person applying for nonassistance support enforcement services does not assign support rights, but agrees to cooperate with the division of child support as provided in WAC 388-14A-2010(3).

History

Statutory Authority: RCW 74.08.090, 26.23.035, 34.05.220(1), 74.20A.270, 74.20A.310. WSR 01-03-089, § 388-14A-2030, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-200.

Wash. Admin. Code § 388-14A-2035 Do I assign my rights to support when I receive public assistance?

(1) When you receive public assistance you assign your rights to support to the state. This section applies to all applicants and recipients of cash assistance under the state program funded under Title IV-A of the federal Social Security Act.

(2) As a condition of eligibility for assistance, a family member must assign to the state the right to collect and keep, subject to the limitation in subsection (3), any support owing to the family member or to any other person for whom the family member has applied for or is receiving assistance.

(3) Amounts assigned under this section may not exceed the lesser of the total amount of assistance paid to the family or the total amount of the assigned support obligation.

(4) When you receive medicaid or medical benefits, you assign your rights to medical support to the state. This applies to all recipients of medical assistance under the state program funded under Title XIX of the federal Social Security Act:

(a) If your children receive medicaid or other state-financed medical coverage through the department under chapter 74.09 RCW for which there is an assignment and if your order provides for the payment of a monthly payment toward the premium when the obligated parent does not provide coverage, the division of child support (DCS) may serve a notice of support owed to establish the amount owed by the noncustodial parent as a monthly payment toward the premium paid for coverage by the state, as provided in WAC 388-14A-3312.

(b) Any amounts established under WAC 388-14A-3312 for periods while your children receive medicaid or other state-financed medical coverage are assigned to the state and are distributed as provided in WAC 388-14A-5001 through 388-14A-5050.

(c) Amounts assigned under this section may not exceed the lesser of the total amount of premiums paid by the state for your children or the total amount of the assigned monthly payment toward the premium.

(5) In addition to the assignment described in this section, there is an assignment of support rights under Title IV-E of the social security act when a child receives foster care services.

(a) The state provides foster care programs which may be federally-funded or state funded, or may place a child with a relative.

(b) As part of its state plan under Title IV-D of the social security act and 45 C.F.R. 302.52, DCS provides child support enforcement services for foster care cases as required by 45 C.F.R. 302.33, RCW 74.20.330 and 74.20A.030.

History

Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-2035, filed 5/19/11, effective 6/19/11. Statutory Authority: RCW 74.20A.310, 45 C.F.R. 302.31 and 302.33. WSR 06-03-120, § 388-14A-2035, filed 1/17/06, effective 2/17/06. Statutory Authority: RCW 74.08.090, 26.23.035, 34.05.220(1), 74.20A.270, 74.20A.310. WSR 01-03-089, § 388-14A-2035, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-200.

Wash. Admin. Code § 388-14A-2036 What does assigning my rights to support mean?

(1) As a condition of eligibility for assistance, a family member must assign to the state the right to collect and keep, subject to the limitation in WAC 388-14A-2035(3):

(a) Any support owing to the family member or to any other person for whom the family member has applied for or is receiving assistance if the family applied for cash public assistance before October 1, 2008.

(b) Support owing to the family member, or to any other person for whom the family member has applied for or is receiving cash public assistance, for any month during which the family receives assistance.

(2) While your family receives assistance, support is distributed and disbursed in accordance with WAC 388-14A-5000 through 388-14A-5015.

(3) After your family terminates from assistance, certain accrued arrears remain assigned to the state in accordance with the following rules:

(a) For assistance applications dated prior to October 1, 1997, you permanently assigned to the state all rights to support which accrued before the application date until the date your family terminated from assistance.

(b) For assistance applications dated on or after October 1, 1997, and before October 1, 2000:

(i) You permanently assigned to the state all rights to support which accrued while your family receives assistance; and

(ii) You temporarily assigned to the state all rights to support which accrued before the application date, until October 1, 2000, or when your family terminated from assistance, whichever date is later.

(i) You permanently assigned to the state all rights to support which accrued while the family received assistance; and

(ii) You temporarily assigned to the state all rights to support which accrued before the application date, until the date your family terminated from assistance.

(d) For assistance applications dated on or after October 1, 2008, you permanently assign to the state all rights to support which accrue while the family receives assistance.

(4) When you assign your medical support rights to the state, you authorize the state on behalf of yourself and the children in your care to enforce the noncustodial parent's full duty to provide medical support.

(a) When you begin receiving medicaid or medical assistance, you do not assign to the state any accrued medical support arrears that may be owed to you by the noncustodial parent (NCP).

(b) If your support order provides for the payment of a monthly payment toward the premium when the obligated parent does not provide coverage, the division of child support (DCS) may serve a notice of support owed to establish the amount owed by the NCP as a monthly payment toward the premium paid for coverage by the state, as provided in WAC 388-14A-3312.

History

Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-2036, filed 5/19/11, effective 6/19/11. Statutory Authority: RCW 26.18.170, 26.23.035, 26.23.050, [26.23.]110, 74.20.040, 74.20A.030, [74.20A.]055, [74.20A.]056, and 74.20A.310. WSR 09-02-059, § 388-14A-2036, filed 1/5/09, effective 1/27/09. Statutory Authority: RCW 74.20A.310, 45 C.F.R. 302.31 and 302.33. WSR 06-03-120, § 388-14A-2036, filed 1/17/06, effective 2/17/06. Statutory Authority: RCW 74.08.090, 26.23.035, 34.05.220(1), 74.20A.270, 74.20A.310. WSR 01-03-089, § 388-14A-2036, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-200.

Wash. Admin. Code § 388-14A-2037 What are permanently assigned arrears?

Permanently assigned arrears accrue only under the following conditions:

(1) For those periods prior to the family receiving assistance, for assistance applications dated before October 1, 1997; and

(2) For those periods while a family receives assistance, for assistance applications dated at any time.

History

Statutory Authority: RCW 26.18.170, 26.23.035, 26.23.050, [26.23.]110, 74.20.040, 74.20A.030, [74.20A.]055, [74.20A.]056, and 74.20A.310. WSR 09-02-059, § 388-14A-2037, filed 1/5/09, effective 1/27/09. Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-2037, filed 1/17/01, effective 2/17/01.

Wash. Admin. Code § 388-14A-2038 What are temporarily assigned arrears?

(1) Temporarily assigned arrears are arrears owed to the family at the time TANF started, for TANF periods beginning before October 1, 2008. These arrears remain temporarily assigned during the assistance period.

(2) Temporarily assigned arrears convert to conditionally assigned arrears when the TANF period ends. See WAC 388-14A-2039 for a description of conditionally assigned arrears.

(3) If any support collections are distributed to temporarily assigned arrears, those collections are retained by the state, up to the amount of unreimbursed assistance.

History

Statutory Authority: RCW 26.18.170, 26.23.035, 26.23.050, [26.23.]110, 74.20.040, 74.20A.030, [74.20A.]055, [74.20A.]056, and 74.20A.310. WSR 09-02-059, § 388-14A-2038, filed 1/5/09, effective 1/27/09. Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-2038, filed 1/17/01, effective 2/17/01.

Wash. Admin. Code § 388-14A-2039 What are conditionally assigned arrears?

(1) Conditionally assigned arrears are any temporarily assigned arrears that remain on a case after the family stops receiving TANF.

(2) These arrears remain conditionally assigned during TANF periods beginning on or after October 1, 2008.

(3) If federal tax refund offset collections are distributed to conditionally assigned arrears, those collections are retained by the state, up to the amount of unreimbursed assistance.

(4) If support collections other than federal tax refund offset collections are distributed to conditionally assigned arrears, those collections are disbursed to the family.

History

Statutory Authority: RCW 26.18.170, 26.23.035, 26.23.050, [26.23.]110, 74.20.040, 74.20A.030, [74.20A.]055, [74.20A.]056, and 74.20A.310. WSR 09-02-059, § 388-14A-2039, filed 1/5/09, effective 1/27/09.

Wash. Admin. Code § 388-14A-2040 Do I have to cooperate with the division of child support in establishing or enforcing child support?

(1) You must cooperate with the division of child support (DCS) when you receive public assistance unless the department determines there is good cause not to cooperate under WAC 388-422-0020.

(2) As described in WAC 388-14A-2080, DCS may close a nonassistance case if the custodial parent (CP) fails to cooperate, if cooperation is essential for the next step in enforcement.

(3) For purposes of this section and WAC 388-14A-2075, cooperating with DCS includes cooperating with those acting on behalf of DCS (its "representatives"), namely the prosecuting attorney, the attorney general, or a private attorney paid per RCW 74.20.350. In cases where parentage is at issue, the CP of a child who receives assistance must cooperate whether or not the parent receives assistance.

(4) Cooperation means giving information, attending interviews, attending hearings, or taking actions to help DCS establish and collect child support. This information and assistance is necessary for DCS to:

(a) Identify and locate the responsible parent;

(b) Establish the parentage of the child or children on assistance in the CP's care; and

(5) The CP must also cooperate by sending to DCS any child support received by the CP while on assistance, as required by RCW 74.20A.275 (3)(c). If the client keeps these payments, known as retained support, the CP must sign an agreement to repay under RCW 74.20A.275, and the CP must honor that agreement.

(6) The cooperation requirements of subsections (1), (3), and (4) of this section, but not subsection (5), apply to a recipient of medicaid-only assistance.

History

Statutory Authority: RCW 26.23.050, 26.23.110, 43.20A.550, 74.04.055, 74.04.057, 74.08.090, 74.20.040, 74.20A.055, 74.20A.056, and 74.20A.310. WSR 25-09-019, s 388-14A-2040, filed 4/7/25, effective 5/8/25. Statutory Authority: 2012 c 253 § 5, 2012 1st sp.s. c 4, RCW 34.05.220, 43.20A.550, 74.04.055, 74.08.090, and 70.20.040. WSR 12-18-027, § 388-14A-2040, filed 8/27/12, effective 9/27/12. Statutory Authority: RCW 34.05.020, 34.05.220, 74.08.090, 74.20.040, and 2011 c 42. WSR 11-23-087, § 388-14A-2040, filed 11/17/11, effective 12/18/11. Statutory Authority: RCW 74.20A.310, 45 C.F.R. 302.31 and 302.33. WSR 06-03-120, § 388-14A-2040, filed 1/17/06, effective 2/17/06. Statutory Authority: RCW 74.08.090, 34.05.310 (4)(d), 26.23.035, 74.20A.310. WSR 03-20-072, § 388-14A-2040, filed 9/29/03, effective 10/30/03. Statutory Authority: RCW 74.08.090, 26.23.035, 74.20A.310. WSR 01-03-089, § 388-14A-2040, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-201.

Wash. Admin. Code § 388-14A-2041 What happens if I don't cooperate with DCS while I receive public assistance?

(1) If you receive public assistance, there may be penalties, called sanctions, for not cooperating with the division of child support (DCS). These sanctions and the noncooperation process are described in WAC 388-14A-2075. You may be sanctioned if:

(a) You do not go to scheduled interviews and answer questions;

(b) There is credible evidence showing that you could have given the information but did not;

(d) You refuse to sign or honor a repayment agreement under WAC 388-14A-2040(3).

(2) You must be given the opportunity to swear you do not have the information.

(3) You cannot be sanctioned because you provided information on a possible parent who was then excluded by genetic testing. In this event you must continue to cooperate in naming other possible parents and taking part in any resulting genetic testing.

(4) You may not be able to help DCS if you do not know, do not possess, or cannot reasonably obtain the requested information. To avoid a sanction, you must, under penalty of perjury, swear or attest to your lack of information in an interview held by DCS or its representative.

(5) If you fear that cooperation may cause harm to you or your children, you may contact the community services division (CSD) to claim good cause not to cooperate under WAC 388-422-0020.

History

Statutory Authority: RCW 34.05.020, 34.05.220, 74.08.090, 74.20.040, and 2011 c 42. WSR 11-23-087, § 388-14A-2041, filed 11/17/11, effective 12/18/11. Statutory Authority: RCW 74.08.090, 26.23.035, 74.20A.310. WSR 01-03-089, § 388-14A-2041, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-202.

Wash. Admin. Code § 388-14A-2045 What can I do if I am afraid that cooperating with the division of child support will be harmful to me or to my children?

(1) If a custodial parent (CP) receiving public assistance fears that the establishment or enforcement of support may result in harm to the CP or the children, the CP may be excused from the cooperation requirements. The CP must contact the community services division (CSD) to claim good cause not to cooperate under WAC 388-422-0020. The CP may claim good cause:

(a) At the time of application for public assistance; or

(b) At any time thereafter.

(2) If a CP who is not receiving public assistance fears that the establishment or enforcement of support may result in harm to the CP or the children, the CP should tell the division of child support (DCS) that family violence is an issue in the case, so that DCS may take appropriate action. The CP may ask DCS to close the nonassistance support enforcement case.

History

Statutory Authority: 2012 c 253 § 5, 2012 1st sp.s. c 4, RCW 34.05.220, 43.20A.550, 74.04.055, 74.08.090, and 70.20.040. WSR 12-18-027, § 388-14A-2045, filed 8/27/12, effective 9/27/12. Statutory Authority: RCW 34.05.020, 34.05.220, 74.08.090, 74.20.040, and 2011 c 42. WSR 11-23-087, § 388-14A-2045, filed 11/17/11, effective 12/18/11. Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-2045, filed 1/17/01, effective 2/17/01.

Wash. Admin. Code § 388-14A-2050 Who decides if I have good cause not to cooperate?

(1) The community services division (CSD) decides whether you have good cause not to cooperate with the division of child support (DCS). You must tell CSD if you want to claim good cause.

(a) CSD determines good cause under WAC 388-422-0020.

(b) You may claim good cause at the time you apply for public assistance, or at any time thereafter.

(2) When you make a claim of good cause not to cooperate, DCS does not take any action on your case while CSD is reviewing your good cause claim.

History

Statutory Authority: 2012 c 253 § 5, 2012 1st sp.s. c 4, RCW 34.05.220, 43.20A.550, 74.04.055, 74.08.090, and 70.20.040. WSR 12-18-027, § 388-14A-2050, filed 8/27/12, effective 9/27/12. Statutory Authority: RCW 34.05.020, 34.05.220, 74.08.090, 74.20.040, and 2011 c 42. WSR 11-23-087, § 388-14A-2050, filed 11/17/11, effective 12/18/11. Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-2050, filed 1/17/01, effective 2/17/01.

Wash. Admin. Code § 388-14A-2060 Are there different kinds of good cause for not cooperating with DCS?

(1) For custodial parents receiving public assistance, there are two kinds of good cause granted by the community services office (CSO):

(a) When the CSO determines that support establishment or enforcement cannot proceed at all because of a risk of danger to the custodial parent (CP) or children, this is called good cause level A.

(b) When the CSO determines that support establishment or enforcement can proceed without input from the CP, but that good cause exists for the CP not to cooperate with DCS, this is called good cause level B.

(2) See WAC 388-422-0020 for how the CSO grants good cause.

History

Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-2060, filed 1/17/01, effective 2/17/01.

Wash. Admin. Code § 388-14A-2065 Does the division of child support provide support enforcement services if the community services division decides I have "good cause level A"?

(1) If the community services division (CSD) grants you good cause level A the division of child support (DCS) closes the case and does not take any action to establish or enforce support for the children covered by the good cause finding.

(a) DCS does not reopen the case while you and the children still receive temporary assistance for needy families (TANF), unless the good cause decision is later withdrawn or denied;

(b) DCS does not reopen the case after your TANF grant ends unless you:

(i) Reapply for TANF and tell CSD that you no longer wish to claim good cause not to cooperate with DCS; or

(ii) Apply for nonassistance child support services by submitting an application to DCS.

(2) If CSD grants good cause level A after DCS has referred your case to the county prosecuting attorney or attorney general's office, DCS advises the prosecutor or attorney general's office of the good cause finding.

(3) When DCS advises the prosecutor or attorney general's office that good cause level A has been granted in your case, DCS requests that the prosecutor or attorney general's office dismiss any action that has been filed and cease all activities to establish or enforce a child support obligation for the children covered by the good cause finding.

(4) If the person whose actions were the basis for the good cause level A finding later receives TANF or submits an application for nonassistance child support services:

(a) DCS provides child support enforcement services to that person only if the children covered by the good cause finding no longer reside with you and currently reside with that person; and

(b) DCS does not provide services to establish that person's parentage of the children covered by the good cause finding, even if the children receive TANF as a member of that person's household, unless your good cause decision is withdrawn or denied.

History

Statutory Authority: RCW 26.23.050, 26.23.110, 43.20A.550, 74.04.055, 74.04.057, 74.08.090, 74.20.040, 74.20A.055, 74.20A.056, and 74.20A.310. WSR 25-09-019, s 388-14A-2065, filed 4/7/25, effective 5/8/25. Statutory Authority: RCW 74.08.090, 74.20A.310. WSR 01-24-080, § 388-14A-2065, filed 12/3/01, effective 1/3/02. Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-2065, filed 1/17/01, effective 2/17/01.

Wash. Admin. Code § 388-14A-2070 Does the division of child support provide support enforcement services if the community services division determines I have "good cause level B"?

(1) If the community services division (CSD) grants you good cause level B, the division of child support provides support enforcement services without requiring the custodial parent (CP) to provide information or cooperate with DCS in any way.

(2) When DCS advises the prosecutor or attorney general's office that good cause level B has been granted in your case, the prosecutor or attorney general's office decides whether there is sufficient evidence to proceed without the CP's cooperation with respect to any action that has been filed to establish or enforce a child support obligation for the child covered by the good cause finding.

History

Statutory Authority: RCW 26.23.050, 26.23.110, 43.20A.550, 74.04.055, 74.04.057, 74.08.090, 74.20.040, 74.20A.055, 74.20A.056, and 74.20A.310. WSR 25-09-019, s 388-14A-2070, filed 4/7/25, effective 5/8/25. Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-2070, filed 1/17/01, effective 2/17/01.

Wash. Admin. Code § 388-14A-2075 What happens if the division of child support determines that I am not cooperating?

WAC 388-14A-2075

(1) When the division of child support (DCS) or its representatives believe that a custodial parent (CP) who receives cash assistance or medical assistance is not cooperating as defined in WAC 388-14A-2040, DCS sends a notice to the CP and to the community services division (CSD) about the noncooperation.

(a) The notice contains the following information:

(i) How the noncooperation was determined, including what actions were required;

(ii) What actions the CP must take to resume cooperation;

(iii) That this notice was sent to CSD;

(iv) That the CP may contact CSD immediately if the CP disagrees with the notice, needs help in order to cooperate, or believes the actions required are unreasonable; and

(v) That CSD may sanction the CP by either reducing or terminating the grant.

(b) CSD sends a notice of planned action to the CP as provided by WAC 388-472-0005.

(d) If the noncooperation was due to missing an interview without reasonable excuse, the CP will be considered to be cooperating when the CP appears for a rescheduled interview and either provides information or attests to the lack of information. DCS or its representative must reschedule the interview within seven business days from the date the CP contacts them to reschedule an interview.

(e) If the noncooperation was due to not taking a required action, cooperation resumes when the CP takes that action.

(2) There is no hearing right for a notice of noncooperation, but the CP may request a hearing on the sanction imposed by CSD.

(3) If the CP takes the actions required to resume cooperation within 60 days, DCS leaves the case open and continues to establish or enforce the support obligation.

(4) The CP may request a hearing to contest case closure, as described in WAC 388-14A-2095.

History

Statutory Authority: RCW 26.18.170, 26.23.035, 26.23.110, 43.20A.550, 74.04.055, 74.08.090, 74.20.040, 74.20A.310, and 74.20A.328. WSR 26-14-086, s 388-14A-2075, filed 6/29/26, effective 7/30/26. Statutory Authority: 2012 c 253 § 5, 2012 1st sp.s. c 4, RCW 34.05.220, 43.20A.550, 74.04.055, 74.08.090, and 70.20.040. WSR 12-18-027, § 388-14A-2075, filed 8/27/12, effective 9/27/12. Statutory Authority: RCW 34.05.020, 34.05.220, 74.08.090, 74.20.040, and 2011 c 42. WSR 11-23-087, § 388-14A-2075, filed 11/17/11, effective 12/18/11. Statutory Authority: RCW 74.08.090, 34.05.310 (4)(d), 26.23.035, 74.20A.310. WSR 03-20-072, § 388-14A-2075, filed 9/29/03, effective 10/30/03. Statutory Authority: RCW 74.08.090, 26.23.035, 74.20A.310. WSR 01-03-089, § 388-14A-2075, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-202.

Wash. Admin. Code § 388-14A-2080 Once DCS opens a support enforcement case, under what circumstances can it be closed?

(1) The circumstances under which the division of child support (DCS) may close a case depend on whether the application for services was made directly to DCS or to another governmental entity.

(2) WAC 388-14A-2081 discusses closure of a case when one of the parties submitted an application for support enforcement services directly to DCS, which includes when DCS opened the case as the result of an application for public assistance in the state of Washington.

(3) WAC 388-14A-2083 discusses closure of an intergovernmental case, which is what we call a case where the application for services was made to the child support enforcement agency of another state, tribe, territory, country or political subdivision thereof, which then requested support enforcement services from DCS.

History

Statutory Authority: RCW 26.23.120, 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310, and 45 C.F.R. Parts 301.1, 302.35, 302.36, 303.3, 303.7, 303.11, 303.20, 305.63, 307.13, and 308.2. WSR 11-22-116, § 388-14A-2080, filed 11/2/11, effective 12/3/11. Statutory Authority: RCW 74.08.090, 26.23.035, 34.05.220(1), 74.20A.310, 45 C.F.R. 303.11, 45 C.F.R. 303.100. WSR 01-03-089, § 388-14A-2080, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-420.

Wash. Admin. Code § 388-14A-2081 Under what circumstances can DCS close a case when the application for services was made directly to DCS?

When the application for services was made directly to the division of child support (DCS) by one of the parties, including when DCS opened the case as the result of an application for public assistance in the state of Washington, the case must remain open unless DCS determines that:

(1) There is no current support order, and the support debt owed by the noncustodial parent (NCP) is less than $500, or cannot be enforced under Washington law;

(2) The NCP or putative (alleged) father is dead with no assets, income, or estate available for collection;

(3) The NCP has no assets or income available for collection and is not able to provide support during the child's minority because of being:

(a) Institutionalized in a psychiatric facility;

(b) Incarcerated without possibility of parole; or

(4) The applicant or recipient of nonassistance services submits a written request for closure, and there is no current assignment of medical or support rights;

(5) DCS has enough information to use an automated locate system, and has not been able to locate the NCP after three years of diligent efforts;

(6) DCS does not have enough information to use an automated locate system, and has not been able to locate the NCP after one year of diligent efforts;

(7) DCS is unable to contact the applicant or recipient of services for at least 60 days;

(8) DCS or the prosecutor documents failure to cooperate by the custodial parent (CP), and that cooperation is essential for the next step in enforcement;

(9) DCS cannot obtain a parentage order because:

(a) The putative father is dead;

(b) Genetic testing has excluded all putative fathers;

(d) DCS, the prosecutor, a court of competent jurisdiction, or an administrative hearing determines that establishing parentage would not be in the best interests of the child in a case involving incest, rape, or pending adoption; or

(e) The biological father is unknown and cannot be identified after diligent efforts, including at least one interview by DCS or its representative with the recipient of support enforcement services.

(10) DCS, the prosecutor, a court of competent jurisdiction, or an administrative hearing determines that the recipient of services has wrongfully deprived the NCP of physical custody of the child as provided in WAC 388-14A-3370(3);

(11) DCS, the prosecutor, the department of social and health services, a court of competent jurisdiction, or an administrative hearing determines that action to establish or enforce a support obligation cannot occur without a risk of harm to the child or the CP;

(12) DCS has provided locate-only services in response to a request for state parent locator services (SPLS);

(13) The NCP is a citizen and resident of a foreign country, and:

(a) The NCP has no assets which can be reached by DCS; and

(b) The country where the NCP resides does not provide reciprocity in child support matters.

(14) The child is incarcerated or confined to a juvenile rehabilitation facility for a period of 90 days or more; or

(15) Any other circumstances exist which would allow closure under 45 C.F.R. 303.11 or any other federal statute or regulation.

History

Statutory Authority: RCW 26.23.050, 26.23.110, 43.20A.550, 74.04.055, 74.04.057, 74.08.090, 74.20.040, 74.20A.055, 74.20A.056, and 74.20A.310. WSR 25-09-019, s 388-14A-2081, filed 4/7/25, effective 5/8/25. Statutory Authority: RCW 26.23.120, 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310, and 45 C.F.R. Parts 301.1, 302.35, 302.36, 303.3, 303.7, 303.11, 303.20, 305.63, 307.13, and 308.2. WSR 11-22-116, § 388-14A-2081, filed 11/2/11, effective 12/3/11.

Wash. Admin. Code § 388-14A-2083 Under what circumstances can DCS close a case where the application for services was originally made to another state, tribe, territory or country, otherwise known as an intergovernmental case?

(1) When the application for services was originally made by a party to the child support enforcement agency of another state, tribe, territory, country or political subdivision thereof, which then requested support enforcement services from the division of child support (DCS), DCS keeps the case open until:

(a) The state, tribe, territory, country or political subdivision that received the application for services tells DCS that its case is closed.

(b) The state, tribe, territory, country or political subdivision that received the application for services tells DCS that it no longer wants DCS to provide services.

(c) DCS documents failure to cooperate by the initiating jurisdiction, and that cooperation is essential for the next step in enforcement.

(2) DCS calls this type of case an "intergovernmental case."

(a) The state, tribe, territory, country or political subdivision thereof which referred the case to DCS is called the "initiating jurisdiction."

(b) In these cases, DCS is the "responding jurisdiction."

History

Statutory Authority: RCW 26.23.120, 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310, and 45 C.F.R. Parts 301.1, 302.35, 302.36, 303.3, 303.7, 303.11, 303.20, 305.63, 307.13, and 308.2. WSR 11-22-116, § 388-14A-2083, filed 11/2/11, effective 12/3/11.

Wash. Admin. Code § 388-14A-2085 Under what circumstances may DCS keep a support enforcement case open despite a request to close it?

WAC 388-14A-2085

(1) The division of child support (DCS) may deny a request to close a support enforcement case when:

(a) There is a current assignment of support or medical rights on behalf of the children in the case;

(b) There is accrued debt under a support order that has been assigned to the state;

(d) The person who requests closure is not the recipient of support enforcement services.

(2) If DCS is the responding jurisdiction in an intergovernmental case DCS cannot deny a request from the initiating jurisdiction to close the intergovernmental portion of a DCS case.

(3) If there is no current assignment of support or medical rights, DCS may close the portion of the case that is owed to the custodial parent (CP), but if there is accrued debt under a support order that has been assigned to the state, DCS keeps that portion of the case open.

(4) If a support order specifies that the noncustodial parent (NCP) must make payments to the WSSR, but the CP does not want support enforcement services, DCS changes the case status to a payment services only (PSO) case, which means that:

(a) DCS provides payment processing and records maintenance; and

(b) DCS does not provide enforcement services.

History

Statutory Authority: RCW 26.18.170, 26.23.035, 26.23.110, 43.20A.550, 74.04.055, 74.08.090, 74.20.040, 74.20A.310, and 74.20A.328. WSR 26-14-086, s 388-14A-2085, filed 6/29/26, effective 7/30/26. Statutory Authority: RCW 26.23.120, 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310, and 45 C.F.R. Parts 301.1, 302.35, 302.36, 303.3, 303.7, 303.11, 303.20, 305.63, 307.13, and 308.2. WSR 11-22-116, § 388-14A-2085, filed 11/2/11, effective 12/3/11. Statutory Authority: RCW 74.08.090, 26.23.035, 34.05.220(1), 74.20A.310, 45 C.F.R. 303.11, 45 C.F.R. 303.100. WSR 01-03-089, § 388-14A-2085, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-421.

Wash. Admin. Code § 388-14A-2090 Who receives notice when DCS closes a case?

(1) The reason for case closure determines whether the division of child support (DCS):

(a) Sends a notice of intent to close;

(b) Sends a notice of case closure; or

(2) DCS mails a notice of intent to close by regular mail to the last known address of the custodial parent (CP) and the noncustodial parent.

(3) If DCS is closing a case under WAC 388-14A-2081, DCS sends a notice of intent to close, advising the parties why DCS is closing the case. DCS sends the notice sixty days before closing the case, except:

(a) DCS sends a notice of case closure but does not send a notice of intent to close when the applicant or recipient of nonassistance services submits a written request for closure, and there is no current assignment of medical or support rights;

(b) DCS notifies the initiating jurisdiction in an intergovernmental case that DCS has closed the case after the initiating jurisdiction requests case closure; and

(i) DCS, the prosecuting attorney, the department of social and health services, a court of competent jurisdiction or an administrative hearing determines that action to establish or enforce a support obligation cannot occur without a risk of harm to the child or the custodial parent (CP); or

(ii) DCS has provided locate-only services in response to a request for state parent locator services (SPLS).

(4) If DCS is the responding jurisdiction and is closing an intergovernmental case because of noncooperation by the initiating jurisdiction, DCS notifies the other jurisdiction's child support agency sixty days before closing the case.

(5) When DCS is the initiating jurisdiction in an intergovernmental case and DCS closes its case, DCS notifies the responding jurisdiction that DCS has closed its case and provides the reason for closure.

History

Statutory Authority: RCW 26.23.120, 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310, and 45 C.F.R. Parts 301.1, 302.35, 302.36, 303.3, 303.7, 303.11, 303.20, 305.63, 307.13, and 308.2. WSR 11-22-116, § 388-14A-2090, filed 11/2/11, effective 12/3/11. Statutory Authority: RCW 74.08.090, 26.23.035, 34.05.220(1), 74.20A.310, 45 C.F.R. 303.11, 45 C.F.R. 303.100. WSR 01-03-089, § 388-14A-2090, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-422.

Wash. Admin. Code § 388-14A-2095 What if I don't agree with the case closure notice?

(1) Only the person who applied for support enforcement services, also known as the recipient of services, may request a hearing to challenge closure of a case.

(2) If the recipient of services requests a hearing, the other party may participate in the hearing.

(3) The closure of a child support case does not stop the custodial parent or noncustodial parent from filing an application for support enforcement services in the future, but the reason for closure may affect whether the division of child support will open a new case.

History

Statutory Authority: RCW 74.08.090, 26.23.035, 34.05.220(1), 74.20A.310, 45 C.F.R. 303.11, 45 C.F.R. 303.100. WSR 01-03-089, § 388-14A-2095, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-423.

Wash. Admin. Code § 388-14A-2097 What happens to payments that come in after a case is closed?

After support enforcement services are terminated, the division of child support (DCS) returns support money to the noncustodial parent except if the case remains open as a payment services only (PSO) case as described in WAC 388-14A-2000(1).

(2) If DCS, as the initiating jurisdiction in an intergovernmental case, closed a case without notifying the responding jurisdiction, DCS must attempt to locate the custodial parent (CP) and disburse any payments the CP is entitled to receive.

History

Statutory Authority: RCW 26.23.120, 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310, and 45 C.F.R. Parts 301.1, 302.35, 302.36, 303.3, 303.7, 303.11, 303.20, 305.63, 307.13, and 308.2. WSR 11-22-116, § 388-14A-2097, filed 11/2/11, effective 12/3/11. Statutory Authority: RCW 74.08.090, 26.23.035, 34.05.220(1), 74.20A.310, 45 C.F.R. 303.11, 45 C.F.R. 303.100. WSR 01-03-089, § 388-14A-2097, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-424.

Wash. Admin. Code § 388-14A-2099 When does DCS file a satisfaction of judgment with the superior court?

(1) When the division of child support (DCS) determines that a support obligation, established by order of a superior court of this state, has been satisfied or is no longer legally enforceable, DCS sends a notice of its intent to file a satisfaction of judgment to the last known address of the payee under the order and to the noncustodial parent (NCP).

(2) DCS includes the following provisions in the notice:

(a) A statement of the facts DCS relied on in making the determination; and

(b) A statement that the payee has twenty days from the date of the notice, to:

(i) Object and request a conference board under WAC 388-14A-6400; or

(ii) Initiate an action to obtain a judgment from the court that entered the order.

(3) If the conference board or the court determines the support obligation or a support debt still exists, DCS withdraws the notice and makes reasonable efforts to enforce and collect the remaining support debt. If the conference board or court determines that a debt does not exist, DCS files a satisfaction of judgment with the clerk of superior court in which the order was entered.

(4) DCS determines that a support obligation is satisfied or is no longer legally enforceable when the obligation to pay current and future support terminates under the order, and:

(a) The NCP has made all payments owed under the support order;

(b) The support debt is no longer enforceable due to the operation of the statute of limitations;

(d) Under RCW 74.20A.220, DCS determines the debt is uncollectible, grants a total or partial charge-off, or accepts an offer to compromise a disputed debt.

History

Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-2099, filed 1/17/01, effective 2/17/01.

Wash. Admin. Code § 388-14A-2105 Basic confidentiality rules for the division of child support.

(1) Under RCW 26.23.120, all information and records, concerning persons who owe a support obligation or for whom the division of child support (DCS) provides support enforcement services, are private and confidential.

(2) DCS discloses information and records only to a person or entity listed in this section or in RCW 26.23.120, and only for a specific purpose allowed by state or federal law. See WAC 388-14A-7500 regarding disclosure of personal information in the context of referrals under the Uniform Interstate Family Support Act (UIFSA).

(3) DCS may disclose information to:

(a) The person who is the subject of the information or records unless the information or records are exempt under RCW 42.56.210;

(b) Local, state, and federal government agencies for support enforcement and related purposes;

(c) A party to a judicial proceeding or a hearing under chapter 34.05 RCW, if the superior court judge or administrative law judge (ALJ) enters an order to disclose. The judge or presiding officer must base the order on a written finding that the need for the information outweighs any reason for maintaining privacy and confidentiality;

(d) A party under contract with DCS, including a federally recognized Indian tribe, if disclosure is for support enforcement and related purposes;

(e) A person or entity, including a federally recognized Indian tribe, when disclosure is necessary to the administration of the child support program or the performance of DCS functions and duties under state and federal law;

(f) A person, representative, or entity if the person who is the subject of the information and records consents, in writing, to disclosure;

(g) The office of administrative hearings or the office of appeals for administration of the hearing process under chapter 34.05 RCW. The ALJ or review judge must:

(i) Not include the address of either party in an administrative order, or disclose a party's address to the other party;

(ii) State in support orders that the address is known by the Washington state support registry; and

(iii) Inform the parties they may obtain the address by submitting a request for disclosure to DCS under WAC 388-14A-2110(2).

(4) DCS may publish information about a noncustodial parent (NCP) for locate and enforcement purposes.

(5) WAC 388-14A-2114(1) sets out the rules for disclosure of address, employment, or other information regarding the custodial parent (CP) or the children in response to a public disclosure request.

(6) WAC 388-14A-2114(2) sets out the rules for disclosure of address, employment, or other information regarding the NCP in response to a public disclosure request.

(7) DCS may disclose the Social Security number of a dependent child to the NCP to enable the NCP to claim the dependency exemption as authorized by the Internal Revenue Service.

(8) DCS may disclose financial records of an individual obtained from a financial institution only for the purpose of, and to the extent necessary, to establish, modify, or enforce a child support obligation of that individual.

(9) Except as provided elsewhere in chapter 388-14A WAC, chapter 388-01 WAC governs the process of requesting and disclosing information and records.

(10) DCS must take timely action on requests for disclosure. DCS must respond in writing within five working days of receipt of the request.

(11) The rules of confidentiality and penalties for misuse of information and reports that apply to a IV-D agency employee, also apply to a person who receives information under this section.

(12) Nothing in these rules:

(a) Prevents DCS from disclosing information and records when such disclosure is necessary to the performance of its duties and functions as provided by state and federal law;

(b) Requires DCS to disclose information and records obtained from a confidential source.

(13) DCS cannot provide copies of the confidential information form contained in court orders. You must go to court to get access to the confidential information form. DCS may disclose information contained within the confidential information form if disclosure is authorized under RCW 26.23.120, chapter 388-01, or 388-14A WAC.

(14) DCS may provide a Support Order Summary to the parties to an administrative support order under WAC 388-14A-2116.

History

Statutory Authority: RCW 26.09.105, 26.18.170, 26.23.050, 26.23.110, 26.23.120, 34.05.020, 34.05.060, 74.08.090, 74.20.040, 74.20A.055, and 74.20A.056. WSR 24-15-143, § 388-14A-2105, filed 7/23/24, effective 8/23/24. Statutory Authority: RCW 34.05.220(2), 43.20A.550, 74.04.055, 74.08.090, 74.20.040, 74.20A.310. WSR 07-08-055, § 388-14A-2105, filed 3/29/07, effective 4/29/07. Statutory Authority: RCW 26.23.120, 74.08.090. WSR 02-07-091, § 388-14A-2105, filed 3/19/02, effective 4/19/02
WSR 01-03-089, § 388-14A-2105, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-030.

Wash. Admin. Code § 388-14A-2107 Are there special rules for requests for whereabouts information?

(1) Address information is sometimes referred to as whereabouts information, meaning information giving someone's home, work, school or day care location.

(2) The last known address of, or employment information about, a party to a court or administrative order for, or a proceeding involving, child support may be given to another party to the order. The party receiving the information may only use the information to establish, enforce, or modify a support order.

(3) The last known address of the natural or adoptive children may be given to a parent having a court order granting that parent visitation rights with, legal custody of or residential time with, the parent's natural or adoptive children. The parent may only use this information to enforce the terms of the court order.

(4) The last known address of a party to an order for child support may be given to another party to the order. The party receiving the information may only use the information to establish a parenting plan for the children covered by the support order.

(5) Disclosure of whereabouts information is subject to the provisions of WAC 388-14A-2114.

(6) Requests from law enforcement agencies are subject to the provisions of RCW 74.04.062.

History

Statutory Authority: RCW 26.23.120, 74.08.090. WSR 02-07-091, § 388-14A-2107, filed 3/19/02, effective 4/19/02.

Wash. Admin. Code § 388-14A-2110 How do I make a request for disclosure of DCS public records?

(1) You can make a request for disclosure of most DCS records either orally or in writing. If you are requesting whereabouts information, see subsection (2).

(2) You must submit a request for disclosure of a parent or child's address in writing or in person, with satisfactory evidence of identity, at any office of the division of child support (DCS).

(a) If the request is made by your attorney, DCS may waive the provisions regarding submission in person with satisfactory evidence of identity.

(b) If you are unable to appear at a DCS office in person, DCS may waive the provision requiring submission in person if you submit a notarized request for disclosure. DCS can provide a form which contains all the required elements for an address disclosure request.

(i) A copy of the superior court order on which the request is based. DCS waives this provision if DCS has a true copy of the order on file;

(ii) A sworn statement by the individual that the order has not been modified; and

(iii) A statement explaining the purpose of the request and how the requestor intends to use the information.

History

Statutory Authority: RCW 26.23.120, 74.08.090. WSR 02-07-091, § 388-14A-2110, filed 3/19/02, effective 4/19/02
WSR 01-03-089, § 388-14A-2110, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-030 and 388-14-035.

Wash. Admin. Code § 388-14A-2112 When I make a public disclosure request, do I get the information or records immediately?

(1) The division of child support (DCS) must respond to a public disclosure request within five days, under RCW 26.23.120 and WAC 388-01-090.

(2) "Respond" can mean:

(a) Providing the requested documents;

(b) Acknowledging receipt of the request and giving an estimate of how long it will take to provide copies;

(d) Requesting that you clarify your request if we are not sure what you are asking for;

(e) Notifying you of any other necessary procedural steps, such as notice to the other party or to a third party; or

(f) Denying your request according to WAC 388-01-090(3).

(3) When someone requests address or other whereabouts information, DCS first gives notice as provided in WAC 388-14A-2114, 388-14A-2120, and 388-14A-2115.

History

Statutory Authority: RCW 26.23.120, 74.08.090. WSR 02-07-091, § 388-14A-2112, filed 3/19/02, effective 4/19/02.

Wash. Admin. Code § 388-14A-2114 Does DCS give notice to anyone before releasing information pursuant to a public disclosure request?

(1) Prior to disclosing the address of the custodial parent (CP) or a child, DCS mails a notice to the last known address of the CP, except as provided under WAC 388-14A-2115. The notice advises the CP that:

(a) A request for disclosure has been made;

(b) DCS intends to disclose the address after thirty days from the date of the notice, unless:

(i) DCS receives a copy of an order which:

(A) Enjoins disclosure of the address;

(B) Restricts the noncustodial parent's right to contact or visit the CP or a child by imposing conditions to protect the CP or the child from harm, including, but not limited to, temporary orders for protection under chapter 26.50 RCW; or

(C) States that the health, safety, or liberty of the CP or child would be unreasonably put at risk by disclosure of address or other identifying information; or

(ii) The CP requests an administrative hearing which ultimately results in a decision that release of the address is reasonably anticipated to result in harm to the CP or a dependent child.

(c) In any hearing under this section, either party may participate in the proceeding by telephone, from any prearranged location. The administrative law judge (ALJ) must not disclose the location and phone number.

(2) DCS does not provide notice to the noncustodial parent (NCP) before disclosing NCP's address information to the CP unless NCP has requested prior notice under WAC 388-14A-2120.

(3) Before releasing confidential information concerning someone who is not a party to the case, DCS gives notice to that person according to WAC 388-01-140.

History

Statutory Authority: RCW 26.23.120, 74.08.090. WSR 02-07-091, § 388-14A-2114, filed 3/19/02, effective 4/19/02.

Wash. Admin. Code § 388-14A-2115 Can the custodial parent waive notice of a request for address?

(1) Any party to a support order may authorize the division of child support (DCS) to release his or her address to the other party with no prior notice.

(2) An authorization to release an address must be:

(a) In writing;

(b) Notarized; and

(c) Effective for any period designated by the party up to three years, or until DCS is notified in writing that the party has revoked the authorizations, whichever is sooner.

History

Statutory Authority: RCW 26.23.120, 74.08.090. WSR 02-07-091, § 388-14A-2115, filed 3/19/02, effective 4/19/02
WSR 01-03-089, § 388-14A-2115, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-030, 388-14-035, and 388-14-045.

Wash. Admin. Code § 388-14A-2116 How do I request a support order summary from DCS?

(1) If you are a party to an administrative support order, you may request a support order summary from the division of child support (DCS). The support order summary includes the following information:

(a) The noncustodial parent's residential address, employer's address, Social Security number; date of birth, and driver's license number; and

(b) The custodial parent's Social Security number.

(2) DCS provides the most current information DCS has available in the support order summary.

(3) DCS must provide notice to the noncustodial parent (NCP) prior to releasing his or her residential and employer address information if the NCP has requested that he or she be provided notice before DCS releases the address information, as provided in WAC 388-14A-2120.

(4) Nonaddress information contained in the Support Order Summary may be released without notice to the other party to the support order.

History

Statutory Authority: RCW 26.23.120, 74.08.090. WSR 02-07-091, § 388-14A-2116, filed 3/19/02, effective 4/19/02.

Wash. Admin. Code § 388-14A-2120 Can the noncustodial parent request notice before DCS releases address information to the custodial parent?

(1) The notice and hearing process in WAC 388-14A-2114 and 388-14A-2140 do not apply to requests for address information of the noncustodial parent (NCP).

(2) The NCP may request notice before whereabouts info is released to the custodial parent by notifying the division of child support (DCS), either orally or in writing.

(3) Once an NCP has submitted a request for notice, DCS follows the notice and hearing provisions in WAC 388-14A-2114 and 388-14A-2140 when it receives a request for address information.

History

Statutory Authority: RCW 26.23.120, 74.08.090. WSR 02-07-091, § 388-14A-2120, filed 3/19/02, effective 4/19/02
WSR 01-03-089, § 388-14A-2120, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-030 and 388-14-050.

Wash. Admin. Code § 388-14A-2125 Can DCS ever release address information without notice?

(1) The division of child support (DCS) does not follow the notice and hearing process of WAC 388-14A-2114 and 388-14A-2140 if:

(a) Disclosure is denied under WAC 388-14A-2135;

(b) The CP has provided a written release as provided in WAC 388-14A-2115;

(d) A court order requires DCS to release the address information.

(2) DCS is not required to mail a notice prior to disclosure if the requesting party presents a facially valid warrant or a judicial finding that:

(a) The other party will likely flee to avoid service of process; or

(b) The other party will likely flee and that:

(i) A court of competent jurisdiction of this state or another state has entered an order giving legal and physical custody of a child whose address is requested to the requesting party; and

(ii) The custody order has not been altered, changed, modified, superseded, or dismissed; and

(iii) A child was taken or enticed from the address requesting party's physical custody without that party's consent; and

(iv) The address requesting party has not subsequently assented to being deprived of physical custody of the children; and

(v) The address requesting party is making reasonable efforts to regain physical custody of the child.

History

Statutory Authority: RCW 26.23.120, 74.08.090. WSR 02-07-091, § 388-14A-2125, filed 3/19/02, effective 4/19/02
WSR 01-03-089, § 388-14A-2125, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-030 and 388-14-040.

Wash. Admin. Code § 388-14A-2130 What if I object to the release of my address?

When a party objects to a notice mailed under WAC 388-14A-2114, the division of child support may:

(1) Deny disclosure if the objection provides information based on which DCS would have denied disclosure under WAC 388-14A-2135; or

(2) Request that the office of administrative hearings (OAH) set the case for an administrative hearing under WAC 388-14A-2140.

History

Statutory Authority: RCW 26.23.120, 74.08.090. WSR 02-07-091, § 388-14A-2130, filed 3/19/02, effective 4/19/02.

Wash. Admin. Code § 388-14A-2135 When might DCS deny a request for address information without going through the notice and hearing process?

(1) The division of child support (DCS) denies a request for address information without going through the notice process under WAC 388-14A-2114 if:

(a) The department has determined, under WAC 388-422-0020, that the custodial parent (CP) has good cause for refusing to cooperate;

(b) The order, on which the request is based, restricts or limits the address requesting party's right to contact or visit the other party or the child by imposing conditions to protect the party or the child from harm;

(c) An order has been entered finding that the health, safety, or liberty of a party or child would be unreasonably put at risk by the disclosure of the information; or

(d) DCS has information which gives DCS reason to believe that release of the address may result in physical or emotional harm to the other party or to the children.

(2) Whenever DCS denies a request for disclosure under subsection (1) of this section, DCS notifies the nonrequesting party that disclosure of the address was requested and was denied.

History

Statutory Authority: RCW 74.08.090, 34.05.310 (4)(d) and 26.23.120. WSR 03-20-072, § 388-14A-2135, filed 9/29/03, effective 10/30/03. Statutory Authority: RCW 26.23.120, 74.08.090. WSR 02-07-091, § 388-14A-2135, filed 3/19/02, effective 4/19/02.

Wash. Admin. Code § 388-14A-2140 What happens at a hearing on objection to disclosure of address information?

In any administrative hearing requested under WAC 388-14A-2114 (1)(b)(ii):

(1) The parent requesting address disclosure and the other party to the order or action are independent parties in the hearing.

(2) The office of administrative hearings (OAH) sets the hearing as a phone hearing;

(3) Each party must provide OAH with a telephone number where the party can be reached for the hearing, at some time before the scheduled hearing.

(4) The administrative law judge (ALJ) must not disclose the location or phone number from which either party is appearing.

(5) The ALJ may, upon good cause shown, convert the hearing to an in-person hearing for the party requesting disclosure.

(6) The initial burden of proof is on the party requesting address disclosure, to show that the address request is for a purpose for which chapter 388-14A WAC specifically permits disclosure.

(7) If the party requesting address disclosure:

(a) Fails to meet this burden, the ALJ enters an order denying the address request;

(b) Establishes that the address was requested for a purpose for which disclosure is permitted, the other party must then show that it is reasonable to anticipate that physical or emotional harm to the party or a child will result from release of the address. The party objecting to address release:

(i) May show reasonable fear of harm by any form of evidence admissible under chapter 34.05 RCW; and

(ii) Is not required to provide supporting evidence required by WAC 388-422-0020, to establish a reasonable fear of harm.

(8) If either party fails to appear, the ALJ enters an order on default:

(a) If the party objecting to disclosure fails to appear, the order requires DCS to release the address unless the record contains documentary evidence which provides the basis for a finding that physical or emotional harm will likely result from release of the address;

(b) If the address requesting party fails to appear, the default order denies the request for address information.

(9) OAH arranges the attendance of the parties by telephone or other procedure showing due regard for the safety of the parties and the children.

(10) DCS issues a final response to the disclosure request within five working days of the exhaustion of administrative remedies, including any late appeal periods.

(11) If the custodial parent (CP) requests a hearing under this section in response to a department initiated review of the support order for modification, both parties to the support order are independent parties in the address disclosure hearing.

History

Statutory Authority: RCW 26.23.120, 74.08.090. WSR 02-07-091, § 388-14A-2140, filed 3/19/02, effective 4/19/02.

Wash. Admin. Code § 388-14A-2150 How much does it cost to get copies of DCS records?

WAC 388-14A-2150

(1) WAC 388-01-080 authorizes the division of child support (DCS) to charge copying and postage costs for responses to requests for public records.

(2) The amount DCS charges depends on the format requested and the method of delivery. See the DSHS website for more information at https://www.dshs.wa.gov/office-of-the-secretary/how-request-public-records.

(3) DCS may waive copy fees in appropriate circumstances.

History

Statutory Authority: RCW 26.18.170, 26.23.035, 26.23.110, 43.20A.550, 74.04.055, 74.08.090, 74.20.040, 74.20A.310, and 74.20A.328. WSR 26-14-086, s 388-14A-2150, filed 6/29/26, effective 7/30/26. Statutory Authority: RCW 74.08.090, 34.05.310 (4)(d). WSR 03-20-072, § 388-14A-2150, filed 9/29/03, effective 10/30/03. Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-2150, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-030.

Wash. Admin. Code § 388-14A-2155 Can I appeal a denial of a request for division of child support records?

WAC 388-14A-2155

(1) If your request for division of child support (DCS) records is denied, you may file an appeal with the economic services administration (ESA) public disclosure unit, P.O. Box 45445, Olympia WA 98504-5445.

(2) If ESA denies your appeal, you may pursue the other options listed in WAC 388-01-130.

History

Statutory Authority: RCW 26.18.170, 26.23.035, 26.23.110, 43.20A.550, 74.04.055, 74.08.090, 74.20.040, 74.20A.310, and 74.20A.328. WSR 26-14-086, s 388-14A-2155, filed 6/29/26, effective 7/30/26. Statutory Authority: RCW 74.08.090, 34.05.310 (4)(d). WSR 03-20-072, § 388-14A-2155, filed 9/29/03, effective 10/30/03. Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-2155, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-030.

Wash. Admin. Code § 388-14A-2160 On what authority does DCS share my confidential information with a credit bureau?

(1) Under 42 U.S.C. §666 (a)(7), the division of child support (DCS) may report to consumer reporting agencies the name and identifying information of any noncustodial parent (NCP) who is delinquent in support and the amount of overdue support owed by that parent. Consumer reporting agencies are sometimes also called credit bureaus.

(2) Once DCS has reported an NCP to the credit bureaus, DCS updates the information on a regular basis as long as DCS continues to enforce the support order, even after the NCP brings the account current.

(3) Before releasing information to the consumer reporting agency, DCS sends a written notice to the NCP's last known address concerning the proposed release of the information.

(4) The notice gives the NCP ten days from the date of the notice to request a conference board under WAC 388-14A-6400 to contest the accuracy of the information. If the NCP requests a conference board, DCS does not release the information until a conference board decision has been issued.

(5) An NCP who disagrees with the information supplied by DCS to a consumer reporting agency or credit bureau may file a notice of dispute under the federal Fair Credit Reporting Act, 15 U.S.C. 1681.

(6) DCS reports to credit bureaus according to the requirements of federal IV-D program rules. In interstate or intergovernmental cases, DCS may report:

(a) As the responding jurisdiction; and

(b) As the initiating jurisdiction when the responding jurisdiction does not report.

History

Statutory Authority: RCW 26.23.120, 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310, and 45 C.F.R. Parts 301.1, 302.35, 302.36, 303.3, 303.7, 303.11, 303.20, 305.63, 307.13, and 308.2. WSR 11-22-116, § 388-14A-2160, filed 11/2/11, effective 12/3/11. Statutory Authority: RCW 26.23.120, 74.08.090, 74.20A.310. WSR 06-06-076, § 388-14A-2160, filed 2/28/06, effective 3/31/06. Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-2160, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-030 and 388-14-410.

Wash. Admin. Code § 388-14A-2200 When does DCS charge a thirty-five dollar annual fee on a child support case?

(1) Under RCW 74.20.040, the division of child support (DCS) must impose an annual fee of thirty-five dollars for each case in which:

(a) The custodial parent (CP) has never received TANF, Tribal TANF or AFDC as the custodian of minor children; and

(b) DCS has collected and disbursed to the CP at least five hundred and fifty dollars on the case during that federal fiscal year. The federal fiscal year runs from October 1 through September 30.

(2) A custodial parent who has children with more than one noncustodial parent (NCP) may be assessed a separate thirty-five dollar fee for each case in which DCS collects at least five hundred and fifty dollars in a federal fiscal year.

(3) If DCS has already collected the thirty-five dollar annual fee on a Washington state case and the CP begins receiving TANF or Tribal TANF during the same federal fiscal year, DCS is not required to refund or cancel the fee.

(4) If the CP with a Washington case has paid a fee to another state during the same federal fiscal year, the CP is still subject to the fee in Washington if the Washington case qualifies for a fee under subsection (1) above.

(5) A CP has the burden of proving prior receipt of TANF, Tribal TANF or AFDC in any jurisdiction, which would exempt the CP from paying the annual fee.

(a) DCS may impose the fee until the CP provides proof of prior receipt of TANF, Tribal TANF or AFDC.

(b) DCS does not refund any fee which has been retained by the state, but stops charging the fee immediately when the CP provides proof that the CP is not subject to the fee.

(6) The fee is retained from support payments collected, which means that the NCP gets credit against the child support obligation for the total amount of the payment.

History

Statutory Authority: 2019 c 275 § 4, RCW 26.09.170, 74.20A.059, 26.09.105, 26.18.170, 74.04.055, 74.08.090, 74.20.040(9), and 74.20A.310. WSR 20-04-031, § 388-14A-2200, filed 1/28/20, effective 2/28/20. Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-2200, filed 5/29/08, effective 7/1/08.

Wash. Admin. Code § 388-14A-2205 How can a custodial parent be excused from payment of the annual fee?

(1) WAC 388-14A-2200 describes the cases that qualify for the thirty-five dollar annual fee.

(2) A custodial parent (CP) seeking to be excused from payment of the fee may provide proof that he or she is exempt from the fee because he or she received TANF, Tribal TANF or AFDC from another state or tribe.

(3) A CP may request a conference board under WAC 388-14A-6400 to request a waiver of the fee for hardship reasons. The CP must provide proof that hardship in the CP's household justifies waiver of the fee.

(4) Payment of the annual fee in another state does not excuse the CP from the annual fee charged for a Washington case.

(5) If the CP seeks a waiver from payment of the annual fee during a year when the fee has already been collected, the fee for that year is not refunded, but DCS waives collection of the fee for future years unless the waiver is overturned at a later time.

History

Statutory Authority: 2019 c 275 § 4, RCW 26.09.170, 74.20A.059, 26.09.105, 26.18.170, 74.04.055, 74.08.090, 74.20.040(9), and 74.20A.310. WSR 20-04-031, § 388-14A-2205, filed 1/28/20, effective 2/28/20. Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-2205, filed 5/29/08, effective 7/1/08.

Wash. Admin. Code § 388-14A-2210 What is the procedure for service by certified mail due to COVID-19?

(1) The United States Postal Service has made temporary changes to its certified mail signature gathering procedures to limit direct contact with recipients. As long as these special signature gathering procedures remain in effect, the division of child support (DCS) will consider service by certified mail, return receipt requested when required under chapter 388-14A WAC to be successful 10 days after the following requirements are satisfied:

(a) The notice is sent by certified mail, return receipt requested, with restricted delivery to the noncustodial or custodial parent DCS is serving; and

(b) The postal service employee signs the receipt on behalf of the individual taking delivery as required by current postal service restricted delivery procedures.

(2) The individual taking delivery under section (1)(b) of this section is presumed to be the subject of service or the authorized agent of the subject.

History

Statutory Authority: RCW 26.23.110, 34.05.220, 74.08.090, and 74.20A.055. WSR 21-23-103, § 388-14A-2210, filed 11/17/21, effective 12/18/21.

Wash. Admin. Code § 388-14A-3100 How does the division of child support establish a child support obligation when there is no child support order?

(1) When there is no order setting the amount of child support a noncustodial parent (NCP) should pay, the division of child support (DCS) serves a support establishment notice on the NCP and the custodial parent (CP). A support establishment notice is an administrative notice that can become an enforceable order for support if nobody requests a hearing on the notice.

(2) DCS may serve a support establishment notice when there is no order that:

(a) Establishes the NCP's support obligation for the child or children named in the notice; or

(b) Specifically relieves the NCP of a support obligation for the child or children named in the notice.

(3) Whether support is based upon an administrative order or a court order, DCS may serve a support establishment notice when the parties to a paternity or parentage order subsequently marry each other and then separate, or parties to a decree of dissolution remarry each other and then separate. The remaining provisions of the paternity or parentage order or the decree of dissolution, including provisions establishing parentage, remain in effect.

(4) DCS may serve a notice and finding of financial responsibility (NFFR) under WAC 388-14A-3115. DCS uses this notice when the NCP's parentage of the child is based on:

(a) The presumption arising from the existence of a marriage or a registered domestic partnership;

(b) The entry of a court order adjudicating the parent-child relationship;

(d) The man's having signed and filed a paternity affidavit, paternity acknowledgment, or acknowledgment of parentage under RCW 26.26A.200 through 26.26A.265, unless the acknowledgment has been rescinded or successfully challenged; or

(e) The NCP's being the biological mother of and having given birth to the child.

(5) Until January 1, 2019, DCS used the notice and finding of parental responsibility (NFPR) to establish support orders if the parents filed a paternity affidavit, paternity acknowledgment, or acknowledgment of paternity which did not become a conclusive presumption of paternity.

(6) DCS may serve a "Medical support only" NFFR under WAC 388-14A-3125.

(a) Until October 1, 2009, DCS used the notice and finding of medical responsibility (NFMR) for this purpose.

(b) From October 1, 2009, until January 1, 2019, DCS used the medical support only NFFR or NFPR for this purpose.

(c) A medical support only NFFR is used when DCS seeks to set only a medical support obligation instead of a monetary child support obligation.

History

Statutory Authority: RCW 26.23.050, 26.23.110, 43.20A.550, 74.04.055, 74.04.057, 74.08.090, 74.20.040, 74.20A.055, 74.20A.056, and 74.20A.310. WSR 25-09-019, s 388-14A-3100, filed 4/7/25, effective 5/8/25. Statutory Authority: 2011 c 283, RCW 34.05.220, 43.20A.550, 74.04.055, 74.04.057, 74.08.090, 74.20A.055, 74.20A.056, and 74.20A.310. WSR 12-01-002, § 388-14A-3100, filed 12/7/11, effective 1/7/12. Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-3100, filed 5/19/11, effective 6/19/11. Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.056, 74.20A.310, 26.26.315, 26.26.320, 26.26.330, 26.26.335, 74.20A.055, 2002 c 302, and 2002 c 199. WSR 03-17-013, § 388-14A-3100, filed 8/12/03, effective 9/12/03. Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.055, 74.20A.056. WSR 00-15-016 and 00-20-022, § 388-14A-3100, filed 7/10/00 and 9/25/00, effective 11/6/00.

Wash. Admin. Code § 388-14A-3102 When the parents have signed a paternity or parentage acknowledgment, which support establishment notice does the division of child support serve on the noncustodial parent?

(1) When the parents of a child are not married, they may sign an acknowledgment of parentage, which may also be called an affidavit of paternity or paternity acknowledgment. The legal effect of the acknowledgment or affidavit depends on when it is filed, in what state it is filed, and whether both parents were over age 18 when the acknowledgment was signed.

(2) For acknowledgments or affidavits filed on or before July 1, 1997, with the center for health statistics in the state of Washington, the division of child support (DCS) served a notice and finding of parental responsibility (NFPR) under WAC 388-14A-3120. DCS stopped serving the NFPR on January 1, 2019.

(3) For acknowledgments or affidavits filed after July 1, 1997, with the center for health statistics in the state of Washington, DCS serves a notice and finding of financial responsibility (NFFR) under WAC 388-14A-3115, because the acknowledgment or affidavit has become a conclusive presumption of parentage under RCW 26.26A.220.

(4) For acknowledgments or affidavits filed with the vital records agency of another state, DCS gives full faith and credit to the acknowledgment or affidavit under RCW 26.26A.250 and serves a NFFR.

(5) DCS relies on the acknowledgment, even if one or more parents were not yet 18 years of age at the time they signed or filed the acknowledgment, as provided in RCW 26.26A.215(4).

(6) If, at the time of the child's birth, the birth mother was married or in a state registered domestic partnership and the person acknowledging parentage was not the birth mother's spouse or domestic partner, DCS may not serve an administrative support establishment notice on the acknowledged parent unless the birth mother's spouse or domestic partner also signed and filed a denial of paternity or parentage.

(7) If the acknowledgment or affidavit is legally deficient in any way, DCS may refer the case for establishment of parentage in the superior court.

(8) If the birth mother is the noncustodial parent, DCS serves a NFFR.

History

Statutory Authority: RCW 26.23.050, 26.23.110, 43.20A.550, 74.04.055, 74.04.057, 74.08.090, 74.20.040, 74.20A.055, 74.20A.056, and 74.20A.310. WSR 25-09-019, s 388-14A-3102, filed 4/7/25, effective 5/8/25. Statutory Authority: 2011 c 283, RCW 34.05.220, 43.20A.550, 74.04.055, 74.04.057, 74.08.090, 74.20A.055, 74.20A.056, and 74.20A.310. WSR 12-01-002, § 388-14A-3102, filed 12/7/11, effective 1/7/12. Statutory Authority: RCW 26.26.315, 26.26.320, 26.26.330, 26.26.335, 34.05.220(1), 74.08.090, 74.20A.055, 74.20A.056, 74.20A.310. WSR 05-12-136, § 388-14A-3102, filed 6/1/05, effective 7/2/05. Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.056, 74.20A.310, 26.26.315, 26.26.320, 26.26.330, 26.26.335, 74.20A.055, 2002 c 302, and 2002 c 199. WSR 03-17-013, § 388-14A-3102, filed 8/12/03, effective 9/12/03. Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.055, 74.20A.056. WSR 00-15-016 and 00-20-022, § 388-14A-3102, filed 7/10/00 and 9/25/00, effective 11/6/00.

Wash. Admin. Code § 388-14A-3105 How does the division of child support serve support establishment notices?

The division of child support (DCS) serves a notice and finding of financial responsibility (NFFR) in the following manner:

(1) On the noncustodial parent:

(a) By certified mail, return receipt requested; or

(b) By personal service.

(2) On the custodial parent:

(a) By first class mail to the last known address, if the custodial parent is the one who applied for services.

(b) In the same manner as on the noncustodial parent, if the custodial parent is not the one who applied for services.

History

Statutory Authority: RCW 26.23.050, 26.23.110, 43.20A.550, 74.04.055, 74.04.057, 74.08.090, 74.20.040, 74.20A.055, 74.20A.056, and 74.20A.310. WSR 25-09-019, s 388-14A-3105, filed 4/7/25, effective 5/8/25. Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.055, 74.20A.056. WSR 00-15-016 and 00-20-022, § 388-14A-3105, filed 7/10/00 and 9/25/00, effective 11/6/00.

Wash. Admin. Code § 388-14A-3110 When can a support establishment notice become a final order?

(1) The notice and finding of financial responsibility (NFFR) becomes a final, enforceable order if neither the custodial parent (CP) nor the noncustodial parent (NCP) objects and requests a timely hearing on the notice. An objection is also called a hearing request.

(2) If a timely objection is filed, the division of child support (DCS) cannot enforce the terms of the notice until a final order as defined in this section is entered.

(3) To be timely, the NCP must object within the following time limits:

(a) Within 20 days of service, if the NCP was served in Washington state.

(b) Within 60 days of service, if the NCP was served outside of Washington state.

(4) To be timely, the CP must object within 20 days of service.

(5) An objection to a support establishment notice is a request for hearing on the notice.

(6) The effective date of the hearing request is the date DCS receives the request for hearing.

(7) When a NFPR was served, the order became a final order if neither parent requested genetic testing under WAC 388-14A-3120(19) within the following time limits:

(a) The NCP must have requested genetic testing within 20 days of service, if the NCP was served in Washington state.

(b) The NCP must have requested genetic testing within 60 days of service, if the NCP was served outside of Washington state.

(8) The NCP or CP must make the hearing request either in writing or orally, at any DCS office. See WAC 388-14A-6100 regarding oral requests for hearing.

(9) After a timely request for hearing, the final order is one of the following, whichever occurs latest:

(a) An agreed settlement or consent order under WAC 388-14A-3600; or

(b) A final order as defined in WAC 388-14A-6105 and further described in WAC 388-14A-6115.

History

Statutory Authority: RCW 26.23.050, 26.23.110, 43.20A.550, 74.04.055, 74.04.057, 74.08.090, 74.20.040, 74.20A.055, 74.20A.056, and 74.20A.310. WSR 25-09-019, s 388-14A-3110, filed 4/7/25, effective 5/8/25. Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.056, 74.20A.310, 26.26.315, 26.26.320, 26.26.330, 26.26.335, 74.20A.055, 2002 c 302, and 2002 c 199. WSR 03-17-013, § 388-14A-3110, filed 8/12/03, effective 9/12/03. Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.055, 74.20A.056. WSR 00-15-016 and 00-20-022, § 388-14A-3110, filed 7/10/00 and 9/25/00, effective 11/6/00. Formerly WAC 388-11-210.

Wash. Admin. Code § 388-14A-3115 The notice and finding of financial responsibility is used to set child support when parentage is not an issue.

(1) A notice and finding of financial responsibility (NFFR) is an administrative notice served by the division of child support (DCS) that can become an enforceable order for support, pursuant to RCW 74.20A.055.

(2) DCS may serve a NFFR when the noncustodial parent (NCP) is a legal parent of the child, based on:

(a) The presumption arising from the existence of a marriage or registered domestic partnership;

(b) The entry of a court order adjudicating the parent-child relationship;

(d) The parents having signed and filed a paternity acknowledgment under RCW 26.26.300 through 26.26.375, or an acknowledgment of parentage under RCW 26.26A.200 through 26.26A.265, unless the acknowledgment has been rescinded or successfully challenged; or

(e) The parents having signed an acknowledgment of parentage, paternity acknowledgment, or affidavit of paternity in another jurisdiction, and by that jurisdiction's laws parentage is therefore conclusively established, unless the acknowledgment or affidavit has been rescinded or successfully challenged; or

(f) The NCP's being the parent who gave birth to the child.

(3) DCS serves a NFFR in the situations listed in this section and in WAC 388-14A-3100. There may be other bases on which a court can determine parentage, establish a child support obligation, or both.

(4) The NFFR:

(a) Advises the NCP and the custodial parent (CP) of the support obligation for the child or children named in the notice. The NFFR fully and fairly advises the parents of their rights and responsibilities under the NFFR.

(b) Includes the information required by RCW 26.23.050 and 74.20A.055.

(c) Includes a provision that the parents are obligated to provide medical support, as required by RCW 26.09.105, 26.18.170, and 26.23.050. This requirement does not apply to the CP when the CP is not one of the parents of the child covered by the order.

(d) Includes a provision that apportions the share of uninsured medical expenses to the parents, pursuant to RCW 26.09.105, 26.18.170, and 26.23.050.

(e) May include an obligation for the NCP to contribute their proportionate share of the cost of day care or childcare, which may be stated either as a sum certain amount per month, or as a proportion of the expenses incurred by the CP.

(f) Warns the NCP and the CP that at an administrative hearing, the administrative law judge (ALJ) may set the support obligation in an amount higher or lower than, or different from, the amount stated in the NFFR, if necessary for an accurate support order.

(5) As provided in WAC 388-14A-3125, DCS may serve a NFFR that can become an enforceable order for support to establish and enforce a health insurance obligation. This type of NFFR is called "medical support only" NFFR.

(6) DCS uses a medical support only NFFR when the CP has requested medical support enforcement services only and has asked DCS in writing not to collect monetary child support.

(7) A medical support only NFFR does not include a monthly financial support obligation, but may include:

(a) An obligation to pay a monthly payment toward the premium paid by the CP or the state for health insurance coverage for the child or children; and

(b) An obligation to pay a proportionate share of the child's or children's uninsured medical expenses.

(8) An administrative order resulting from a medical support only NFFR may later be modified to include a monthly financial support obligation, as provided in WAC 388-14A-3127.

(9) After service of the NFFR, the NCP and the CP must notify DCS of any change of address, or of any changes that may affect the support obligation.

(10) The NCP must make all support payments to the Washington state support registry after service of the NFFR. DCS does not give the NCP credit for payments made to any other party after service of a NFFR, except as provided by WAC 388-14A-3375.

(11) DCS may take immediate wage withholding action and enforcement action without further notice under chapters 26.18, 26.23, and 74.20A RCW when the NFFR is a final order. WAC 388-14A-3110 describes when the notice becomes a final order.

(12) In most cases, a child support obligation continues until the child reaches the age of 18. WAC 388-14A-3810 describes when the obligation under the NFFR can end sooner or later than age 18.

(13) If parentage has been established by a paternity acknowledgment, an affidavit of paternity, or acknowledgment of parentage, DCS attaches a copy of the acknowledgment, affidavit, or certificate of birth record information to the notice. A party wishing to rescind or challenge the acknowledgment or denial of parentage may only do so under RCW 26.26A.235 through 26.26A.245 or equivalent laws of the jurisdiction where the acknowledgment or denial was filed.

(14) If the parents filed a paternity acknowledgment, affidavit of paternity, or acknowledgment of parentage in another jurisdiction, and by that jurisdiction's law parentage is therefore conclusively established, DCS may serve a NFFR to establish a support obligation.

(15) A hearing on a NFFR is for the limited purpose of resolving the NCP's accrued support debt and current support obligation. The hearing is not for the purpose of setting a payment schedule on the support debt. The NCP has the burden of proving any defenses to liability.

History

Statutory Authority: RCW 26.23.050, 26.23.110, 43.20A.550, 74.04.055, 74.04.057, 74.08.090, 74.20.040, 74.20A.055, 74.20A.056, and 74.20A.310. WSR 25-09-019, s 388-14A-3115, filed 4/7/25, effective 5/8/25. Statutory Authority: 2011 c 283, RCW 34.05.220, 43.20A.550, 74.04.055, 74.04.057, 74.08.090, 74.20A.055, 74.20A.056, and 74.20A.310. WSR 12-01-002, § 388-14A-3115, filed 12/7/11, effective 1/7/12. Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-3115, filed 5/19/11, effective 6/19/11. Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-3115, filed 5/29/08, effective 7/1/08. Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.160. WSR 06-09-015, § 388-14A-3115, filed 4/10/06, effective 5/11/06. Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.056, 74.20A.310, 26.26.315, 26.26.320, 26.26.330, 26.26.335, 74.20A.055, 2002 c 302, and 2002 c 199. WSR 03-17-013, § 388-14A-3115, filed 8/12/03, effective 9/12/03. Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.055, 74.20A.056. WSR 00-15-016 and 00-20-022, § 388-14A-3115, filed 7/10/00 and 9/25/00, effective 11/6/00. Formerly WAC 388-11-285.

Wash. Admin. Code § 388-14A-3120 The notice and finding of parental responsibility was used to set child support when the father's duty of support was based upon an affidavit of paternity which was not a conclusive presumption of paternity.

(1) A notice and finding of parental responsibility (NFPR) was an administrative notice served by the division of child support (DCS) prior to January 1, 2019, pursuant to RCW 74.20A.056.

(2) The NFPR differs from a notice and finding of financial responsibility (NFFR) (see WAC 388-14A-3115) because the parties could make a timely request genetic testing to contest paternity after being served with a NFPR.

(3) DCS served a NFPR when:

(a) An affidavit acknowledging paternity is on file with the center for health statistics and was filed before July 1, 1997; or

(b) An affidavit or acknowledgment of paternity, or an acknowledgment of parentage, is on file with the vital records agency of another state and the laws of that state allow the parents to withdraw the affidavit or acknowledgment or challenge paternity.

(4) DCS served the NFPR in the manner described in WAC 388-14A-3105.

(5) DCS attached a copy of the acknowledgment of paternity or certification of birth record information to the NFPR.

(6) The NFPR advises the noncustodial parent (NCP) and the custodial parent (who is either the mother or the physical custodian of the child) of the support obligation for the child or children named in the notice. The NFPR fully and fairly advises the parents of their rights and responsibilities under the NFPR. The NFPR warns the NCP and the custodial parent (CP) that at an administrative hearing on the notice, the administrative law judge (ALJ) may set the support obligation in an amount higher or lower than, or different from, the amount stated in the NFPR, if necessary for an accurate support order.

(7) The NFPR includes the information required by RCW 26.23.050, 74.20A.055, and 74.20A.056.

(8) The NFPR includes a provision that both parents are obligated to provide medical support, pursuant to RCW 26.09.105, 26.18.170, and 26.23.050. This requirement does not apply to the custodial parent when the custodial parent is not one of the parents of the child covered by the order.

(9) The NFPR includes a provision that apportions the share of uninsured medical expenses to both the parents, pursuant to RCW 26.09.105, 26.18.170, and 26.23.050.

(10) The NFPR may include an obligation for the noncustodial parent to contribute their proportionate share of the cost of day care expenses or childcare, which may be stated either as a sum certain amount per month, or as a proportion of the expenses incurred by the custodial parent.

(11) A NFPR does not assess an accrued support debt for a period longer than five years before the NFPR was served. This limitation does not apply to the extent that the NCP hid or left the state of Washington for the purpose of avoiding service.

(12) Prior to January 1, 2019, DCS could serve a notice and finding of parental responsibility that could become an enforceable order for support to establish and enforce a health insurance obligation. This type of NFPR is called a "medical support only" NFPR.

(13) DCS used a medical support only NFPR when the custodial parent requested medical support enforcement services only and asked DCS in writing not to collect monetary child support.

(14) A medical support only NFPR did not include a monthly financial support obligation, but could include:

(a) An obligation to pay a monthly payment toward the premium paid by the CP or the state for health insurance coverage for the child or children; and

(b) An obligation to pay a proportionate share of the child's or children's uninsured medical expenses.

(15) An administrative order resulting from a medical support only NFPR could later be modified to include a monthly financial support obligation, as provided in WAC 388-14A-3925.

(16) After service of the NFPR, the NCP and the CP must notify DCS of any change of address, or of any changes that may affect the support obligation.

(17) The NCP must make all support payments to the Washington state support registry after service of the NFPR. DCS does not give the NCP credit for payments made to any other party after service of the NFPR, except as provided by 388-14A-3375.

(18) DCS may take immediate wage withholding action and enforcement action without further notice under chapters 26.18, 26.23, and 74.20A RCW when the NFPR is a final order. See WAC 388-14A-3110 for when the notice becomes a final order.

(19) In most cases, a child support obligation continues until the child reaches the age of 18. WAC 388-14A-3810 describes when the obligation under the NFPR can end sooner or later than age 18.

(20) Either the NCP or the mother, if she is also the CP, could request genetic tests subject to the time limits set out in WAC 388-14A-3110. A mother who is not the CP could have requested that DCS refer the case for paternity establishment in the superior court.

(21) DCS did not stop enforcement of the order unless DCS received a timely request for hearing or a timely request for genetic tests. See WAC 388-14A-3110 for time limits. DCS does not refund any money collected under the notice if the NCP is later:

(a) Excluded from being the father by genetic tests; or

(b) Found not to be the father by a court of competent jurisdiction.

(22) If the NCP requested genetic tests and was not excluded as the father, he could have requested within 20 days from the date of service of the genetic tests in Washington, or 60 days from the date of service of the genetic tests outside of Washington:

(a) A hearing on the NFPR.

(b) That DCS initiate a parentage action in superior court under chapter 26.26 RCW.

(23) If the NCP was not excluded as the father, the CP (or the mother, if she is also the CP), could have within 20 days of the date of service of the genetic tests request:

(a) A hearing on the NFPR; or

(b) That DCS initiate a parentage action in superior court under chapter 26.26 RCW.

(24) If the NCP was excluded by genetic testing, DCS referred the case for paternity establishment in the superior court.

(25) A hearing on a NFPR is for the limited purpose of resolving the NCP's current support obligation, accrued support debt, and amount of reimbursement to DCS for paternity-related costs. The hearing is not for the purpose of setting a payment schedule on the support debt. The NCP has the burden of proving any defenses to liability.

History

Statutory Authority: RCW 26.23.050, 26.23.110, 43.20A.550, 74.04.055, 74.04.057, 74.08.090, 74.20.040, 74.20A.055, 74.20A.056, and 74.20A.310. WSR 25-09-019, s 388-14A-3120, filed 4/7/25, effective 5/8/25. Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-3120, filed 5/19/11, effective 6/19/11. Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-3120, filed 5/29/08, effective 7/1/08. Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.160. WSR 06-09-015, § 388-14A-3120, filed 4/10/06, effective 5/11/06. Statutory Authority: RCW 26.26.315, 26.26.320, 26.26.330, 26.26.335, 34.05.220(1), 74.08.090, 74.20A.055, 74.20A.056, 74.20A.310. WSR 05-12-136, § 388-14A-3120, filed 6/1/05, effective 7/2/05. Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.056, 74.20A.310, 26.26.315, 26.26.320, 26.26.330, 26.26.335, 74.20A.055, 2002 c 302, and 2002 c 199. WSR 03-17-013, § 388-14A-3120, filed 8/12/03, effective 9/12/03. Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.055, 74.20A.056. WSR 00-15-016 and 00-20-022, § 388-14A-3120, filed 7/10/00 and 9/25/00, effective 11/6/00. Formerly WAC 388-11-290.

Wash. Admin. Code § 388-14A-3125 DCS may establish a medical support obligation when the custodial parent receiving medical assistance declines full child support enforcement services.

(1) When a custodial parent (CP) has requested medical support enforcement services only and has asked in writing that the department not collect monetary child support, the division of child support (DCS) serves a notice and finding of financial responsibility (NFFR) under RCW 74.20A.055 on the noncustodial parent (NCP) to establish an administrative support order that can become an enforceable order for support to establish and enforce a medical support obligation.

(a) A NFFR served to establish an administrative support order that can become an enforceable order for support to establish and enforce a health insurance obligation is called a "medical support only" NFFR.

(b) Prior to October 1, 2009, DCS used another notice, called the notice and finding of medical responsibility (NFMR), for this purpose.

(c) Between October 1, 2009, and January 1, 2019, DCS used either the NFFR or another notice, called the notice and finding of parental responsibility (NFPR), to set medical support only.

(d) DCS uses the medical support only NFFR as of January 1, 2019.

(2) DCS may serve a medical support only NFFR when:

(a) The custodial parent (who is either a parent or the physical custodian of the child) or a dependent child receives or is certified eligible to receive medical assistance and is not receiving cash grant public assistance under 74.12 RCW; and

(b) The custodial parent has requested medical support enforcement services only and has asked DCS in writing not to collect monetary child support.

(3) The medical support only NFFR advises the noncustodial parent (NCP) and the CP (when appropriate) of their respective medical support obligations for the children named in the notice. The medical support only NFFR fully and fairly advises the parties of their rights and responsibilities under the medical support only NFFR.

(4) The medical support only NFFR warns the NCP and the CP that at an administrative hearing on the notice, the administrative law judge (ALJ) may set the support obligation in an amount higher or lower than, or different from, the amount stated in the notice, if necessary for an accurate support order.

(5) The medical support only NFFR includes:

(a) The information required by RCW 26.23.050;

(b) The medical support obligation of both parents, pursuant to RCW 26.18.170;

(d) The income basis used to calculate the maximum premium amount, pursuant to WAC 388-14A-3200.

(6) The income basis for an obligation established by DCS for a medical support only NFFR is not binding on any party in any later action to establish a monthly financial child support obligation.

(7) After service of the medical support only NFFR, both the NCP and CP must notify DCS of any change of address, or of any changes that may affect the support obligation.

(8) DCS may take enforcement action under RCW 26.18.170 and chapter 388-14A WAC without further notice when the medical support only NFFR is a final order. See WAC 388-14A-3110 for how a notice becomes a final order.

(9) In most cases, a child support obligation continues until the child reaches the age of 18. WAC 388-14A-3810 describes when the obligation under the medical support only NFFR can end sooner or later than age 18.

(10) If the CP applies for full enforcement services or if a TANF grant opens while a hearing on a medical support only NFFR is pending, DCS may, at any time before the hearing record is closed, convert the hearing to a hearing on a notice and finding of financial responsibility (NFFR) under WAC 388-14A-3115. To convert the hearing, DCS serves a NFFR on the parents and files a copy with the administrative law judge (ALJ). The ALJ may grant a continuance if a party requests additional time to respond to the claim for monetary child support.

(11) In a hearing on a medical support only NFFR, the ALJ must determine the:

(a) Basic support obligation, without deviations; and

(b) Maximum premium amount for both parents under chapter 26.19 RCW.

(12) A hearing on a medical support only NFFR is for the limited purpose of resolving the parents' medical support responsibility. The parties each have the burden of proving defenses to their own liability.

(13) If the CP later applies for full enforcement services or if a child covered by the order receives public assistance, DCS may add a monthly financial support obligation to an administrative child support order for medical support only. The procedure required to add the monthly financial support obligation is addressed in WAC 388-14A-3127.

History

Statutory Authority: RCW 26.23.050, 26.23.110, 43.20A.550, 74.04.055, 74.04.057, 74.08.090, 74.20.040, 74.20A.055, 74.20A.056, and 74.20A.310. WSR 25-09-019, s 388-14A-3125, filed 4/7/25, effective 5/8/25. Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-3125, filed 5/19/11, effective 6/19/11. Statutory Authority: RCW 74.08.090, 34.05.310 (4)(d), 34.05.220(1), 74.20A.055, 74.20A.056. WSR 03-20-072, § 388-14A-3125, filed 9/29/03, effective 10/30/03. Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.055, 74.20A.056. WSR 00-15-016 and 00-20-022, § 388-14A-3125, filed 7/10/00 and 9/25/00, effective 11/6/00. Formerly WAC 388-11-215 and 388-11-295.

Wash. Admin. Code § 388-14A-3127 How does DCS ask to add a monthly financial obligation to an existing administrative order for medical support only?

(1) The division of child support (DCS) may ask to add a monthly financial support obligation to an administrative child support order for medical support only, if:

(a) The custodial parent who previously requested medical support only services, files an application for full support enforcement services; or

(b) A child covered by the order receives public assistance.

(2) The procedure required to add the monthly financial support obligation depends on whether DCS served a notice and finding of medical responsibility (NFMR) or medical support only notice and finding of financial responsibility (NFFR) to establish the administrative support order:

(a) If the medical support obligation was established through service of a NFMR, DCS serves a NFFR under WAC 388-14A-3115 which requests a monthly financial obligation.

(b) If the medical support obligation was established through service of a NFFR, DCS files a petition to modify the previous administrative order under WAC 388-14A-3925.

History

Statutory Authority: RCW 26.23.050, 26.23.110, 43.20A.550, 74.04.055, 74.04.057, 74.08.090, 74.20.040, 74.20A.055, 74.20A.056, and 74.20A.310. WSR 25-09-019, s 388-14A-3127, filed 4/7/25, effective 5/8/25. Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-3127, filed 5/19/11, effective 6/19/11.

Wash. Admin. Code § 388-14A-3130 What happens if a party makes a timely request for hearing on a support establishment notice?

(1) A timely request for hearing is an objection made within the time limits of WAC 388-14A-3110. For late (or untimely) hearing requests, see WAC 388-14A-3135.

(2) If either party makes a timely request for hearing, the division of child support (DCS) submits the hearing request to the office of administrative hearings (OAH) for scheduling.

(3) OAH sends a notice of hearing by first class mail to all parties at their address last known to DCS, notifying each party of the date, time and place of the hearing. DCS, the noncustodial parent (NCP), and the custodial parent are all parties to the hearing.

(4) A timely request for hearing stops the support establishment notice from becoming a final order, so DCS cannot collect on the notice. However, in appropriate circumstances, the administrative law judge (ALJ) may enter a temporary support order under WAC 388-14A-3850.

(5) A hearing on an objection to a support establishment notice is for the limited purpose of resolving the NCP's accrued support debt and current support obligation. The NCP has the burden of proving any defenses to liability.

History

Statutory Authority: RCW 26.23.120, 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310, and 45 C.F.R. Parts 301.1, 302.35, 302.36, 303.3, 303.7, 303.11, 303.20, 305.63, 307.13, and 308.2. WSR 11-22-116, § 388-14A-3130, filed 11/2/11, effective 12/3/11. Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.055, 74.20A.056. WSR 02-06-098, § 388-14A-3130, filed 3/4/02, effective 4/4/02
WSR 00-15-016 and 00-20-022, § 388-14A-3130, filed 7/10/00 and 9/25/00, effective 11/6/00. Formerly WAC 388-11-135 and 388-11-400.

Wash. Admin. Code § 388-14A-3131 What happens if neither parent appears for the hearing?

(1) If neither parent appears at the scheduled hearing after being sent a notice of hearing, the administrative law judge (ALJ) enters an order on default, declaring the support establishment notice's claim for support to be final and subject to collection action. See WAC 388-14A-6110 and 388-14A-6115 to determine whether the ALJ issues an initial order or a final order.

(2) As provided in WAC 388-14A-6125, an initial order on default is subject to collection action on the twenty-second day after the order was mailed by the office of administrative hearings, and a final default order is enforceable immediately upon entry.

(3) A parent that did not appear may petition to vacate the default order pursuant to WAC 388-14A-6150.

(a) If the ALJ vacates the order of default, the ALJ then conducts a full hearing on the merits of the NFFR, NFPR or NFMR. All parties may participate in the hearing.

(b) If the parent who did not appear at the hearing is unsuccessful in the motion to vacate the default order, the ALJ may treat the petition as a petition to modify the support order.

History

Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.056, 74.20A.310, 26.26.315, 26.26.320, 26.26.330, 26.26.335, 74.20A.055, 2002 c 302, and 2002 c 199. WSR 03-17-013, § 388-14A-3131, filed 8/12/03, effective 9/12/03. Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.055, 74.20A.056. WSR 01-24-081, § 388-14A-3131, filed 12/3/01, effective 1/3/02
WSR 00-15-016 and 00-20-022, § 388-14A-3131, filed 7/10/00 and 9/25/00, effective 11/6/00. Formerly WAC 388-11-400 and 388-11-425.

Wash. Admin. Code § 388-14A-3132 What happens if only one parent appears for the hearing?

(1) If one parent appears at the hearing, but the other parent fails to appear after being sent a notice of hearing, the administrative law judge (ALJ) enters an order of default against the parent that did not appear. The hearing proceeds as described in WAC 388-14A-3140. See WAC 388-14A-6110 and 388-14A-6115 to determine whether the ALJ issues an initial order or a final order.

(2) The division of child support (DCS) and the parent that did appear may enter a consent order, but not an agreed settlement. The obligation in the consent order may be higher or lower, or different from, the terms set forth in the notice, without further notice to the nonappearing parent, if necessary for an accurate support order. The terms of the consent order become final when the order of default to the parent that did not appear becomes final, as provided in WAC 388-14A-6125.

(3) DCS and the parent that did appear may proceed to hearing. The ALJ may enter an initial decision setting an obligation which is higher or lower, or different from, the terms set forth in the notice, without further notice to the nonappearing parent, if necessary for an accurate support order. See WAC 388-14A-6110 and 388-14A-6115 to determine whether the ALJ issues an initial order or a final order.

(4) The parent that did not appear may petition to vacate the order of default pursuant to WAC 388-14A-6150.

(5) If the ALJ vacates the order of default, the ALJ then conducts a full hearing on the merits of the notice and finding of financial responsibility (NFFR), notice and finding of parental responsibility (NFPR) or notice and finding of medical responsibility (NFMR). All parties may participate in the hearing.

(6) If the parent who did not appear at the hearing is unsuccessful in the motion to vacate the default order, the ALJ may treat the petition as a petition to modify the support order.

History

Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.056, 74.20A.310, 26.26.315, 26.26.320, 26.26.330, 26.26.335, 74.20A.055, 2002 c 302, and 2002 c 199. WSR 03-17-013, § 388-14A-3132, filed 8/12/03, effective 9/12/03. Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.055, 74.20A.056. WSR 01-24-081, § 388-14A-3132, filed 12/3/01, effective 1/3/02
WSR 00-15-016 and 00-20-022, § 388-14A-3132, filed 7/10/00 and 9/25/00, effective 11/6/00. Formerly WAC 388-11-400 and 388-11-425.

Wash. Admin. Code § 388-14A-3133 What happens when the noncustodial parent and the custodial parent both appear for the hearing?

If both parents appear at the hearing:

(1) All parties may enter an agreed settlement or consent order. WAC 388-14A-3600 describes when an agreed settlement or consent order is a final order.

(2) All parties may proceed to hearing, after which the ALJ issues an order. The ALJ may enter an order setting an obligation which is higher or lower, or different from, the terms set forth in the notice, if necessary for an accurate support order. See WAC 388-14A-6110 and 388-14A-6115 to determine whether the ALJ issues an initial order or a final order.

(3) In a hearing under this section, the division of child support (DCS) proceeds first to document the support amount that DCS believes to be correct. Following DCS' presentation, the custodial parent (CP) and the noncustodial parent (NCP) may proceed in turn to show why the DCS position is wrong.

History

Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.056, 74.20A.310, 26.26.315, 26.26.320, 26.26.330, 26.26.335, 74.20A.055, 2002 c 302, and 2002 c 199. WSR 03-17-013, § 388-14A-3133, filed 8/12/03, effective 9/12/03. Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.055, 74.20A.056. WSR 00-15-016 and 00-20-022, § 388-14A-3133, filed 7/10/00 and 9/25/00, effective 11/6/00. Formerly WAC 388-11-400 and 388-11-425.

Wash. Admin. Code § 388-14A-3135 Late hearings, or hearing on untimely objections to support establishment notices.

(1) For orders established before August 30, 1997, if the noncustodial parent did not timely object to the notice and finding of financial responsibility (NFFR), notice and finding of parental responsibility (NFPR), or notice and finding of medical responsibility (NFMR), only the noncustodial parent may petition for a late hearing, pursuant to WAC 388-14A-3500.

(2) For orders established after August 30, 1997, if neither parent timely objected to the NFFR, NFPR, or NFMR, either the noncustodial parent or the custodial parent may petition for a late hearing, pursuant to WAC 388-14A-3500. See WAC 388-14A-3110 for the time limits for a timely hearing request.

(3) The division of child support (DCS) continues to enforce the order even if a late request for hearing is filed.

(4) If DCS receives the late hearing request within one year of the date of service of the notice, the parent requesting the hearing is not required to show good cause to have a hearing on the merits of the notice.

(5) If DCS receives the late hearing request more than a year after the date of service of the notice, the parent requesting the hearing must show good cause why the hearing request was not timely. WAC 388-14A-1020 contains the definition of good cause.

History

Statutory Authority: RCW 74.08.090, 34.05.310 (4)(d), 34.05.220(1), 74.20A.055, 74.20A.056. WSR 03-20-072, § 388-14A-3135, filed 9/29/03, effective 10/30/03. Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.055, 74.20A.056. WSR 00-15-016 and 00-20-022, § 388-14A-3135, filed 7/10/00 and 9/25/00, effective 11/6/00. Formerly WAC 388-11-400 and 388-11-425.

Wash. Admin. Code § 388-14A-3140 What can happen at a hearing on a support establishment notice?

(1) When a party requests a hearing on a notice and finding of financial responsibility (NFFR), notice and finding of parental responsibility (NFPR), or notice and finding of medical responsibility (NFMR), the hearing is limited to:

(a) Resolving the current and future support obligation and the accrued support debt of the noncustodial parent (NCP); and

(b) Establishing the medical support obligations of both the NCP and the custodial parent (CP), if the CP is the legal or biological parent of the child or children.

(2) The hearing is not for the purpose of setting a payment schedule on the support debt.

(3) The NCP and the CP each have the burden of proving any defenses to their own liability. See WAC 388-14A-3370.

(4) The NCP and/or the CP must show cause why the terms in the NFFR, NFPR, or NFMR are incorrect.

(5) The administrative law judge (ALJ) has authority to enter a support obligation that may be higher or lower than the amounts set forth in the NFFR, NFPR, or NFMR, including the support debt, current support, and the future support obligation.

(a) The ALJ may enter an order that differs from the terms stated in the notice, including different debt periods, if the obligation is supported by credible evidence presented by any party at the hearing, without further notice to any non-appearing party, if the ALJ finds that due process requirements have been met.

(b) Any support order entered by the ALJ must comply with the requirements of WAC 388-14A-6300.

(6) The ALJ has no authority to determine custody or visitation issues, or to set a payment schedule for the arrears debt.

(7) When a party has advised the ALJ that they will participate by telephone, the ALJ attempts to contact that party on the record before beginning the proceeding or rules on a motion. The ALJ may not disclose to the other parties the telephone number of the location of the party appearing by phone.

(8) In support establishment hearings, both the NCP and CP may participate in the hearing. However, in certain cases, there is no "custodial parent" because the child or children are in foster care.

(a) If the NCP and CP both fail to appear for hearing, see WAC 388-14A-3131.

(b) If only one of the parties appears for the hearing, see WAC 388-14A-3132.

(9) In some cases prior to May 1, 2022, there could be two NCPs, called "joint NCPs." This happened when DCS served a joint support establishment notice on the marital community made up of spouses who resided together, or on the domestic partnership community made up of two registered domestic partners who resided together, seeking to establish a support obligation for a child in common who was not residing in their home.

(a) If both of the joint NCPs fail to appear for hearing, see WAC 388-14A-3131;

(b) If both of the joint NCPs appear for hearing, see WAC 388-14A-3133; or

(10) When a CP is granted good cause level B (see WAC 388-422-0020), DCS notifies the CP that the CP will receive documents, notices, and orders. The CP may choose to participate at any time. Failure to appear at hearing results in a default order but does not result in a sanction for noncooperation under WAC 388-14A-2041.

(11) If any party appears for the hearing and elects to proceed, the ALJ hears the matter and enters a final order based on the evidence presented, unless the ALJ grants a continuance. The ALJ includes a party's failure to appear in the initial decision and order as an order of default against that party. The direct appeal rights of the party who failed to appear are limited to an appeal on the record made at the hearing.

History

Statutory Authority: RCW 26.09.105, 26.18.170, 26.23.050, 26.23.110, 34.05.220, 74.08.090, and 74.20A.055. WSR 22-08-067, § 388-14A-3140, filed 4/4/22, effective 5/5/22. Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-3140, filed 5/19/11, effective 6/19/11. Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.160. WSR 06-09-015, § 388-14A-3140, filed 4/10/06, effective 5/11/06. Statutory Authority: RCW 74.08.090, 34.05.310 (4)(d), 34.05.220(1), 74.20A.055, 74.20A.056. WSR 03-20-072, § 388-14A-3140, filed 9/29/03, effective 10/30/03. Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.055, 74.20A.056. WSR 00-15-016 and 00-20-022, § 388-14A-3140, filed 7/10/00 and 9/25/00, effective 11/6/00. Formerly WAC 388-11-400 and 388-11-425.

Wash. Admin. Code § 388-14A-3200 How does DCS determine my support obligation?

(1) The division of child support (DCS) determines support obligations using the Washington state child support schedule (the WSCSS), chapter 26.19 RCW, for the establishment and modification of support orders.

(2) When calculating child support obligations, DCS must use the WSCSS worksheets developed by the administrative office of the courts (AOC).

(3) RCW 26.23.050 provides that every child support order must state the monthly child support obligation as a sum certain amount, but does not require that the support obligation be stated in a "per month per child" amount when more than one child is covered by the order. DCS sets support obligations in a per month per child amount whenever possible.

(4) When DCS is calculating a support obligation for more than one child in an administrative support establishment notice, DCS may set the monthly support obligation as an undifferentiated amount, as defined in WAC 388-14A-4800. DCS may do this if one or more of the following are true:

(a) The calculation involves a deviation from the standard calculation based on the existence of children from other relationships;

(b) The support obligation is subject to the "forty-five percent limitation" provided in RCW 26.19.065(1) and described in WAC 388-14A-3400 (1)(a);

(c) The support obligation is subject to the self-support reserve limitation, and the monthly support obligation is greater than the presumptive minimum obligation of fifty dollars per month per child; or

(d) Part III of the worksheets includes health care or day care expenses.

(5) See WAC 388-14A-8100 for rules on completing the worksheets under the WSCSS for cases where DCS is determining support for a child in foster care.

(6) DCS does not have statutory authority to set the child support obligations of both the noncustodial parent (NCP) and custodial parent (CP) in the same administrative proceeding, except that RCW 26.09.105, 26.18.170 and 26.23.050 provide that an administrative order that sets the NCP's child support obligation can also determine the CP's medical support obligation.

(a) DCS orders can not set off the support obligation of one parent against the other.

(b) Therefore, the method set forth in Marriage of Arvey, 77 Wn. App 817, 894 P.2d 1346 (1995), must not be applied when DCS determines a support obligation.

(7) The limitations in this section apply to DCS staff and to administrative law judges (ALJs) who are setting child support obligations.

(8) See WAC 388-14A-4800 through 388-14A-4830 for more information on differentiated and undifferentiated support amounts.

History

Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-3200, filed 5/19/11, effective 6/19/11. Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-3200, filed 5/29/08, effective 7/1/08. Statutory Authority: RCW 74.08.090, 34.05.220 (1)(a), 74.20A.055. WSR 07-06-053, § 388-14A-3200, filed 3/2/07, effective 4/2/07. Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.055, 74.20A.056. WSR 06-16-073, § 388-14A-3200, filed 7/28/06, effective 8/28/06
WSR 00-15-016 and 00-20-022, § 388-14A-3200, filed 7/10/00 and 9/25/00, effective 11/6/00. Formerly WAC 388-11-205.

Wash. Admin. Code § 388-14A-3205 How does DCS calculate my income?

(1) The division of child support (DCS) calculates a parent's income using the best available information. If a parent is voluntarily unemployed or underemployed, either DCS or the administrative law judge (ALJ), or both may impute income to that parent. Voluntary underemployment or unemployment is determined based upon the parent's assets, residence, employment and earnings history, job skills, educational attainment, literacy, health, age, criminal record, dependency court obligations, and other employment barriers, record of seeking work, the local job market, the availability of employers willing to hire the parent, the prevailing earnings level in the local community, or any other relevant factors. Income is not imputed for an unemployable parent. Income is also not imputed to a parent to the extent the parent is unemployed or significantly underemployed due to the parent's efforts to comply with court-ordered reunification efforts under chapter 13.34 RCW or under a voluntary placement agreement with an agency supervising the child.

(2) In the absence of records of a parent's actual earnings, either DCS or the administrative law judge (ALJ), or both may impute a parent's income under RCW 26.19.071(6) in the following order of priority:

(a) Full-time earnings at the current rate of pay;

(b) Full-time earnings at the historical rate of pay based on reliable information, such as employment security department data;

(d) Earnings of thirty-two hours per week at minimum wage in the jurisdiction where the parent resides if the parent is on or recently coming off temporary assistance for needy families or recently coming off aged, blind, or disabled assistance benefits, pregnant women assistance benefits, essential needs and housing support, supplemental security income, or disability, has recently been released from incarceration, or is a recent high school graduate. Imputation at thirty-two hours per week under this subsection is a rebuttable presumption;

(e) Full-time earnings at minimum wage in the jurisdiction where the parent resides if the parent has a recent history of minimum wage earnings, has never been employed and has no earnings history, or has no significant earnings history; or

(f) Median net monthly income of year-round full-time workers as derived from the United States bureau of census, current population reports.

(3) When a parent is currently enrolled in high school full-time, either DCS or the ALJ, or both may consider the totality of the circumstances of both parents when determining whether each parent is voluntarily unemployed or voluntarily underemployed. If the parent who is enrolled in high school is determined to be voluntarily unemployed or voluntarily underemployed, either DCS or the ALJ, or both may impute earnings of 20 hours per week at minimum wage in the jurisdiction where the parent resides. Imputation of earnings at 20 hours per week under this subsection is a rebuttable presumption.

(4) DCS and the ALJ impute earnings of 32 hours per week at the minimum wage to a TANF recipient in the absence of actual income information. You may rebut the imputation of income if you are excused from being required to work while receiving TANF, because:

(a) You are either engaged in other qualifying WorkFirst activities which do not generate income, such as job search; or

(b) You are excused or exempt from being required to work in order to receive TANF, because of other barriers such as family violence or mental health issues.

History

Statutory Authority: RCW 26.09.105, 26.23.110, 74.04.055, 74.08.090, 74.20.040, and 74.20A.310. WSR 21-24-063, § 388-14A-3205, filed 11/29/21, effective 12/30/21. Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-3205, filed 5/19/11, effective 6/19/11. Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-3205, filed 5/29/08, effective 7/1/08. Statutory Authority: RCW 74.08.090, 34.05.310 (4)(d), 34.05.220(1), 74.20A.055, 74.20A.056. WSR 03-20-072, § 388-14A-3205, filed 9/29/03, effective 10/30/03. Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.055, 74.20A.056. WSR 00-15-016 and 00-20-022, § 388-14A-3205, filed 7/10/00 and 9/25/00, effective 11/6/00. Formerly WAC 388-11-205.

Wash. Admin. Code § 388-14A-3275 The division of child support may amend an administrative notice at any time before a final administrative order is entered.

(1) The division of child support (DCS) may orally amend a notice issued under this chapter at the hearing to conform to the evidence. When DCS amends a notice at the hearing:

(a) The administrative law judge (ALJ) may grant a continuance when necessary to give the parties additional time to present evidence and argument as to the amendment; and

(b) DCS must put the terms of the amendment in writing and provide a copy, in person or by regular mail to the last known address of the parties, and to the ALJ within a reasonable time after amending the notice.

(2) The amended notice does not generate a new hearing right.

(3) When DCS has obtained reliable information that the income basis of the notice is inaccurate, DCS amends a notice issued under WAC 388-14A-3115, 388-14A-3120, or 388-14A-3125 prior to seeking a default order for failure to appear. An amendment under this subsection must be made according to the terms of subsection (1) above.

(4) Subsection (3) of this section does not apply:

(a) To cases in which no one has requested a hearing; or

(b) After the ALJ has closed the hearing record.

(5) If DCS has amended the notice under this section and either the noncustodial parent or the custodial parent fail to appear at a rescheduled hearing date, the ALJ must enter a default order on the terms of the amended notice.

History

Statutory Authority: RCW 74.08.090, 74.20A.055. WSR 01-03-089, § 388-14A-3275, filed 1/17/01, effective 2/17/01. Formerly WAC 388-11-300.

Wash. Admin. Code § 388-14A-3300 How does the division of child support require me to make my support payments to the Washington state support registry when my support order says to pay someone else?

(1) If a support order requires the noncustodial parent (NCP) to pay support to anywhere other than the Washington state support registry (WSSR), the division of child support (DCS) may serve a notice on the NCP telling the NCP to make all future payments to the WSSR.

(2) DCS determines which notice to serve on the NCP as provided in WAC 388-14A-3302 and elsewhere in this chapter.

(3) When DCS serves a notice of support debt under RCW 74.20A.040 or a notice of support owed under RCW 26.23.110, DCS notifies the person entitled to receive the support as well as the payee under the order if appropriate. See WAC 388-14A-3315.

History

Statutory Authority: RCW 26.09.105, 26.23.110, 74.04.055, 74.08.090, 74.20.040, and 74.20A.310. WSR 21-24-063, § 388-14A-3300, filed 11/29/21, effective 12/30/21. Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-3300, filed 5/19/11, effective 6/19/11. Statutory Authority: RCW 74.08.090, 34.05.310 (4)(d). WSR 03-20-072, § 388-14A-3300, filed 9/29/03, effective 10/30/03. Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-3300, filed 1/17/01, effective 2/17/01.

Wash. Admin. Code § 388-14A-3302 How does the division of child support decide what notice to serve when there is already an existing order for child support?

(1) When the division of child support (DCS) serves a notice under WAC 388-14A-3300 to advise a noncustodial parent (NCP) that DCS is enforcing a support order, DCS may serve a notice of support debt, a notice of support debt and registration, a notice of support owed, or any other appropriate notice as provided in this chapter.

(2) If the support order sets the amount of the support obligation in a sum certain amount, DCS may serve a notice of support debt on the NCP as provided in RCW 74.20A.040 and WAC 388-14A-3304.

(3) If DCS is registering a support order or income-withholding order issued in another state, DCS may serve a notice of support debt and registration on the NCP, as provided in RCW 26.21A.500, 26.21A.540 and WAC 388-14A-7100.

(4) Under RCW 26.23.110, DCS may serve a notice of support owed on an NCP or a custodial parent (CP), as appropriate, if the underlying support order:

(a) Does not state the monthly support obligation as a fixed dollar amount stated in U.S. dollars;

(b) Contains an escalation clause or adjustment provision for which additional information not contained in the support order is needed to determine the fixed dollar amount of the support debt or the fixed dollar amount of the current and future support obligation, or both;

(c) Provides that the NCP is responsible for a portion of nonmedical expenses incurred on behalf of the child, but does not reduce the amount owed to a fixed dollar amount; or

(d) Provides that either the NCP or the custodial parent (CP) must provide medical support as provided under either RCW 26.19.105 or 74.20A.300, but does not reduce the medical support obligation to a fixed dollar amount.

(5) As of the effective date of this section, DCS does not serve a notice of support owed under RCW 26.23.110 to determine the NCP's proportionate share of any nonmedical expenses other than daycare or child care expenses incurred on behalf of the child(ren) covered by the order.

(6) The fact that an NCP or CP's request that DCS act on his or her claim for unreimbursed nonmedical expenses is rejected by DCS does not mean that the NCP or CP cannot pursue reimbursement of those expenses by proceeding in court.

(a) If a CP obtains a judgment for unreimbursed nonmedical expenses, DCS may enforce the judgment if the CP qualifies for services under WAC 388-14A-2000.

(b) If DCS served a notice of support owed to determine the NCP's proportionate share of nonmedical expenses at some time before the effective date of this section and either NCP or CP requests an annual review under RCW 26.23.110, DCS may continue to provide annual reviews for the support order which was the subject of the prior notice of support owed but only for the same nonmedical expenses addressed in the prior notice of support owed.

(7) See WAC 388-14A-3310 for the general rules for a notice of support owed.

(a) WAC 388-14A-3311 describes the procedures for service of a notice of support owed to:

(i) Determine the fixed dollar amount of the support debt or the fixed dollar amount of the current and future support obligation;

(ii) Implement an escalation clause or adjustment provision;

(iii) Convert a support order set in foreign currency using the current rate of exchange to fix the amount of support in U.S. dollars; or

(iv) Determine as a sum certain the NCP's proportionate share of daycare or child care expenses paid by the NCP.

(b) WAC 388-14A-3312 describes the procedures for service of a notice of support owed to establish a parent's share of medical expenses and/or medical support owed for the child or children covered by a support order.

(c) WAC 388-14A-3330 describes the procedures for service of a notice of support owed when DCS conducts an annual review of the amounts determined by an order resulting from a previous notice of support owed.

(8) WAC 388-14A-3307 discusses how DCS proceeds when DCS decides that a determination of controlling order under chapter 26.21A RCW is required. Under that section, DCS may serve a notice of support debt and registration as provided in WAC 388-14A-7100.

(9) WAC 388-14A-3315 provides that:

(a) When DCS serves a notice of support debt or a notice of support owed on the NCP, DCS notifies the CP and the payee under the order, if the CP is not the payee under the order; and

(b) When DCS serves a notice of support owed under WAC 388-14A-3312 on the CP, DCS notifies the NCP.

History

Statutory Authority: RCW 26.09.105, 26.23.110, 74.04.055, 74.08.090, 74.20.040, and 74.20A.310. WSR 21-24-063, § 388-14A-3302, filed 11/29/21, effective 12/30/21. Statutory Authority: RCW 26.23.120, 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310, and 45 C.F.R. Parts 301.1, 302.35, 302.36, 303.3, 303.7, 303.11, 303.20, 305.63, 307.13, and 308.2. WSR 11-22-116, § 388-14A-3302, filed 11/2/11, effective 12/3/11. Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-3302, filed 5/19/11, effective 6/19/11.

Wash. Admin. Code § 388-14A-3304 The division of child support may serve a notice of support debt and demand for payment when it is enforcing a support order issued in Washington state, a foreign court order or a foreign administrative order for support.

(1) The division of child support (DCS) may serve a notice of support debt and demand for payment on a noncustodial parent (NCP) under RCW 74.20A.040 to provide notice that DCS is enforcing a support order entered in Washington state, a foreign court order or a foreign administrative order for support.

(a) A "foreign" order is one entered in a jurisdiction other than a Washington state court or administrative forum.

(b) DCS uses the notice of support debt and demand for payment when there is only one current child support order for the NCP and the child or children in the case.

(c) When there are multiple current support orders for the same obligor and child or children, DCS determines which order to enforce as provided under WAC 388-14A-3307.

(2) DCS serves a notice of support debt and demand for payment like a summons in a civil action or by certified mail, return receipt requested.

(3) In a notice of support debt and demand for payment, DCS includes the information required by RCW 74.20A.040, the amount of current and future support, accrued support debt, interest (if interest is being assessed under WAC 388-14A-7110), any health insurance coverage obligation, and any day care or child care costs under the court or administrative order.

(4) After service of a notice of support debt and demand for payment, the NCP must make all support payments to the Washington state support registry. DCS does not credit payments made to any other party after service of a notice of support debt and demand for payment except as provided in WAC 388-14A-3375.

(5) A notice of support debt and demand for payment becomes final and subject to immediate wage withholding and enforcement without further notice under chapters 26.18, 26.23, and 74.20A RCW, subject to the terms of the order, unless, within twenty days of service of the notice in Washington, or within sixty days of service of the notice outside of Washington, the NCP:

(a) Files a request with DCS for a conference board under WAC 388-14A-6400. The effective date of a conference board request is the date DCS receives the request;

(b) Obtains a stay from the superior court; or

(c) Objects to either the validity of the foreign support order or the administrative enforcement of the foreign support order, in which case DCS proceeds with registration of the foreign support order under WAC 388-14A-7100.

(6) RCW 26.21A.515 controls the calculation of the debt on a notice of support debt and demand for payment.

(7) Enforcement of the following are not stayed by a request for a conference board or hearing under this section or WAC 388-14A-6400:

(a) Current and future support stated in the order; and

(b) Any portion of the support debt that the NCP and custodial parent (CP) fail to claim is not owed.

(8) At the same time that DCS sends the notice of support debt and demand for payment for service on the NCP, DCS notifies either the CP or the payee under the order, or both if appropriate, by mailing a form called the notice to payee, which is described in WAC 388-14A-3315.

(a) DCS does not wait to confirm service of the notice of support debt and demand for payment before mailing out the notice to payee;

(b) DCS mails to the last known address of the CP or the payee under the order, as appropriate;

(i) A copy of the notice of support debt and demand for payment; and

(ii) A statement that:

(A) The payee has the right to contest the notice of support debt; and

(B) A CP who is not the payee under the order has the same rights to contest the notice of support debt and demand for payment.

(9) If the NCP requests a conference board under subsection (5)(a) of this section, DCS mails a copy of the notice of conference board to the CP informing the CP of the CP's right to:

(a) Participate in the conference board; or

(b) Request a hearing under WAC 388-14A-3321 within twenty days of the date of a notice of conference board that was mailed to a Washington address. If the notice of conference board was mailed to an out-of-state address, the CP may request a hearing within sixty days of the date of the notice of conference board. The effective date of a hearing request is the date DCS receives the request.

(10) If the CP requests a hearing under subsection (8)(c) of this section, DCS must:

(a) Stay enforcement of the notice of support debt and demand for payment except as required under subsection (7) of this section; and

(b) Notify the NCP of the hearing.

(11) If a CP requests a late hearing under subsection (8)(c) of this section, the CP must show good cause for filing the late request.

(12) The NCP is limited to a conference board to contest the notice and may not request a hearing on a notice of support debt and demand for payment. However, if the CP requests a hearing, the NCP may participate in the hearing.

(13) A notice of support debt and demand for payment must fully and fairly inform the NCP of the rights and responsibilities in this section.

History

Statutory Authority: RCW 26.09.105, 26.18.170, 26.23.110, 34.05.220, 74.04.055, 74.08.090, 74.20.040, and 74.20A.310. WSR 20-03-024, § 388-14A-3304, filed 1/6/20, effective 4/1/20. Statutory Authority: RCW 26.23.120, 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310, and 45 C.F.R. Parts 301.1, 302.35, 302.36, 303.3, 303.7, 303.11, 303.20, 305.63, 307.13, and 308.2. WSR 11-22-116, § 388-14A-3304, filed 11/2/11, effective 12/3/11. Statutory Authority: RCW 34.05.220(2), 43.20A.550, 74.04.055, 74.08.090, 74.20.040, 74.20A.310. WSR 07-08-055, § 388-14A-3304, filed 3/29/07, effective 4/29/07. Statutory Authority: RCW 26.21.016, 74.08.090, 26.23.035, 34.05.220(1), 74.20A.310, 26.23.110, and 74.20A.040. WSR 05-07-059, § 388-14A-3304, filed 3/11/05, effective 4/11/05. Statutory Authority: RCW 74.08.090, 26.23.035, 34.05.220(1), 74.20A.310. WSR 01-03-089, § 388-14A-3304, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-435.

Wash. Admin. Code § 388-14A-3305 What can I do if I disagree with a notice of support debt and demand for payment?

Once the division of child support has served a notice of support debt and demand for payment, either party may disagree with the notice.

(1) If either party objects to the enforcement of a non-Washington support order, that party may request that DCS register that order under chapter 26.21A RCW. DCS then serves a notice of support debt and registration as provided in WAC 388-14A-7100.

(2) If the noncustodial parent (NCP) objects to the amount of current support or the amount of support debt stated in the notice, the NCP may request a conference board under WAC 388-14A-6400.

(a) The custodial parent (CP) may participate in the conference board under this section.

(b) The CP may choose to convert the proceeding to an administrative hearing. The NCP may participate in a hearing held under this section.

(3) If the custodial parent objects to the amount of current support or the amount of support debt stated in the notice, the CP may request an administrative hearing. The NCP may participate in a hearing held under this section.

(4) See WAC 388-14A-3304 for a more full description of the hearing process on the notice of support debt and demand for payment.

History

Statutory Authority: RCW 26.23.120, 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310, and 45 C.F.R. Parts 301.1, 302.35, 302.36, 303.3, 303.7, 303.11, 303.20, 305.63, 307.13, and 308.2. WSR 11-22-116, § 388-14A-3305, filed 11/2/11, effective 12/3/11. Statutory Authority: RCW 34.05.220(2), 43.20A.550, 74.04.055, 74.08.090, 74.20.040, 74.20A.310. WSR 07-08-055, § 388-14A-3305, filed 3/29/07, effective 4/29/07.

Wash. Admin. Code § 388-14A-3306 Does a notice of support debt and demand for payment result in a final determination of support arrears?

(1) After service of a notice of support debt and demand for payment as provided in WAC 388-14A-3304, the final administrative order determines the support debt as of the date of the order, and:

(a) The debt determination is not a final determination under the Uniform Interstate Family Support Act (UIFSA), chapter 26.21A RCW.

(b) RCW 26.21A.515 controls in any computation and/or determination of accrued interest on arrearages under the support order.

(2) The final administrative order comes about by:

(a) Operation of law if nobody objects to the notice;

(b) Agreed settlement or consent order under WAC 388-14A-3600;

(d) Final administrative order entered after hearing or a party's failure to appear for hearing.

History

Statutory Authority: RCW 26.23.120, 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310, and 45 C.F.R. Parts 301.1, 302.35, 302.36, 303.3, 303.7, 303.11, 303.20, 305.63, 307.13, and 308.2. WSR 11-22-116, § 388-14A-3306, filed 11/2/11, effective 12/3/11. Statutory Authority: RCW 34.05.220(2), 43.20A.550, 74.04.055, 74.08.090, 74.20.040, 74.20A.310. WSR 07-08-055, § 388-14A-3306, filed 3/29/07, effective 4/29/07.

Wash. Admin. Code § 388-14A-3307 How does the division of child support proceed when there are multiple child support orders for the same obligor and children?

When more than one current child support order exists for the same obligor and children, the division of child support (DCS) may proceed as follows:

(1) When not acting as a responding jurisdiction, DCS decides whether or not a determination of controlling order is necessary, and which state has the authority to make a determination of controlling order (DCO) under UIFSA.

(2) The controlling order is the single order used for prospective enforcement and modification, determined according to the priority scheme set out in the Uniform Interstate Family Support Act (UIFSA).

(3) Using the criteria listed in RCW 26.21A.130, DCS may decide which child support order it should enforce and may serve a notice of support debt and demand for payment under WAC 388-14A-3304.

(4) When a party objects to enforcement of the order selected for enforcement under subsection (1) of this section, or when the order that DCS decides to enforce is not the order presented by a party or another jurisdiction for enforcement of current support, DCS may serve a notice of support debt and registration as provided in WAC 388-14A-7100.

(5) WAC 388-14A-7305 describes how either party or the initiating jurisdiction can ask for a DCO.

(6) WAC 388-14A-7315 describes how DCS decides whether to deny a request for a DCO.

(7) If DCS reviews the orders in response to a request for a DCO and decides that a Washington order is the presumed controlling order, DCS refers the case to superior court.

(8) If DCS reviews the orders in response to a request for a DCO and decides that a non-Washington order is the presumed controlling order, DCS serves a notice of support debt and registration as provided in WAC 388-14A-7325.

History

Statutory Authority: RCW 26.23.120, 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310, and 45 C.F.R. Parts 301.1, 302.35, 302.36, 303.3, 303.7, 303.11, 303.20, 305.63, 307.13, and 308.2. WSR 11-22-116, § 388-14A-3307, filed 11/2/11, effective 12/3/11. Statutory Authority: RCW 34.05.220(2), 43.20A.550, 74.04.055, 74.08.090, 74.20.040, 74.20A.310. WSR 07-08-055, § 388-14A-3307, filed 3/29/07, effective 4/29/07.

Wash. Admin. Code § 388-14A-3310 What notice does the division of child support serve to establish a fixed dollar amount under an existing child support order?

(1) The division of child support (DCS) may serve a notice of support owed under RCW 26.23.110 on either the noncustodial parent (NCP) or the custodial parent (CP) whenever it is necessary to establish a fixed dollar amount owed under a child support order that was entered in Washington or by any other tribunal. This section provides general information regarding the notice of support owed.

(a) WAC 388-14A-3311 describes the procedures for service of a notice of support owed on the NCP to determine the fixed dollar amount of the support debt or the fixed dollar amount of the current and future support obligation for nonmedical expenses.

(b) WAC 388-14A-3312 describes the procedures for service of a notice of support owed on either parent to establish that parent's share of medical expenses or medical support, or both, owed for the child or children covered by a support order.

(2) The notice of support owed contains an initial finding, showing DCS' calculation of the fixed dollar amount of:

(a) The current and future support obligation;

(b) Any support debt owed; or

(3) The notice of support owed facilitates enforcement of the underlying support order by implementing the terms of the order, but it cannot modify the terms of the order.

(4) The reasons that DCS may serve a notice of support owed include, but are not limited to:

(a) The underlying support order sets a support obligation but does not state the monthly support obligation as a fixed dollar amount;

(b) The underlying support order sets a support obligation stated in foreign currency and DCS seeks to convert that amount using the current rate of exchange to fix the amount of support stated in U.S. dollars;

(d) The support order provides that the NCP is responsible for paying for a portion of daycare or child care expenses incurred on behalf of the child or children, but does not reduce the amount owed to a fixed dollar amount. DCS serves the notice of support owed to determine the NCP's proportionate share of those expenses; or

(e) The support order provides that either the NCP or the CP must provide medical support as required under either RCW 26.19.105 or 74.20A.300, but does not reduce the medical support obligation to a fixed dollar amount.

(5) DCS uses four separate forms to use for the notice of support owed:

(a) The basic form used by DCS to establish a fixed dollar amount owed by an NCP under an existing child support order is called the notice of support owed. The notice of support owed is also used to notify parties of an annual review of amounts owed established by a previous notice of support owed.

(b) The "notice of support owed - Medical support" is used for the following purposes:

(i) To notify an obligated parent of the obligation to pay a portion of the premium for health insurance provided by the other parent or state of Washington; or

(ii) To determine a fixed dollar amount for uninsured medical expenses incurred on behalf of the child or children and to demand payment of the obligated parent's proportionate share when a support order requires the obligated parent to pay a specific percentage of uninsured medical expenses.

(iii) To determine the amounts owed in an annual review of the amounts established by a previous notice of support owed-Medical support.

(c) The notice of support owed-Daycare establishment is used to establish a daycare obligation for past-due and current and future daycare when the underlying order provides that daycare expenses must be determined by a percentage stated in the underlying order.

(d) The notice of support owed-Daycare annual review is used to review daycare expenses established by a previous notice of support owed-Daycare establishment or notice of support owed-Daycare annual review and to determine current and future daycare obligation subsequent to the effective period of the previous notice of support owed that addressed a daycare obligation.

(6) For the purposes of this chapter, the term "notice of support owed" includes "notice of support owed," "notice of support owed - Medical support," "notice of support owed-Daycare establishment," and "notice of support owed-Daycare annual review."

(7) DCS serves an initial notice of support owed on the NCP or the CP, as appropriate, like a summons in a civil action or by certified mail, return receipt requested.

(8) When DCS serves a notice of support owed on one party, DCS notifies the other party to the support order by sending a form called the notice to payee, and encloses a copy of the notice.

(a) If DCS is serving a notice of support owed on the NCP, DCS mails the notice to payee to the CP and to the payee under the order, if the CP is not the payee under the order.

(b) If DCS is serving a notice of support owed on the CP, DCS mails the notice to payee to the NCP.

(9) If the order resulting from a previous notice of support owed included a statement that subsequent notices of support owed to review the amounts will be served in regular mail, DCS may serve a subsequent notice of support owed by regular mail to the parties at their last known mailing addresses on file with the department.

(10) If the previous notice of support owed does not include a statement that a subsequent notice of support owed may be mailed by first class mail, DCS must serve the notice of support owed in the same manner as an initial notice of support owed.

(11) See WAC 388-14A-3330 for procedures used by DCS for annual review of an obligation established by a prior notice of support owed.

(12) In a notice of support owed, DCS includes:

(a) The information required by RCW 26.23.110;

(b) Any provision or factors contained in the underlying order regarding how to calculate the monthly support or the amounts claimed for medical support;

(d) Notice of the right to request an annual review of the order or a review on the date given in the order for an annual review, if any. WAC 388-14A-3330 describes the procedures for the annual review of a notice of support owed; and

(e) Notice that a subsequent notice of support owed for an annual review of the amounts established by the notice of support owed may be served by regular mail to each party at their last known address.

(13) A notice of support owed fully and fairly informs the parties of the rights and responsibilities in this section.

(14) After service of a notice of support owed, the recipient of the notice (which could be either the CP or the NCP, as appropriate,) must make all support payments required by the notice to the Washington state support registry (WSSR). DCS does not credit payments made to any other party after service of a notice of support owed except as provided in WAC 388-14A-3375.

(15) The need to serve a notice of support owed does not require DCS to cease all enforcement actions on a case. At any time, DCS may enforce:

(a) A fixed or minimum dollar amount for monthly support stated in the court order or a prior administrative order entered under this section;

(b) Any part of a support debt that has been reduced to a fixed dollar amount by a court or administrative order; and

(16) A notice of support owed becomes final and subject to immediate income withholding and enforcement as provided in WAC 388-14A-3316.

(17) An objection or request for hearing on a notice of support owed may be timely or untimely:

(a) WAC 388-14A-3317 discusses what happens if a parent makes a timely request for hearing; and

(b) WAC 388-14A-3318 discusses what happens if a parent makes an untimely request for hearing.

(18) WAC 388-14A-3320 provides general information regarding an administrative hearing on a notice of support owed.

(19) WAC 388-14A-3330 provides information regarding the annual review of a notice of support owed.

(20) For the purposes of this section and WAC 388-14A-3311 through 388-14A-3331, the term "payee" includes "physical custodian," "custodial parent," or "party seeking reimbursement."

History

Statutory Authority: RCW 26.09.105, 26.23.110, 74.04.055, 74.08.090, 74.20.040, and 74.20A.310. WSR 21-24-063, § 388-14A-3310, filed 11/29/21, effective 12/30/21. Statutory Authority: RCW 26.09.105, 26.18.170, 26.23.110, 34.05.220, 74.04.055, 74.08.090, 74.20.040, and 74.20A.310. WSR 20-03-024, § 388-14A-3310, filed 1/6/20, effective 4/1/20. Statutory Authority: RCW 26.23.120, 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310, and 45 C.F.R. Parts 301.1, 302.35, 302.36, 303.3, 303.7, 303.11, 303.20, 305.63, 307.13, and 308.2. WSR 11-22-116, § 388-14A-3310, filed 11/2/11, effective 12/3/11. Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-3310, filed 5/19/11, effective 6/19/11. Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-3310, filed 5/29/08, effective 7/1/08. Statutory Authority: RCW 74.08.090, 26.23.035, 34.05.220(1), 74.20A.310 and 26.23.110, and 74.20A.040. WSR 05-07-059, § 388-14A-3310, filed 3/11/05, effective 4/11/05. Statutory Authority: RCW 74.08.090, 26.23.035, 34.05.220(1), 74.20A.310. WSR 01-03-089, § 388-14A-3310, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-415.

Wash. Admin. Code § 388-14A-3311 How does DCS prepare a notice of support owed to determine amounts owed to establish a fixed dollar amount under an existing child support order?

(1) The division of child support (DCS) serves a notice of support owed under RCW 26.23.110, WAC 388-14A-3310 and this section on the noncustodial parent (NCP) to determine the fixed dollar amount of the support debt, the fixed dollar amount of the current and future support obligation, or both.

(2) DCS may serve a notice of support owed on the NCP to determine the fixed dollar amount of the current and future support obligation when a support order provides that the NCP's support obligation is:

(a) A certain percentage of the NCP's gross or net earnings;

(b) Set as a sum-certain amount, but the amount is to be paid other than monthly; or

(c) To be determined by some other formula or method requiring the use of information that is not contained in the order, including currency conversion when DCS is enforcing a support order which sets the support amount in a foreign currency.

(3) DCS may serve a notice of support owed-Daycare establishment on the NCP to determine the amount of the NCP's share of daycare or child care expenses for the children when the support order sets the NCP's obligation as a percentage or proportion of those expenses. A custodial parent (CP) seeking reimbursement for daycare or childcare expenses for the child or children must:

(a) Apply for full collection services at the time of the request, unless the CP already has an open full collection case with DCS;

(b) Have paid the daycare or child care expenses before seeking reimbursement through DCS;

(d) Complete the forms provided by DCS for the claim, or at a minimum present the required information and documentation in a format similar to that in the DCS forms; and

(e) Declare under penalty of perjury that he or she has asked the NCP to pay his or her share of the daycare or child care expenses or provide good cause for not asking the NCP for payment.

(4) DCS' denial of a request from either the CP or the NCP to serve a notice of support owed under this section does not affect either party's ability to bring an action in another tribunal to enforce a claim for the other party's proportionate share of expenses paid for the children. Either party may file an action in court to:

(a) Make a claim for reimbursement of daycare or childcare expenses;

(b) Make a claim for reimbursement of any other child rearing expenses; or

(5) DCS may serve a notice of support owed under this section on the NCP to implement an escalation clause or adjustment provision for which additional information not contained in the support order is needed to determine the fixed dollar amount of the support debt or the fixed dollar amount of the current and future support obligation.

(6) Whenever DCS serves a notice of support owed on the NCP under subsections (2), (3) or (5) above, that notice may also include a determination of the fixed dollar amount of:

(a) Any support debt owing;

(b) Any amount paid by the NCP that exceeds his or her actual current and future support obligation; and

(7) If DCS is preparing a notice of support owed as part of an annual review, the notice may also include a determination of the fixed dollar amount of:

(a) Any support debt owed by the NCP; and

(b) Any amounts calculated under an order resulting from a previous notice of support owed that exceed the NCP's actual obligation after actual income or expenses are considered.

(8) If the notice of support owed contains a determination that the amount owed by the NCP under the previous notice of support owed (if any) is more than his or her actual current and future support obligation or his or her actual share of expenses, the notice addresses how the difference may be credited or repaid, in the absence of an agreement between the parties.

(a) Any overpayment may be applied an as offset to nonassistance child support arrears owed by the NCP on that case only.

(b) If there is no nonassistance debt owed on the case, the reimbursement must be in the form of a credit against the NCP's future child support obligation:

(i) Spread equally over a 12 month period starting the month after the administrative order becomes final; or

(ii) In a case where the underlying order provides that the NCP's support obligation will end in less than 12 months, spread equally over the remaining life of the order.

(9) In a notice of support owed under this section, DCS includes:

(a) The information required by RCW 26.23.110 and WAC 388-14A-3110;

(b) A description of any provisions or factors contained in the underlying order regarding how to calculate the monthly support obligation or the amounts claimed for nonmedical expenses; and

(10) See WAC 388-14A-3330 for additional procedures used by DCS for an annual review of the amounts established by a notice of support owed.

History

Statutory Authority: RCW 26.09.105, 26.23.110, 74.04.055, 74.08.090, 74.20.040, and 74.20A.310. WSR 21-24-063, § 388-14A-3311, filed 11/29/21, effective 12/30/21. Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-3311, filed 5/19/11, effective 6/19/11.

Wash. Admin. Code § 388-14A-3312 The division of child support serves a notice of support owed to establish a fixed dollar amount owed by either parent for medical support.

(1) Depending on the specific requirements of the child support order, and only if the case meets the criteria set out in WAC 388-14A-4100, the division of child support (DCS) may serve a notice of support owed under RCW 26.23.110, WAC 388-14A-3310 and this section:

(a) On either the noncustodial parent (NCP) or the custodial parent (CP), as appropriate, in order to:

(i) Establish as a sum certain and collect the obligated parent's proportionate share of uninsured medical expenses owed to the parent seeking reimbursement. This process is called reimbursement of uninsured medical expenses;

(ii) Establish as a sum certain and collect the obligated parent's monthly payment toward the premium currently being paid by the other parent for health care coverage for a child named in the support order; or

(iii) Establish and collect amounts owed under both subsections (a)(i) and (a)(ii) of this section.

(b) On the NCP in order to establish as a sum certain and collect the NCP's monthly payment toward the premium paid by the state for managed care coverage for a child named in the support order, if the child receives public health care coverage in the state of Washington, whether or not there is an assignment of rights.

(2) Unless otherwise specified in the order, each parent's proportionate share of uninsured medical expenses and health care premiums is the same as the proportionate share of income shown on the Washington state child support schedule worksheet that was completed as part of the support order.

(a) On occasion, a tribunal may specify that medical support obligations are to be shared between the parents at a different percentage than the one on the worksheet.

(b) DCS follows the terms of the underlying order when serving a notice of support owed under this section.

(3) WAC 388-14A-4111 and 388-14A-4112 set out some of the reasons why DCS may decline a party's request to enforce a medical support obligation.

(4) Only a CP who is both a parent of the child and a party to the support order may ask DCS to serve a notice of support owed on the NCP under subsection (1)(a) of this section. If the CP is not both a parent of the child and a party to the support order, DCS' denial of the request does not affect the CP's ability to bring an action in another tribunal to enforce the CP's claim against the NCP for medical support. The CP may file an action in court to:

(a) Make a claim for reimbursement of uninsured medical expenses;

(b) Make a claim for a monthly contribution toward any health care coverage provided by the CP; or

(5) DCS may serve a notice of support owed on the NCP under subsection (1)(b) of this section without regard to the CP's status as a parent or party to the order, if the child receives public health care coverage in the state of Washington, whether or not there is an assignment of rights.

(6) Except as limited in subsection (4) above, either the NCP or the CP may ask DCS to serve a notice of support owed on the other party to the support order in order to establish the obligated parent's proportionate share of uninsured medical expenses as a sum certain amount if the support order establishes such an obligation. The parent seeking reimbursement for uninsured medical expenses must:

(a) Apply for full collection services at the time of the request, unless the parent already has an open full collection case with DCS;

(b) Have paid the uninsured medical expenses before seeking reimbursement through DCS;

(d) Complete the forms provided by DCS for the claim, or at a minimum present the required information and documentation in a format similar to that in the DCS forms; and

(e) Declare under penalty of perjury that he or she has asked the obligated parent to pay his or her share of the uninsured medical expenses or provide good cause for not asking the obligated parent.

(i) If the uninsured medical expenses have been incurred within the last 12 months, this requirement is waived; and

(ii) If the obligated party denies having received notice that the other party was seeking reimbursement for uninsured medical expenses or support, the service of the notice of support owed constitutes the required notice.

(7) A party's request that DCS serve a notice of support owed to establish the other parent's obligation for medical support, including reimbursement for uninsured medical expenses:

(a) May be for a period of up to 24 consecutive months;

(b) May include only medical services provided after July 21, 2007;

(c) May not include months which were included in a prior notice of support owed for medical support or a prior judgment;

(d) Need not be for the 24 month period immediately following the period included in the prior notice of support owed for medical support;

(e) May include a claim for the obligated parent's proportionate share of any health care coverage premiums paid by the requesting parent after July 21, 2007, but this type of claim is limited as provided in subsections (11) and (12) of this section; and

(f) May include a request that DCS establish a monthly payment toward the premium representing the obligated parent's proportionate share of the premium paid by the requesting parent only for premiums paid for health care coverage provided after September 30, 2009.

(8) The party seeking reimbursement must ask DCS to serve a notice of support owed for medical support within two years of the date that the uninsured medical expense or premium was incurred.

(a) The fact that a request that DCS serve a notice of support owed for medical support is denied, either in whole or in part, does not mean that the party cannot pursue reimbursement of those uninsured medical expenses by proceeding in court.

(b) If a party obtains a judgment for reimbursement of uninsured medical expenses or other type of medical support, DCS enforces the judgment.

(9) When either party asks DCS to serve a notice of support owed under this section to establish the other party's proportionate share of uninsured medical expenses as a sum certain amount and the medical expenses include premiums for health care coverage for the children covered by the order, DCS reviews the order to determine whether it provides for a monthly payment toward the premium when the obligated parent does not have insurance available through his or her employer or union.

(a) If the order does not have such a requirement, DCS includes the health care coverage premiums in the claim for reimbursement of uninsured medical expenses, but limits the obligated parent's obligation as provided in subsections (11) and (12) of this section.

(b) If the order does have such a requirement, DCS serves a notice of support owed which:

(i) Includes the health care coverage premiums in the claim for reimbursement of uninsured medical expenses; and

(ii) If appropriate, includes the provisions necessary to establish a monthly contribution which represents the obligated parent's proportionate share of the premium paid by the other parent (not to exceed 25 percent of the obligated parent's basic support obligation), if the obligated parent is not already providing health care coverage for the children.

(10) There are two circumstances under which DCS may serve a notice of support owed to establish the amount owed by an obligated parent as a monthly payment toward the premium paid for coverage by the other parent or the state. DCS may serve the notice of support owed when the support order:

(a) Specifically provides that the obligated parent's medical support obligation under RCW 26.09.105 (1)(c) is to pay a monthly payment toward the premium instead of providing health care coverage, but does not set that obligation as a sum certain; or

(b) Provides that, if health insurance is not available through the obligated parent's employer or union at a cost not to exceed 25 percent of the obligated parent's basic support obligation, the obligated parent must pay a monthly payment toward the premium but does not set that obligation as a sum certain. In this situation, DCS serves the notice of support owed to establish a monthly payment toward the premium paid only if the obligated parent is not already providing coverage for the children.

(11) DCS may collect a maximum of 25 percent of the obligated parent's basic support obligation for medical premium costs claimed by the requesting party.

(12) DCS may not collect for medical premium costs claimed by the requesting party through either the monthly payment toward the premium or the reimbursement of uninsured medical expenses if the obligated parent is providing accessible health care coverage for the child. The obligated parent is only required to pay those costs if he or she is not providing accessible health care coverage for the child.

(13) Once DCS serves a notice of support owed under this section that establishes a medical support obligation representing the obligated parent's proportionate share of the premium paid by the other parent, the obligated parent is not required to reimburse the other parent for any amounts of that proportionate share of the premium which are not paid because those amounts exceed 25 percent of the obligated parent's basic support obligation.

(a) That portion of the obligated parent's proportionate share of the premium for a month that is not included in the obligated parent's monthly payment toward the premium may not be recovered by a later claim for unreimbursed medical expenses; and

(b) The obligation to contribute a proportionate share of other uninsured medical expenses is not affected by the establishment of a medical support obligation for medical premiums paid by the requesting parent under this section.

(14) Once DCS serves a notice of support owed under this section that establishes a monthly payment toward the premium which represents the NCP's proportionate share of the premium paid by the state, the NCP is not required to reimburse the state for any amounts of that proportionate share of the premium which are not paid because those amounts exceed 25 percent of the NCP's basic support obligation.

(15) An NCP who wants DCS to enforce the CP's medical support obligation must first apply for full child support enforcement services.

(a) DCS enforces a CP's medical support obligation only as provided under WAC 388-14A-4112.

(b) If the parties already have an open full enforcement case with DCS, DCS opens up a new case which is called the medical support case, and the previously existing case is called the main case.

(i) The case where DCS is acting on NCP's request to enforce CP's medical support obligation is called the medical support case; and

(ii) The case where DCS is enforcing the underlying support order and collecting from the NCP is called the main case.

(16) In a notice of support owed under this section, DCS includes the information required by RCW 26.23.110, and:

(a) The factors stated in the order regarding medical support;

(b) A statement of uninsured medical expenses and a declaration by the parent seeking reimbursement; and

(17) Whenever DCS serves a notice of support owed under this section, that notice may also include a determination of the fixed dollar amount of:

(a) Any medical support debt owed by the obligated parent;

(b) Any amounts owed by the obligated parent under a previous notice of support owed that exceed the obligated parent's actual monthly obligation to pay a proportionate share of the premium after actual expenses or updated proportionate shares owed are considered, but not to exceed 25 percent of the obligated parent's basic support obligation; and

(c) Any amounts owed by the obligated parent under a previous notice of support owed that are less than the obligated parent's actual monthly obligation to pay a proportionate share of the premium after actual expenses or updated proportionate shares owed are considered, but not to exceed 25 percent of the obligated parent's basic support obligation.

(18) If the notice of support owed contains a determination that the order resulting from a previous notice of support owed calculated a medical support obligation that differed from the obligated parent's actual obligation after actual expenses or updated proportionate shares owed are considered, the notice may address how any difference may be credited or repaid in the absence of any agreement between the parties.

(19) If the obligated parent is the NCP, any amounts owed under a previous notice of support owed exceeding the actual obligation after actual expenses or updated proportionate shares owed are considered in the final administrative order are added to the NCP's support debt.

(a) Amounts owed to the CP are added to the unassigned arrears on the case.

(b) Amounts owed to reimburse the state for medicaid or other public health care coverage in the state of Washington are added to the main case as permanently assigned arrears.

(20) If the obligated parent is the CP, any amounts owed under a previous notice of support owed exceeding the actual obligation after actual expenses are considered in the final administrative order are paid in the following order:

(a) Any amount owed by the CP to the NCP is applied as an offset to any nonassistance child support arrears owed by the NCP on the main case only; or

(b) If there is no debt owed to the CP on the main case, payment of the amount owed by the CP is in the form of a credit against the NCP's future child support obligation:

(i) Spread equally over a 12 month period starting the month after the administrative order becomes final; or

(ii) When the future support obligation will end under the terms of the order in less than 12 months, spread equally over the life of the order.

(c) If the amount owed by the CP exceeds the amount that can be paid off using the methods specified in subsections (a) and (b) of this section, DCS uses the medical support case to collect the remaining amounts owed using the remedies available to DCS for collecting child support debts.

(21) If both the CP and the NCP request that DCS serve a notice of support owed under this section on the other party, those notices remain separate and may not be combined.

(a) The office of administrative hearings (OAH) may schedule consecutive hearings but may not combine the matters under the same docket number.

(b) The administrative law judge (ALJ) must issue two separate administrative orders, one for each obligated parent.

(22) See WAC 388-14A-3330 for additional procedures used by DCS for an annual review of the amounts established by a notice of support owed.

History

Statutory Authority: RCW 26.09.105, 26.23.110, 74.04.055, 74.08.090, 74.20.040, and 74.20A.310. WSR 21-24-063, § 388-14A-3312, filed 11/29/21, effective 12/30/21. Statutory Authority: Part I of 2018 c 150 and RCW 26.09.105, 26.18.170, 26.23.050, 34.05.220 (1)(a), 34.05.350(1), 74.08.090, and 74.20.040(9). WSR 19-02-017, § 388-14A-3312, filed 12/21/18, effective 1/21/19. Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-3312, filed 5/19/11, effective 6/19/11. Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-3312, filed 5/29/08, effective 7/1/08.

Wash. Admin. Code § 388-14A-3315 When DCS serves a notice of support debt or a notice of support owed, we notify the other party to the child support order.

(1) When the division of child support (DCS) needs to notify the parties that DCS is enforcing a previously entered support order, DCS serves the appropriate notice under WAC 388-14A-3302. DCS may serve a notice of support owed on either the noncustodial parent (NCP) or the custodial parent (CP), as provided in WAC 388-14A-3310.

(2) At the same time that DCS sends a notice of support debt or a notice of support owed for service on one party, DCS notifies the other party by sending a form called the notice to payee, with a copy of the notice.

(3) DCS serves a notice of support debt or a notice of support owed on the NCP when DCS is enforcing an order that sets the NCP's support obligation. At the same time that DCS sends the notice for service on the NCP:

(a) DCS sends the notice to payee to the CP, if the CP is the payee under the order; and

(b) DCS sends the notice to payee to the CP and to the payee under the order, if the CP is not also the payee under the order.

(4) When DCS serves a notice of support owed on the CP because DCS is enforcing an order that sets the CP's medical support obligation, DCS sends the notice to payee to the NCP.

(5) DCS sends the notice to payee by first class mail to the last known address DCS has on file, and encloses a copy of the notice that was sent for service on the obligated parent.

(a) In a notice to payee, DCS informs the payee of the right to file a request with DCS for a hearing on the notice of support owed or the notice of support debt within 20 days of the date of a notice to payee that was mailed to a Washington address.

(b) If the notice to payee was mailed to an out-of-state address, the payee may request a hearing within 60 days of the date of the notice to payee.

(6) The effective date of a hearing request is the date DCS receives the request.

History

Statutory Authority: RCW 26.09.105, 26.18.170, 26.23.110, 34.05.220, 74.04.055, 74.08.090, 74.20.040, and 74.20A.310. WSR 20-03-024, § 388-14A-3315, filed 1/6/20, effective 4/1/20. Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-3315, filed 5/19/11, effective 6/19/11. Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-3315, filed 5/29/08, effective 7/1/08. Statutory Authority: RCW 74.08.090, 34.05.310 (4)(d), 26.23.035, 34.05.220(1), 74.20A.310. WSR 03-20-072, § 388-14A-3315, filed 9/29/03, effective 10/30/03. Statutory Authority: RCW 74.08.090, 26.23.035, 34.05.220(1), 74.20A.310. WSR 01-03-089, § 388-14A-3315, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-440.

Wash. Admin. Code § 388-14A-3316 When can a notice of support owed become a final order?

(1) The division of child support (DCS) may serve a notice of support owed on either the noncustodial parent (NCP) or the custodial parent (CP), as described in WAC 388-14A-3310, 388-14A-3311, and 388-14A-3312.

(2) The notice of support owed becomes a final administrative order subject to immediate income withholding and enforcement without further notice under chapters 26.18, 26.23, 74.20, and 74.20A RCW unless one of the parties, no matter which one was served with the notice, contacts DCS within the time limits provided in this section and:

(a) Objects to the notice;

(b) Requests a hearing;

(d) Obtains a stay from the superior court.

(3) DCS treats any objection to the notice of support owed as a request for hearing on the notice.

(4) If a timely objection is filed, DCS cannot enforce the contested amounts claimed in the notice of support owed until a final order as defined in this section is entered.

(a) WAC 388-14A-3317 discusses what happens if a party makes a timely objection or request for hearing on a notice of support owed.

(b) Even after a timely objection, DCS may still enforce those parts of the support obligation listed in WAC 388-14A-3310(10).

(5) To be timely, the party must object within the following time limits:

(a) Within 20 days of service, if the notice was served in Washington state.

(b) Within 60 days of service, if the notice was served outside of Washington state.

(6) The effective date of an objection or hearing request is the date that DCS receives the objection or request for hearing.

(7) After a timely request for hearing, the final order is one of the following, whichever occurs latest:

(a) An agreed settlement or consent order under WAC 388-14A-3600; or

(b) A final order as defined in WAC 388-14A-6105 and further described in WAC 388-14A-6115.

(8) WAC 388-14A-3318 describes what happens when a party makes an untimely request for hearing on a notice of support owed.

(9) RCW 26.23.110 provides that if a party who receives a notice of support owed does not initiate an action in superior court and serve notice on DCS and on the other party to the support order within 20 days after service of the notice, that party is considered to have made an election of remedies. This means that the party (either the CP or the NCP) must exhaust the administrative remedies under chapter 26.23 RCW before bringing a court action to challenge the notice.

History

Statutory Authority: RCW 26.09.105, 26.23.110, 74.04.055, 74.08.090, 74.20.040, and 74.20A.310. WSR 21-24-063, § 388-14A-3316, filed 11/29/21, effective 12/30/21. Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-3316, filed 5/19/11, effective 6/19/11.

Wash. Admin. Code § 388-14A-3317 What happens if a party makes a timely request for hearing on a notice of support owed?

WAC 388-14A-3317

(1) A party who has been served with a notice of support owed may make a timely or untimely objection to the notice.

(a) A timely request for hearing on a notice of support owed is an objection made within the time limits of WAC 388-14A-3316.

(b) WAC 388-14A-3318 describes what happens when the party files an untimely objection.

(2) When the division of child support (DCS) serves a notice of support owed, DCS sends a notice to payee as provided in WAC 388-14A-3115. The party who receives the notice to payee has the right to object to the notice of support owed.

(3) If either party makes a timely request for hearing, DCS submits the hearing request to the office of administrative hearings (OAH) for scheduling.

(4) OAH sends a notice of hearing electronically or by first class mail to all parties at their addresses last known to DCS, notifying each party of the date, time, and place of the hearing.

(5) DCS, the noncustodial parent (NCP), and the custodial parent (CP) are all parties to a hearing on a notice of support owed.

(6) A timely request for hearing stops the notice from becoming a final order, but DCS may still enforce those parts of the support obligation listed in WAC 388-14A-3310(15). In addition, any party may request that the administrative law judge (ALJ) enter a temporary support order under WAC 388-14A-3850.

(7) See WAC 388-14A-3320 for general information regarding a hearing on a notice of support owed.

History

Statutory Authority: RCW 26.18.170, 26.23.035, 26.23.110, 43.20A.550, 74.04.055, 74.08.090, 74.20.040, 74.20A.310, and 74.20A.328. WSR 26-14-086, s 388-14A-3317, filed 6/29/26, effective 7/30/26. Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-3317, filed 5/19/11, effective 6/19/11. Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-3317, filed 5/29/08, effective 7/1/08. Statutory Authority: RCW 74.08.090, 26.23.035, 34.05.220(1), 74.20A.310, 26.23.110, and 74.20A.040. WSR 05-07-059, § 388-14A-3317, filed 3/11/05, effective 4/11/05.

Wash. Admin. Code § 388-14A-3318 What happens if a party makes an untimely request for hearing on a notice of support owed?

(1) A party who has been served with a notice of support owed may make a timely or untimely objection to the notice.

(a) WAC 388-14A-3117 describes what happens when the party files a timely objection.

(b) An objection which is not made within the time limits of WAC 388-14A-3116 is an untimely objection.

(2) The division of child support (DCS) continues to enforce the administrative order that resulted from the notice of support owed even if one of the parties files a late request for hearing.

(3) If DCS receives the late hearing request within one year of the date of service of the notice, the party requesting the hearing is not required to show good cause to have a hearing on the merits of the notice.

(4) If the party who has been served with a notice of support owed files an untimely request for hearing, he or she must show good cause for filing the late hearing request if the request is filed more than one year after service of the notice. See WAC 388-14A-3500 regarding good cause for filing a late request for hearing.

History

Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-3318, filed 5/19/11, effective 6/19/11. Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-3318, filed 5/29/08, effective 7/1/08.

Wash. Admin. Code § 388-14A-3320 What happens at a hearing on a notice of support owed?

(1) This section provides general information regarding hearings on a notice of support owed.

(2) Either the noncustodial parent (NCP) or the custodial parent (CP) may request a hearing on a notice of support owed.

(3) The division of child support (DCS) serves two basic types of notice of support owed:

(a) The initial notice of support owed served to establish a sum certain amount for a support obligation under an existing order, as described in WAC 388-14A-3310; and

(b) A notice of support owed served as part of the annual review under RCW 26.23.110, as described in WAC 388-14A-3330.

(4) WAC 388-14A-3310(5) describes the two different forms created by DCS which are used for different types of notice of support owed:

(a) The specialized "notice of support owed - Medical support" is used only for specific purposes related to the medical support obligations of either parent; and

(b) The notice of support owed is served on the NCP for all other purposes under RCW 26.23.110 and WAC 388-14A-3311.

(5) DCS and the parties may enter a consent order or agreed settlement instead of proceeding to hearing any time a parent has requested a hearing on a notice of support owed served by DCS. See WAC 388-14A-3600 for the rules regarding consent orders and agreed settlements.

(6) A hearing on a notice of support owed is only for:

(a) Interpreting the underlying order for support and any modifying orders;

(b) Determining whether a condition precedent set in the underlying order was met;

(d) Determining the difference between the obligation calculated in the order resulting from the previous notice of support owed and the actual amount owed for the period covered by the previous notice of support owed; and

(e) Determining the amount of accrued arrears or overpayment for daycare expenses or medical support through the last day of the month before the hearing, or of the month in which the hearing was held; this date is determined at the discretion of the administrative law judge (ALJ) if not agreed upon by the parties.

(7) A hearing on an initial notice of support owed is not for:

(a) Changing or deferring the support provisions of the underlying order; or

(b) Setting a payment schedule on any support amount or support debt that was not covered by the notice which is the subject of the hearing.

(8) A hearing on the annual review of a notice of support owed must comply with this section, but in addition must determine:

(a) Whether there is a difference between the obligation calculated in the order resulting from the previous notice of support owed and the actual obligation for that period after actual expenses or income are considered; and

(b) How that difference should be resolved.

(9) The party who requested the hearing has the burden of proving any defenses to liability that apply under WAC 388-14A-3370 or that the amounts stated in the notice of support owed are incorrect.

(10) The office of administrative hearings (OAH) sends a notice of hearing to DCS, the NCP and the CP. The NCP and the CP each may participate in the hearing as an independent party.

(11) If only one party appears for the hearing, the ALJ may entertain requests for a continuance, and if there is no continuance granted, the ALJ holds a hearing and issues an order based on the evidence presented. The provisions of WAC 388-14A-6110 and 388-14A-6115 determine if the ALJ enters an initial order or a final order.

An order issued under this subsection includes an order of default against the nonappearing party and limits the appeal rights of the nonappearing party to the record made at the hearing.

(12) If neither the NCP nor the CP appears or wishes to proceed with the hearing, the ALJ issues an order of default against both parties.

(13) If either party requests a late hearing on a notice of support owed, that party must show good cause for filing the late hearing request, as provided in WAC 388-14A-3500.

(14) For purposes of this section, the terms "payee" and "CP" are used interchangeably and can mean either the CP, the payee under the order or both, except that a CP who is not also the payee under the support order may not ask DCS to serve a notice of support owed for unreimbursed medical expenses under WAC 388-14A-3312.

(15) This section, WAC 388-14A-3323, 388-14A-3324, 388-14A-3325 and 388-14A-6300 describe the duties of the ALJ in a hearing on a notice of support owed.

(16) Additional information regarding hearings on the notice of support owed can be found in the following sections:

(a) WAC 388-14A-3323 describes a hearing on a notice of support owed served under WAC 388-14A-3311; and

(b) WAC 388-14A-3324 describes a hearing on a notice of support owed served under WAC 388-14A-3312.

(17) WAC 388-14A-3330 describes the annual review of a notice of support owed.

History

Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-3320, filed 5/19/11, effective 6/19/11. Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-3320, filed 5/29/08, effective 7/1/08. Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.160. WSR 06-09-015, § 388-14A-3320, filed 4/10/06, effective 5/11/06. Statutory Authority: RCW 74.08.090, 26.23.035, 34.05.220(1), 74.20A.310, 26.23.110, and 74.20A.040. WSR 05-07-059, § 388-14A-3320, filed 3/11/05, effective 4/11/05. Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-3320, filed 1/17/01, effective 2/17/01.

Wash. Admin. Code § 388-14A-3321 What happens if the custodial parent requests a hearing on a notice of support debt and demand for payment?

(1) If the custodial parent (CP) requests a hearing on a notice of support debt and demand for payment (also called the "notice of support debt"), the hearing is for the limited purpose of determining the support debt under the order through the date of the hearing.

(2) The office of administrative hearings (OAH) sends a notice of hearing to the NCP, to the division of child support (DCS), and to the payee.

(a) The NCP and the payee each may participate in the hearing.

(b) "Participating in" or "proceeding with" the hearing may include signing a consent order or agreed settlement under WAC 388-14A-3600.

(3) If only one party appears and wishes to proceed with the hearing, the administrative law judge (ALJ) holds a hearing and issues an order based on the evidence presented or continues the hearing. See WAC 388-14A-6110 and 388-14A-6115 to determine if the ALJ enters an initial order or a final order.

(a) An order issued under this subsection includes an order of default against the nonappearing party and limits the appeal rights of the nonappearing party to the record made at the hearing.

(b) If neither the NCP nor the payee appears or wishes to proceed with the hearing, the ALJ issues an order of default against both parties.

(4) If the payee requests a late hearing on a notice of support debt, the payee must show good cause for filing the late hearing request.

(5) When DCS uses a notice of support debt to assess and collect interest on an out-of-state support order, see WAC 388-14A-7110.

(6) For the purpose of this section, the terms "payee" and "CP" are interchangeable, and can mean either the payee under the order or the person with whom the child resides the majority of the time.

History

Statutory Authority: RCW 74.08.090, 26.23.035, 34.05.220(1), 74.20A.310, 26.23.110, and 74.20A.040. WSR 05-07-059, § 388-14A-3321, filed 3/11/05, effective 4/11/05.

Wash. Admin. Code § 388-14A-3323 What happens in a hearing on a notice of support owed served under WAC 388-14A-3311?

(1) A hearing on a notice of support owed served under WAC 388-14A-3311 is subject to WAC 388-14A-3320 and this section.

(2) A hearing on a notice of support owed served under WAC 388-14A-3311 is only for the purpose of determining the amounts owed by the noncustodial parent (NCP) that are not stated as a fixed dollar amount in the underlying support order, either as part of the monthly support obligation or for nonmedical expenses of the children. See WAC 388-14A-3324 for the rules concerning a hearing on a notice of support owed for medical support.

(3) The administrative law judge (ALJ) must determine some or all of the following, depending on what was requested in the notice of support owed:

(a) The amount of monthly support as a fixed dollar amount;

(b) Any accrued arrears;

(c) Any difference between the NCP's obligation under a previous notice of support owed and his or her actual obligation after actual income or expenses are considered; and

(d) The amount of the NCP's share of nonmedical expenses for the children, including:

(i) The amount that the NCP must pay each month as his or her ongoing share of daycare and child care expenses for the children; and

(ii) Whether the custodial parent (CP) has provided sufficient proof of payment of daycare and child care expenses for the children; and

(iii) The amount of NCP's accrued debt for daycare and child care expenses.

(4) If the ALJ determines that the NCP's obligation under a previous notice of support owed is less than his or her actual obligation under the order after actual expenses or income are considered, the ALJ may not set a payment schedule on the support debt.

(5) If the ALJ determines that the NCP's obligation under a previous notice of support owed is more than his or her actual obligation under the order after actual expenses or income are considered, and the parties cannot agree on how the overpayment may be credited or repaid, the ALJ must enter an order providing that any difference may be:

(a) Applied as an offset to any nonassistance child support arrears owed by the NCP to the CP.

(b) In the form of a credit against the NCP's future child support obligation:

(i) Spread equally over a twelve-month period starting the month after the administrative order becomes final; or

(ii) When the future support obligation will end under the terms of the order in less than twelve months, spread equally over the life of the order.

(c) Paid in the form of a direct reimbursement by the CP to the NCP, but only with the consent of the CP, unless support has been assigned to the state.

History

Statutory Authority: RCW 34.05.353(4), 26.09.015(20), 26.18.170(21), 26.23.050, 26.23.110(14), 43.20A.550, 74.04.055, 74.04.057, 74.08.090, and 74.20A.310. WSR 19-23-038, § 388-14A-3323, filed 11/12/19, effective 12/13/19. Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-3323, filed 5/19/11, effective 6/19/11.

Wash. Admin. Code § 388-14A-3324 What happens in a hearing on a notice of support owed served under WAC 388-14A-3312?

(1) A hearing on a notice of support owed for medical support served under WAC 388-14A-3312 is subject to WAC 388-14A-3320 and this section. See WAC 388-14A-3323 for the rules concerning a hearing on a notice of support owed under WAC 388-14A-3311.

(2) A hearing on a notice of support owed served under WAC 388-14A-3312 is only for the purpose of determining:

(a) Issues regarding the reimbursement of uninsured medical expenses, such as:

(i) Whether the party on whom the notice was served is obligated under a support order to pay for uninsured medical expenses for the children covered by the order;

(ii) Whether the party seeking reimbursement has provided sufficient proof of payment for uninsured medical expenses for the children;

(iii) The total amount of uninsured medical expenses paid by the party seeking reimbursement;

(iv) The obligated parent's share of the uninsured medical expenses;

(v) The amount, if any, the obligated parent has already paid to the party seeking reimbursement;

(vi) Whether the obligated parent provided coverage during the time in question if reimbursement of medical premium costs is requested; and

(vii) The amount owed by the obligated parent to the party seeking reimbursement for unreimbursed medical expenses.

(b) Issues regarding a monthly payment toward the premium paid for coverage for the children, such as:

(i) Whether the support order requires the obligated parent to pay when the obligated parent does not provide coverage;

(ii) Whether the obligated parent is currently providing coverage, or did so during the time period in question;

(iii) The amount of the premium paid by the other parent or by the state to cover the children;

(iv) The obligated parent's proportionate share of the premium;

(v) The amount, if any, the obligated parent has already contributed toward health care coverage premiums paid by the other parent or the state for the time period in question; and

(vi) The monthly amount to be paid by the obligated parent as his or her proportionate share of the health care coverage premium.

(3) If the administrative law judge (ALJ) determines that the uninsured medical expenses claimed by the party seeking reimbursement do not amount to at least five hundred dollars, the ALJ:

(a) May not dismiss the notice on this basis;

(b) Must make the determinations listed in subsection (2)(a) above.

(4) In an annual review hearing under WAC 388-14A-3330, the ALJ may not set a payment schedule on the support debt other than as provided in WAC 388-14A-3312 if the ALJ determines that the obligated parent has paid less than his or her actual obligation for medical support under the order after actual expenses or updated proportionate shares owed are considered.

(a) If the obligated parent is the noncustodial parent (NCP), any amounts owed are added to the NCP's support debt.

(i) Any amounts owed to the custodial parent (CP) are added to the nonassistance child support arrears owed by the NCP to the CP.

(ii) Any amounts owed to the state are added to the assigned child support arrears owed by the NCP.

(b) If the obligated parent is the CP, any amounts owed are paid as provided in WAC 388-14A-3312(17).

(5) If, in an annual review hearing under WAC 388-14A-3330, the ALJ determines that the NCP's obligation calculated in a previous notice of support owed is more than his or her actual obligation for medical support under the order after actual expenses or updated proportionate shares owed are considered, and the parties cannot agree on how the difference may be credited or repaid, the ALJ must enter an order providing that any difference may be:

(a) Applied as an offset to any nonassistance child support arrears owed by the NCP to the CP.

(b) In the form of a credit against the NCP's future child support obligation, if there is no nonassistance debt owed to the CP:

(i) Spread equally over a twelve-month period starting the month after the administrative order becomes final; or

(ii) When the future support obligation will end under the terms of the order in less than twelve months, spread equally over the life of the order.

(6) If the ALJ determines that the CP's obligation under a previous notice of support owed is more than his or her actual obligation for medical support under the order after actual expenses and updated proportionate share amounts are considered, and the parties cannot agree on how the difference may be credited or repaid, the ALJ must enter an order providing that any difference must be added to the nonassistance child support arrears owed by the NCP.

(7) The ALJ must determine either or both of the following, depending on what was requested in the notice of support owed:

(a) The amount owed by the obligated parent to the other for reimbursement of uninsured medical expenses; and

(b) The monthly amount to be paid by the obligated parent as his or her proportionate share of the health care coverage premium paid by the other parent or the state.

History

Statutory Authority: Part I of 2018 c 150 and RCW 26.09.105, 26.18.170, 26.23.050, 34.05.220 (1)(a), 34.05.350(1), 74.08.090, and 74.20.040(9). WSR 19-02-017, § 388-14A-3324, filed 12/21/18, effective 1/21/19. Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-3324, filed 5/19/11, effective 6/19/11.

Wash. Admin. Code § 388-14A-3330 What are the procedures for the annual review of a notice of support owed?

(1) RCW 26.23.110 provides for an annual review of the support order which was previously the subject of a notice of support owed under that statute if the division of child support (DCS), the noncustodial parent (NCP), or the custodial parent (CP) requests a review.

(a) Either the CP or the NCP may request an annual review of the support order.

(b) DCS may request an annual review of the support order but has no duty to do so.

(2) For purposes of chapter 388-14A WAC, an "annual review of a support order" is defined as:

(a) The collection by DCS of necessary information from CP and NCP;

(b) The service of a notice of support owed under WAC 388-14A-3310, 388-14A-3311, or 388-14A-3312; and

(c) The determination of arrears and current support amount with an effective date which is at least 12 months after the date the last notice of support owed, or the last administrative order or decision based on a notice of support owed, became a final administrative order.

(3) A notice of support owed may be prepared and served sooner than 12 months after the date the last notice of support owed, or the last administrative order or decision based on a notice of support owed, became a final administrative order, but the amounts determined under the notice of support owed may not be effective sooner than 12 months after that date unless the notice of support owed resulted from an accelerated review under WAC 388-14A-3331.

(4) For the purpose of this section, the terms "payee" and "CP" are interchangeable, and can mean either the payee under the order or the person with whom the child resides the majority of the time.

(5) For purposes of chapter 388-14A WAC, the following rules apply to an "annual review of a support order" for a notice of support owed served under WAC 388-14A-3312:

(a) Either the CP or the NCP may be the party seeking reimbursement, so long as the CP is both a party to the order and a parent of the child or children for whom the expenses were incurred.

(b) The party seeking reimbursement must provide proof of payment of at least 500 dollars in uninsured medical expenses for services provided in the last 24 months.

(i) The date the last notice of support owed for unreimbursed medical expenses on behalf of the party seeking reimbursement became a final order; or

(ii) The last administrative order or decision based on a notice of support owed for unreimbursed medical expenses on behalf of that party became a final administrative order.

(6) WAC 388-14A-3310(1) describes the different types of notice of support owed which are served by DCS. In the event that DCS has served more than one type of notice of support owed on the same case, each notice of support owed has its own 12 month cycle for annual review.

(7) For purposes of this section, the 12 month cycle for annual review runs separately for the NCP and for the CP, depending on which one is the party seeking reimbursement.

(8) DCS serves the notice for an annual review on both parties by regular mail to each party's last known address if the order resulting from the prior notice of support owed included a statement that subsequent notices of support owed to review the amounts will be served by regular mail.

History

Statutory Authority: RCW 26.09.105, 26.23.110, 74.04.055, 74.08.090, 74.20.040, and 74.20A.310. WSR 21-24-063, § 388-14A-3330, filed 11/29/21, effective 12/30/21. Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-3330, filed 5/19/11, effective 6/19/11.

Wash. Admin. Code § 388-14A-3331 What are the procedures for the accelerated review of a notice of support owed for daycare expenses?

(1) RCW 26.23.110 provides for an accelerated review of the amounts established by a prior notice of support owed if the division of child support (DCS), the noncustodial parent (NCP), or the custodial parent (CP) requests a review.

(a) Either the CP or the NCP may request an accelerated review of the support order.

(b) DCS may request an accelerated review of the support order but has no duty to do so.

(2) For purposes of chapter 388-14A WAC, an "accelerated review of a support order" is defined as:

(a) A review of the daycare expenses established under a prior notice of support owed;

(b) The collection by DCS of necessary information from CP and NCP;

(c) The service of a notice of support owed to review the amounts determined under a previous notice of support owed; and

(d) The service of a notice of support owed less than 12 months after the effective date of the last notice of support owed or the last administrative based on a notice of support owed.

(3) DCS may accelerate the review of a notice of support owed for daycare expenses if:

(a) The CP informs DCS in writing that daycare expenses have terminated and are not expected to resume;

(b) The NCP alleges that daycare expenses have terminated and not expected to resume and the CP fails to provide documentation to indicate continuing daycare expenses;

(c) A new child support order modifies the proportionate shares of the parties' obligations that may change the NCP's daycare obligation;

(d) A child emancipates who is the subject of a current notice of support owed.

(4) A notice of support owed on an accelerated review includes a determination of the fixed dollar amount of:

(a) Any support debt owed by the NCP; and

(b) Any amounts calculated under an order resulting from the prior notice of support owed that exceed the NCP's actual obligation after actual income or expenses are considered.

(5) If the notice of support owed contains a determination that the amount owed by the NCP under the prior notice of support owed is more than his or her actual current and future support obligation or his or her actual share of expenses, the notice addresses how the difference may be credited or repaid.

(a) Any overpayment may be applied an as offset to nonassistance child support arrears owed by the NCP on that case only.

(b) If there is no nonassistance debt owed on the case, the reimbursement must be in the form of a credit against the NCP's future child support obligation:

(i) Spread equally over a 12 month period starting the month after the administrative order becomes final; or

(ii) In a case where the underlying order provides that the NCP's support obligation will end in less than 12 months, spread equally over the remaining life of the order.

(6) In a notice of support owed under this section, DCS includes:

(a) The information required by RCW 26.23.110 and WAC 388-14A-3110;

(b) A description of any provisions or factors contained in the underlying order regarding how to calculate the monthly support obligation or the amounts claimed for daycare expenses; and

(7) An order resulting from an accelerated review of a notice of support owed is subject to the rules in chapter 388-14A WAC regarding annual review of notices of support owed.

History

Statutory Authority: RCW 26.09.105, 26.23.110, 74.04.055, 74.08.090, 74.20.040, and 74.20A.310. WSR 21-24-063, § 388-14A-3331, filed 11/29/21, effective 12/30/21.

Wash. Admin. Code § 388-14A-3350 Are there any limits on how much back support the division of child support can seek to establish?

(1) When no public assistance is being paid to the custodial parent (CP) and the children, the division of child support (DCS) starts the claim for support as of the date:

(a) DCS receives the application for nonassistance services if the CP applies directly to DCS for services; or

(b) An Indian tribe, another state, or country received the application for nonassistance services or the actual date the tribe, state, or country requests that child support start, whichever is later, if the initiating jurisdiction requests DCS to establish a support order.

(2) When the children are receiving medicaid-only benefits, DCS starts the claim for support as of the date the medicaid benefits began. See WAC 388-14A-2005(4) to determine whether DCS seeks to establish medical support only for a particular case.

(3) This section does not limit in any way the right of the court to order payment for back support as provided in RCW 26.26A.470, 26.26B.020, and 26.26B.040 if the case requires establishment of parentage.

(4) When an Indian tribe, another state, or country is paying public assistance to the CP and children, DCS starts the claim for support as of the date specified by the tribe, state, or country.

(5) For the notice and finding of parental responsibility, WAC 388-14A-3120(11) limits the back support obligation.

(6) When the state of Washington is paying public assistance to the CP and the children, or just the children, the following rules apply:

(a) For support obligations owed for months on or after September 1, 1979, DCS must exercise reasonable efforts to locate the noncustodial parent (NCP);

(b) DCS serves a notice and finding of financial responsibility within 60 days of the date the state assumes responsibility for the support of a dependent child on whose behalf support is sought;

(c) If DCS does not serve the notice within 60 days, DCS loses the right to reimbursement of public assistance payments made after the 60th day and before the notice is served;

(d) DCS does not lose the right to reimbursement of public assistance payments for any period of time:

(i) During which DCS exercised reasonable efforts to locate the NCP; or

(ii) For 60 days after the date on which DCS received an affidavit or acknowledgment of paternity or acknowledgment of parentage for the child for whom the state has assumed responsibility, and parentage has not been established.

(7) The limitation in subsection (6) of this section does not apply to:

(a) Cases in which the physical custodian is claiming good cause for not cooperating with the department; and

(b) Cases where parentage is an issue and:

(i) Has not been established by superior court order; or

(ii) Is not the subject of a presumption under RCW 26.26A.220.

(8) DCS considers a prorated share of each monthly public assistance payment as paid on each day of the month.

History

Statutory Authority: RCW 26.23.050, 26.23.110, 43.20A.550, 74.04.055, 74.04.057, 74.08.090, 74.20.040, 74.20A.055, 74.20A.056, and 74.20A.310. WSR 25-09-019, s 388-14A-3350, filed 4/7/25, effective 5/8/25. Statutory Authority: RCW 26.23.120, 34.05.350 (1)(b), 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310 and 45 C.F.R. Parts 301.1, 302.36, 303.7, 303.11, 305.63, and 308.2. WSR 13-01-075, § 388-14A-3350, filed 12/18/12, effective 1/18/13. Statutory Authority: RCW 74.20A.310, 45 C.F.R. 302.31 and 302.33. WSR 06-03-120, § 388-14A-3350, filed 1/17/06, effective 2/17/06. Statutory Authority: RCW 74.08.090, 74.20A.055, and 74.20A.310. WSR 05-14-099, § 388-14A-3350, filed 6/30/05, effective 7/31/05. Statutory Authority: RCW 74.08.090, 34.05.310 (4)(d) and 74.20A.055. WSR 03-20-072, § 388-14A-3350, filed 9/29/03, effective 10/30/03. Statutory Authority: RCW 74.08.090, 74.20A.055. WSR 01-03-089, § 388-14A-3350, filed 1/17/01, effective 2/17/01. Formerly WAC 388-11-045.

Wash. Admin. Code § 388-14A-3370 What legal defenses are available to a noncustodial parent when DCS seeks to enforce a support obligation?

(1) A noncustodial parent (NCP) who objects to a notice and finding of financial, parental, or medical responsibility has the burden of establishing defenses to liability. Defenses include, but are not limited to:

(a) Proof of payment;

(b) The existence of a superior court order, tribal court order, or administrative order that sets the NCP's support obligation or specifically relieves the NCP of a support obligation for the child(ren) named in the notice;

(d) The amount requested in the notice is inconsistent with the Washington state child support schedule, chapter 26.19 RCW;

(e) Equitable estoppel, subject to WAC 388-14A-6500; or

(f) Any other matter constituting an avoidance or affirmative defense.

(2) A dependent child's or a custodial parent's ineligibility to receive public assistance is not a defense to the assessment of a support obligation.

(3) An NCP may be excused from providing support for a dependent child if the NCP is the legal custodian of the child and has been wrongfully deprived of physical custody of the child. The NCP may be excused only for any period during which the NCP was wrongfully deprived of custody. The NCP must establish that:

(a) A court of competent jurisdiction of any state, tribe or country has entered an order giving legal and physical custody of the child to the NCP;

(b) The custody order has not been modified, superseded, or dismissed;

(c) The child was taken or enticed from the NCP's physical custody and the NCP has not subsequently assented to deprivation. Proof of enticement requires more than a showing that the child is allowed to live without certain restrictions the NCP would impose; and

(d) Within a reasonable time after deprivation, the NCP exerted and continues to exert reasonable efforts to regain physical custody of the child.

History

Statutory Authority: RCW 26.23.120, 34.05.350 (1)(b), 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310 and 45 C.F.R. Parts 301.1, 302.36, 303.7, 303.11, 305.63, and 308.2. WSR 13-01-075, § 388-14A-3370, filed 12/18/12, effective 1/18/13. Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.056, 74.20A.310, 26.26.315, 26.26.320, 26.26.330, 26.26.335, 74.20A.055, 2002 c 302, and 2002 c 199. WSR 03-17-013, § 388-14A-3370, filed 8/12/03, effective 9/12/03. Statutory Authority: RCW 74.08.090, 74.20A.055, 74.20A.056. WSR 01-03-089, § 388-14A-3370, filed 1/17/01, effective 2/17/01. Formerly WAC 388-11-065.

Wash. Admin. Code § 388-14A-3375 What kinds of credits does the division of child support give when establishing or enforcing an administrative support order?

(1) After the noncustodial parent (NCP) has been advised of the requirement to make payments to the Washington state support registry (WSSR) by service of a support establishment notice, or by entry of a support order requiring payments to WSSR, the NCP may obtain credit against the support obligation only:

(a) By cash, check, electronic funds transfer, or money order payments through WSSR or payment of health insurance premiums; or

(b) As provided under subsections (3) and (6) of this section.

(2) The division of child support (DCS) allows credit against a NCP's support debt for family needs provided directly to a custodial parent (CP), a child, or provided through a vendor or third party only when the:

(a) Items are provided before service of the notice on the NCP;

(b) NCP proves the items provided were intended to satisfy the NCP's support obligation; and

(c) Items are food, clothing, shelter, or medical attendance directly related to the care, support, and maintenance of a child.

(3) After service of the notice, an NCP may obtain credit against the parent's current support obligation only when the NCP proves that the payments were made and:

(a) DCS determines there is no prejudice to:

(i) The CP, a child, or other person; or

(ii) An agency entitled to receive the support payments; and

(b) Special circumstances of an equitable nature justify credit for the parent's payments; or

(c) A court of competent jurisdiction determines credit should be granted after a hearing where all interested parties were given an opportunity to be heard.

(4) DCS does not allow credit for shelter payments made before service of the notice in an amount more than one-half of the actual shelter payment.

(5) DCS does not allow credit for shelter payments made after service of the notice.

(6) DCS applies credits for dependent benefits allowed under RCW 26.18.190 as required by WAC 388-14A-4200.

History

Statutory Authority: RCW 26.23.110, 34.05.220, 74.08.090, 74.20A.055, and 74.20A.056. WSR 24-16-135, § 388-14A-3375, filed 8/6/24, effective 9/6/24. Statutory Authority: RCW 74.08.090, 34.05.310 (4)(d) and 74.20A.055. WSR 03-20-072, § 388-14A-3375, filed 9/29/03, effective 10/30/03. Statutory Authority: RCW 74.08.090, 74.20A.055. WSR 01-03-089, § 388-14A-3375, filed 1/17/01, effective 2/17/01. Formerly WAC 388-11-015 and 388-14-210.

Wash. Admin. Code § 388-14A-3400 Are there limitations on how much of my income is available for child support?

(1) The Washington State child support schedule (WSCSS) provides two limitations based on income, the 45% limitation and the self-support reserve. The division of child support (DCS) applies these limitations when we calculate your child support obligation. These limitations do not apply to child support arrears, or to the enforcement of your child support obligation.

(a) Your basic child support obligation for all of your biological or legal children cannot exceed 45% of your monthly net income, unless there are special circumstances as provided in chapter 26.19 RCW. When the 45% limitation applies, DCS calculates your support obligation in a way that gives each child an equal share of the income.

(b) The monthly basic child support obligation cannot reduce your net monthly income below the self-support reserve of 180% of the federal poverty guideline, unless there are special circumstances as provided in chapter 26.19 RCW.

(c) RCW 26.19.065 provides that all of the children are entitled to a "pro rata" share of the parents' income after application of either the self-support reserve, the 45% limitation, or both.

(i) DCS and the administrative law judge (ALJ) only apply the "pro rata" share to the support obligation for the children in the order before them.

(ii) Either party may argue to the ALJ that "pro rata" does not mean the same as "equal," and may propose a different method of calculation or a different amount for the support obligation for the children in the case.

(2) See WAC 388-14A-3410 for information about the self-support reserve.

(3) No matter what your monthly child support obligation may be, RCW 26.23.060 and 74.20A.090 limit the amount that can be withheld from your wages for child support to 50% of your disposable earnings.

History

Statutory Authority: RCW 74.20.040, 74.20A.055, 74.20A.310, and 26.19.065. WSR 25-22-018, s 388-14A-3400, filed 10/24/25, effective 1/1/26. Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-3400, filed 5/19/11, effective 6/19/11. Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-3400, filed 1/17/01, effective 2/17/01. Formerly WAC 388-11-205.

Wash. Admin. Code § 388-14A-3410 What amount does DCS use for the self-support reserve?

(1) When the division of child support (DCS) calculates and applies the self-support reserve, DCS:

(a) Uses the amount shown for a one-person family in the federal poverty guideline for the current year; and

(b) Multiplies that amount by 180%.

(2) The self-support reserve does not vary depending on whether or not the parent is responsible for shelter costs.

(3) An administrative law judge (ALJ) must calculate and apply the self-support reserve using the one-person family amount.

(4) The provisions of the Washington Administrative Code (WAC) are not binding on the superior courts or tribal courts. Those tribunals may use different methods for calculating and applying the self-support reserve.

History

Statutory Authority: RCW 74.20.040, 74.20A.055, 74.20A.310, and 26.19.065. WSR 25-22-018, s 388-14A-3410, filed 10/24/25, effective 1/1/26. Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-3410, filed 5/19/11, effective 6/19/11.

Wash. Admin. Code § 388-14A-3500 A person must show good cause for filing a late request for hearing.

(1) A person with a right to a hearing under this chapter may file a request for a late hearing after the period for requesting a timely hearing has passed. The effective date of a hearing request is the date the division of child support (DCS) receives the request.

(2) Filing a request for a late hearing does not stop:

(a) Collection and enforcement under chapters 26.18, 26.23, or 74.20A RCW;

(b) The effect of any qualified domestic relations order;

(d) Distribution upon receipt of moneys collected.

(3)(a) A person who files a late hearing request must show good cause for not filing a timely hearing request unless good cause is not required by the rule governing the notice that is objected to.

(b) If the administrative law judge (ALJ) finds good cause for filing a late hearing request, the ALJ:

(i) Issues a decision on the merits of the objection to the notice; and

(ii) Considers whether to order a stay of collection activities until such time as an initial decision or a temporary order under WAC 388-14A-3850(ff) is issued. Upon request, the ALJ must, based on the evidence presented at hearing, issue an order under WAC 388-14A-3850(ff), setting or denying temporary support pending the initial decision.

(c) If the ALJ does not find good cause for filing a late hearing request, the ALJ may issue a decision on modification of the current and future support obligation, if applicable, without a showing of a change of circumstances.

(4) If the ALJ finds good cause for filing a late hearing request, the division of child support (DCS) does not refund any excess amounts collected before the finding of good cause. The ALJ may issue a decision which gives credit against future support in the amount of the excess collections, so long as this does not:

(a) Create hardship to the children for whom support is sought; and

(b) Offset an overpayment of the obligation to the custodial parent (CP) against a debt owed to the department; or

History

Statutory Authority: RCW 74.08.090, 34.05.220(1), 74.20A.055, 74.20A.056. WSR 01-03-089, § 388-14A-3500, filed 1/17/01, effective 2/17/01. Formerly WAC 388-11-310.

Wash. Admin. Code § 388-14A-3600 The parties may resolve any child support case by entering a consent order or an agreed settlement.

(1) The division of child support (DCS) may enter a consent order or agreed settlement to finalize any dispute in which a party requests a hearing. DCS attempts to settle matters through agreement when possible.

(a) An agreed settlement is signed only by the parties to the dispute.

(b) A consent order must be signed by the parties and by an administrative law judge (ALJ) provided that:

(i) In a telephone hearing, the ALJ may sign on behalf of any party if that party gives their consent on the record; and

(ii) The ALJ approves a consent order without requiring testimony or a hearing, unless entry of the order would be unlawful.

(2) An agreed settlement or consent order is final and enforceable on:

(a) The date the last party signs the agreed settlement, if all parties signed the agreed settlement;

(b) The date the ALJ signs the consent order; or

(i) The date the ALJ signed the consent order;

(ii) The date the last party signed the agreed settlement; or

(iii) The date the order of default is final. See WAC 388-14A-6110 and 388-14A-6115 to determine whether the ALJ issues an initial order or a final order.

(3) A party to a consent order or an agreed settlement may:

(a) Not petition for review of the settlement or order under WAC 388-02-0560;

(b) Petition for modification under WAC 388-14A-3925; and

(c) Petition to vacate the settlement or consent order under WAC 388-14A-3700. However, the ALJ may only vacate a settlement or consent order after making a finding of fraud by a party, or on any other basis that would result in manifest injustice.

(4) If a hearing has been scheduled, DCS files a copy of the agreed settlement or consent order with the office of administrative hearings (OAH), and OAH issues an order dismissing the hearing. There are no hearing rights on the order dismissing the hearing.

(5) An agreed settlement or consent order entered under this section must comply with the requirements of WAC 388-14A-6300 if the dispute concerns a notice and finding of financial responsibility or a notice and finding of parental responsibility or other notice or petition to determine the amount of a support obligation.

History

Statutory Authority: RCW 26.23.050, 34.05.220, 74.08.090, 74.20A.310. WSR 05-14-102, § 388-14A-3600, filed 6/30/05, effective 7/31/05. Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.056, 74.20A.310, 26.26.315, 26.26.320, 26.26.330, 26.26.335, 74.20A.055, 2002 c 302, and 2002 c 199. WSR 03-17-013, § 388-14A-3600, filed 8/12/03, effective 9/12/03. Statutory Authority: RCW 74.08.090, 34.05.220(1). WSR 01-24-082, § 388-14A-3600, filed 12/3/01, effective 1/3/02. Statutory Authority: RCW 74.08.090, 34.05.220(1), 74.20A.055, 74.20A.056. WSR 01-03-089, § 388-14A-3600, filed 1/17/01, effective 2/17/01. Formerly WAC 388-11-150 and 388-11-430.

Wash. Admin. Code § 388-14A-3700 When is it appropriate to vacate a default order?

(1) If a party fails to appear at a hearing, the administrative law judge (ALJ) must, upon a showing of valid service, enter an initial decision and default order or proceed in the absence of the defaulting party as provided in WAC 388-14A-3131, 388-14A-3132, or 388-14A-3140.

(2) The ALJ must state in the decision that the:

(a) Support debt and the current support obligation stated in the notice are assessed, determined, and subject to collection action;

(b) Health insurance provisions of the notice are subject to direct enforcement action; and,

(3) Decisions and orders on default become final twenty-one days from the date of mailing under WAC 388-08-464 or chapter 388-02 WAC.

(4) Any party against whom the ALJ has entered an initial decision and order on default may petition the secretary or the secretary's designee for vacation of the default order, subject to the provisions, including time limits, of civil rule 60.

(5) DCS must:

(a) Request that the office of administrative hearings (OAH) schedule a hearing to determine whether or not the petitioner has good cause for vacating the default order; and

(b) Give any other parties to the hearing notice of the time and date of the hearing. OAH must send the notice to the last known address of the party.

(6) If, in a hearing under this section, the ALJ finds that the petitioner has good cause for vacating the default order, the ALJ:

(a) Must conduct a hearing on the merits of the petitioner's objection to the notice that was the basis for the hearing at which the petitioner failed to appear; and

(b) May stay any further collection to the extent provided for under the regulations authorizing the notice the parent originally objected to.

(7) The ALJ must apply civil rule 60 to determine whether the petitioner has good cause. Before vacating an order of default at the request of the NCP or CP, the ALJ must consider the prejudice to the non-DCS party that did appear for hearing.

History

Statutory Authority: RCW 74.08.090, 34.05.220(1), 74.20A.055, 74.20A.056. WSR 01-03-089, § 388-14A-3700, filed 1/17/01, effective 2/17/01. Formerly WAC 388-11-120.

Wash. Admin. Code § 388-14A-3800 Once a support order is entered, can it be changed?

(1) A support order entered by a superior court may only be modified by a superior court or a court of comparable jurisdiction of an Indian tribe or another state or country. The Uniform Interstate Family Support Act (UIFSA, adopted in Washington as chapter 26.21A RCW) determines which state, tribe or country may modify the order.

(2) If the order specifically states how the amount of support may be adjusted, the division of child support (DCS) may bring an administrative action under RCW 26.23.110 and WAC 388-14A-3310.

(3) As provided in WAC 388-14A-3900, DCS may review any support order to determine whether DCS should petition to modify the support provisions of the order.

(4) Either DCS, the CP or the NCP may petition to modify an administrative order under WAC 388-14A-3925. Acting as a responding jurisdiction, DCS may petition to modify an administrative order at the request of the initiating jurisdiction.

(5) Under appropriate circumstances, an administrative support order may be vacated. See WAC 388-14A-3700.

(6) Child support orders may be changed under WAC 388-14A-3940 to include abatement language for purposes of abatement as required by this chapter.

History

Statutory Authority: RCW 26.09.916, 74.08.090, 74.20A.055. WSR 22-02-063, § 388-14A-3800, filed 1/4/22, effective 2/4/22. Statutory Authority: RCW 26.23.120, 34.05.350 (1)(b), 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310 and 45 C.F.R. Parts 301.1, 302.36, 303.7, 303.11, 305.63, and 308.2. WSR 13-01-075, § 388-14A-3800, filed 12/18/12, effective 1/18/13. Statutory Authority: RCW 74.08.090, 34.05.310 (4)(d), chapter 26.19 RCW, RCW 34.05.220(1), 74.20A.055, 74.20A.056. WSR 03-20-072, § 388-14A-3800, filed 9/29/03, effective 10/30/03. Statutory Authority: RCW 74.08.090, chapter 26.19 RCW, 34.05.220(1), 74.20A.055, 74.20A.056. WSR 01-03-089, § 388-14A-3800, filed 1/17/01, effective 2/17/01. Formerly WAC 388-11-140.

Wash. Admin. Code § 388-14A-3810 Once an administrative child support order is entered, how long does the support obligation last?

(1) A noncustodial parent's obligation to pay support under an administrative order continues until:

(a) A superior or tribal court order supersedes the order, either as provided by RCW 74.20A.055(7) or by the Uniform Interstate Family Support Act (UIFSA);

(b) The order is modified under WAC 388-14A-3925;

(d) The child is emancipated;

(e) The child marries;

(f) The child becomes a member of the United States armed forces;

(g) The child or the responsible parent die;

(h) A responsible stepparent's marriage is dissolved;

(i) The parties to the order marry or remarry, as provided in WAC 388-14A-3100(3); or

(j) A superior court order terminates the responsible parent's liability as provided under RCW 26.16.205.

(2) As an exception to the above rule, a noncustodial parent's obligation to pay support under an administrative order continues for a dependent child over the age of eighteen if the child is under age nineteen, and participating full-time in a secondary school program or the same level of vocational or technical training, as defined in WAC 388-404-0005 (1)(b). However, if the child has already met the requirements to finish the educational program, the child is no longer considered to be dependent.

(3) A noncustodial parent's obligation to pay support under an administrative order may be temporarily suspended when the:

(a) Noncustodial parent (NCP) resides with the child for whom support is sought for purposes other than visitation;

(b) NCP reconciles with the child and the custodial parent; or

(4) When the NCP's obligation to pay current support on a case is suspended under subsection (3) of this section, the division of child support (DCS) informs the NCP that the obligation is suspended, in writing, sent by regular mail to the NCP's last known address.

(5) If circumstances causing an NCP's support obligation to be temporarily suspended change, the support obligation resumes. DCS sends the NCP a notice that the obligation to make current support payments has resumed.

History

Statutory Authority: RCW 26.23.120, 34.05.350 (1)(b), 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310 and 45 C.F.R. Parts 301.1, 302.36, 303.7, 303.11, 305.63, and 308.2. WSR 13-01-075, § 388-14A-3810, filed 12/18/12, effective 1/18/13. Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.055, 74.20A.056, 74.20A.310. WSR 05-14-101, § 388-14A-3810, filed 6/30/05, effective 7/31/05. Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.056, 74.20A.310, 26.26.315, 26.26.320, 26.26.330, 26.26.335, 74.20A.055, 2002 c 302, and 2002 c 199. WSR 03-17-013, § 388-14A-3810, filed 8/12/03, effective 9/12/03. Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-3810, filed 1/17/01, effective 2/17/01. Formerly WAC 388-11-155.

Wash. Admin. Code § 388-14A-3850 When may someone ask for a temporary support order?

(1) There are two times when a temporary support order is appropriate in the course of an administrative hearing:

(a) If in a hearing to establish a support obligation or to determine the amount due under an existing order, the administrative law judge (ALJ) postpones the hearing. A postponement is also called a continuance (see WAC 388-14A-3855); or

(b) If any party files a petition for review of an initial decision which establishes or determines a current support obligation (see WAC 388-14A-3860).

(2) For the purposes of this section and WAC 388-14A-3855 through 388-14A-3875, "a party" means the division of child support (DCS), the noncustodial parent, or the physical custodian of the child.

History

Statutory Authority: RCW 74.20A.055 and 74.08.090. WSR 00-09-076, § 388-14A-3850, filed 4/18/00, effective 5/19/00. Formerly WAC 388-11-210 and 388-11-315.

Wash. Admin. Code § 388-14A-3855 How does a party request a temporary order when the hearing is continued?

(1) A party may make a request that a scheduled hearing be postponed either prior to the date of the hearing, or on the date of the hearing.

(2) When the administrative law judge (ALJ) grants a continuance prior to the day of hearing, a party must request entry of a temporary support order at the time the ALJ rules on the request for continuance.

(3) When the ALJ grants a continuance on the day of hearing, a party must request entry of a temporary support order before the hearing is adjourned.

(4) When a party requests a temporary support order due to a continuance, the ALJ must either:

(a) Conduct a temporary order hearing at the same time the ALJ hears the motion for continuance; or

(b) Set a time and date within ten business days when the ALJ will hear testimony on the need for and amount of a temporary order.

(5) The ALJ may hear testimony by telephone conference call.

(6) The ALJ may allow the parties to present the evidence then available, and allow five working days from the date of the hearing for submission of additional documents or evidence.

History

Statutory Authority: RCW 74.20A.055 and 74.08.090. WSR 00-09-076, § 388-14A-3855, filed 4/18/00, effective 5/19/00. Formerly WAC 388-11-315.

Wash. Admin. Code § 388-14A-3860 How does a party request a temporary order when a petition for review has been filed?

(1) If the temporary order is requested because of the filing of a petition for review, a party must request the temporary order within ten days of:

(a) The date that party files the petition for review; or

(b) The date that party receives notice that another party has filed a petition for review.

(2) The request must be made to the office of administrative hearings (OAH) office that entered the initial decision.

(3) The administrative law judge (ALJ) who entered the initial decision must hear the motion for temporary order. If that ALJ is not available, the chief ALJ must designate a substitute ALJ.

(4) The ALJ may enter a temporary order based on the record that was created at the hearing, or may set a telephone conference call hearing within ten working days.

(5) The ALJ may hear testimony by telephone conference call.

(6) The ALJ may allow the parties to present the evidence then available, and allow five working days from the date of the hearing for submission of additional documents or evidence.

History

Statutory Authority: RCW 74.20A.055 and 74.08.090. WSR 00-09-076, § 388-14A-3860, filed 4/18/00, effective 5/19/00. Formerly WAC 388-11-315.

Wash. Admin. Code § 388-14A-3865 Duties of the administrative law judge when a party requests a temporary support order.

(1) An administrative law judge (ALJ) who hears a request for a temporary support order must:

(a) Issue a written order which either:

(i) Determines the responsible parent's current and future support obligation beginning no later than the month following the hearing; or

(ii) Denies the request for a temporary support order.

(b) Include in the temporary order:

(i) A statement that any amounts collected under the temporary order will be credited and will be offset against any debt established in the initial decision;

(ii) A statement that amounts collected will be distributed and may be subject to recovery under WAC 388-14A-5300 from the physical custodian; and

(iii) The information required by RCW 26.23.050 and 26.18.170.

(c) Issue the temporary order within twenty calendar days of the date the request for temporary order is heard by the ALJ.

(2) If the temporary order is entered subsequent to a continuance, the ALJ must set a new hearing date within ninety days from the date of the date the ALJ hears the request for continuance;

(3) The ALJ must comply with the DSHS rules on child support and include a Washington state child support schedule worksheet when entering a temporary support order.

History

Statutory Authority: RCW 74.08.090, 34.05.310 (4)(d) and 74.20A.055. WSR 03-20-072, § 388-14A-3865, filed 9/29/03, effective 10/30/03. Statutory Authority: RCW 74.20A.055 and 74.08.090. WSR 00-09-076, § 388-14A-3865, filed 4/18/00, effective 5/19/00. Formerly WAC 388-11-315.

Wash. Admin. Code § 388-14A-3870 When does a temporary support order end?

(1) A temporary support order ends on the date an initial decision becomes a final order or on the date of a review decision, if any, whichever is later.

(2) If the parties settle all issues in the case by signing an agreed settlement or consent order, the temporary support order ends on the date the agreed settlement or consent order becomes a final order.

History

Statutory Authority: RCW 74.20A.055 and 74.08.090. WSR 00-09-076, § 388-14A-3870, filed 4/18/00, effective 5/19/00. Formerly WAC 388-11-315.

Wash. Admin. Code § 388-14A-3875 What if a party does not agree with a temporary support order?

(1) A temporary support order or the denial of a TSO is not an initial decision subject to review under WAC 388-02-0560. This means that no party has the right to file a petition for review of a temporary support order.

(2) The terms of a temporary order are not binding on the administrative law judge (ALJ) who later enters the initial decision in the matter.

(3) The issuance of a temporary support order does not affect any party's right to ask for review of the initial decision subsequently entered in the matter.

History

Statutory Authority: RCW 74.08.090, 34.05.310 (4)(d) and 74.20A.055. WSR 03-20-072, § 388-14A-3875, filed 9/29/03, effective 10/30/03. Statutory Authority: RCW 74.20A.055 and 74.08.090. WSR 00-09-076, § 388-14A-3875, filed 4/18/00, effective 5/19/00. Formerly WAC 388-11-315.

Wash. Admin. Code § 388-14A-3900 Does DCS review my support order to see if it should be modified?

(1) When the division of child support (DCS) is providing support enforcement services under Title IV-D of the Social Security Act, DCS must:

(a) Review a superior court or administrative order for child support to determine whether DCS will petition to modify the child support provisions of the order; or

(b) Evaluate an intergovernmental case to determine whether to refer the case to an Indian tribe or another state or country for review of the support order for modification.

(2) Recipients of payment services only under WAC 388-14A-2000(1) are not eligible for a review of their support order under this section until they have submitted an application for support enforcement services.

(3) DCS reviews a child support order for the limited purpose of referring the order to the appropriate tribunal to add abatement language under WAC 388-14A-3940.

History

Statutory Authority: RCW 26.09.916, 74.08.090, 74.20A.055. WSR 22-02-063, § 388-14A-3900, filed 1/4/22, effective 2/4/22. Statutory Authority: RCW 26.23.120, 34.05.350 (1)(b), 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310 and 45 C.F.R. Parts 301.1, 302.36, 303.7, 303.11, 305.63, and 308.2. WSR 13-01-075, § 388-14A-3900, filed 12/18/12, effective 1/18/13. Statutory Authority: RCW 74.08.090, 45 C.F.R. 302.70, 45 C.F.R. 303.7, 45 C.F.R. 303.8. WSR 01-03-089, § 388-14A-3900, filed 1/17/01, effective 2/17/01. Formerly WAC 388-11-143.

Wash. Admin. Code § 388-14A-3901 Under what circumstances does DCS review a support order for modification?

(1) The division of child support (DCS) reviews child support orders under WAC 388-14A-3900 when DCS has enough locate information to obtain personal service on both parties to the order; and:

(a) The department is paying public assistance or has determined that the children are eligible for medical assistance, and thirty-five months have passed since:

(i) DCS last reviewed the order under this section;

(ii) The order was last modified; or

(iii) The order was entered; or

(b) A party to the order, the IV-D agency of a tribe or another state, or the central authority of another country, submits a request for review to DCS and thirty-five months have passed since:

(i) DCS or another state or tribe's IV-D agency last reviewed the order under this section;

(ii) The order was last modified; or

(iii) The order was entered.

(2) DCS may refer a request for review to another state or tribe's IV-D agency for action.

(3) DCS reviews a child support order for the limited purpose of referring the order to the appropriate tribunal to add abatement language under WAC 388-14A-3940. A review under this subsection does not impact reviews conducted under subsections (1) or (2) of this section.

History

Statutory Authority: RCW 26.09.916, 74.08.090, 74.20A.055. WSR 22-02-063, § 388-14A-3901, filed 1/4/22, effective 2/4/22. Statutory Authority: RCW 26.23.120, 34.05.350 (1)(b), 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310 and 45 C.F.R. Parts 301.1, 302.36, 303.7, 303.11, 305.63, and 308.2. WSR 13-01-075, § 388-14A-3901, filed 12/18/12, effective 1/18/13. Statutory Authority: RCW 74.08.090, 45 C.F.R. 302.70, 45 C.F.R. 303.7, 45 C.F.R. 303.8. WSR 01-03-089, § 388-14A-3901, filed 1/17/01, effective 2/17/01. Formerly WAC 388-11-143.

Wash. Admin. Code § 388-14A-3902 How does DCS notify me that my order is eligible for review for modification?

(1) The division of child support (DCS) must:

(a) Notify recipients of support enforcement services, that the review and modification process is available; and

(b) Send notice of a pending review by regular mail to the last known address of the parties to the order thirty days before the review. The notice explains the parties':

(i) Rights in the review and modification process; and

(ii) Responsibility to submit:

(A) Completed Washington state child support schedule worksheets; and

(B) Income verification as required by the Washington state child support schedule, chapter 26.19 RCW.

(2) During the thirty days before conducting the review, DCS uses all appropriate procedures to obtain up to date income and asset information.

History

Statutory Authority: RCW 74.08.090, 45 C.F.R. 302.70, 45 C.F.R. 303.7, 45 C.F.R. 303.8. WSR 01-03-089, § 388-14A-3902, filed 1/17/01, effective 2/17/01. Formerly WAC 388-11-143.

Wash. Admin. Code § 388-14A-3903 How does DCS decide whether to petition for modification of a support order?

(1) The division of child support (DCS) petitions to modify a support order when DCS finds during the review that each of the following conditions are present:

(a) The proposed change in child support based on the Washington state child support schedule:

(i) Is at least fifteen percent above or below the current support obligation;

(ii) Is at least one hundred dollars per month above or below the current support obligation; and

(iii) Is at least a two thousand four hundred dollar change over the remaining life of the support order; or

(iv) Will provide enough income to:

(A) Make the family ineligible for public assistance if the noncustodial parent (NCP) pays the full amount due under the proposed order; or

(B) Allow a family, otherwise eligible for public assistance, to remain off of assistance.

(b) The case meets the legal requirements for modification under RCW 26.09.170, 74.20A.059, or WAC 388-14A-3925.

(2) DCS may petition to modify the order without regard to subsection (1)(a)(i) of this section if the reason DCS reviewed the order is the noncustodial parent's incarceration.

(3) DCS may petition to modify the order without regard to subsection (1)(a) of this section when:

(a) The order does not require the NCP to provide health insurance coverage for the children; and

(b) Health insurance coverage is available through the NCP's employer or union at a reasonable cost; or

(d) DCS learns that an NCP is incarcerated and qualifies for abatement under this chapter and the child support order does not include abatement language.

History

Statutory Authority: RCW 26.09.916, 74.08.090, 74.20A.055. WSR 22-02-063, § 388-14A-3903, filed 1/4/22, effective 2/4/22. Statutory Authority: 2019 c 275 §§ 2 and 3, RCW 26.09.170, 74.20A.059, 26.09.105, 26.18.170, 74.04.055, 74.08.090, 74.20.040(9), and 74.20A.310. WSR 20-04-032, § 388-14A-3903, filed 1/28/20, effective 2/28/20. Statutory Authority: RCW 74.08.090, 45 C.F.R. 302.70, 45 C.F.R. 303.7, 45 C.F.R. 303.8. WSR 01-03-089, § 388-14A-3903, filed 1/17/01, effective 2/17/01. Formerly WAC 388-11-143.

Wash. Admin. Code § 388-14A-3904 How do I find out the results of DCS' review for modification?

After reviewing a case under WAC 388-14A-3903, the division of child support (DCS) notifies the parties of:

(1) The findings of the review by regular mail at the parties' last known address;

(2) The parties' right to challenge the review findings; and

(3) The appropriate forum and procedure for challenging the review findings.

History

Statutory Authority: RCW 74.08.090, 45 C.F.R. 302.70, 45 C.F.R. 303.7, 45 C.F.R. 303.8. WSR 01-03-089, § 388-14A-3904, filed 1/17/01, effective 2/17/01. Formerly WAC 388-11-143.

Wash. Admin. Code § 388-14A-3905 What if I don't agree with DCS' findings after review?

(1) Except as provided under subsection (3) of this section, a party to the review process may contest DCS's review findings by requesting a modification conference within thirty days of the date of the notice of review findings.

(2) The modification conference is conducted by:

(a) DCS when the review findings indicate that the case is not appropriate for DCS to petition for modification under WAC 388-14A-3903;

(b) The county prosecutor, or the attorney general's office when DCS has referred the case to the prosecutor or attorney general's office as a result of a review conducted under this section.

(3) When DCS has petitioned for modification of:

(a) A superior court order, the prosecutor or attorney general's office may, in their discretion, allow the parties to contest the review findings in the modification proceeding, rather than a modification conference. The modification proceeding is the sole means to contest the review findings.

(b) An administrative order, the parties may contest the review findings in the modification proceeding. In this case, the modification proceeding is the sole means to contest the review findings.

(4) In a modification conference, DCS the prosecutor, or the attorney general's office:

(a) Review all available income and asset information to determine if the review findings are correct; and

(b) Advise the parties of the results of the modification conference.

(5) A modification conference is not an adjudicative proceeding under the Administrative Procedure Act, chapter 34.05 RCW.

(6) This section does not limit the right of any party to petition for a modification of the support order independent from the review and modification process.

(7) The CP's refusal to accept a proposed agreed order modifying support does not constitute noncooperation for the purpose of WAC 388-14A-2075.

History

Statutory Authority: RCW 74.08.090, 45 C.F.R. 302.70, 45 C.F.R. 303.7, 45 C.F.R. 303.8. WSR 01-03-089, § 388-14A-3905, filed 1/17/01, effective 2/17/01. Formerly WAC 388-11-143.

Wash. Admin. Code § 388-14A-3906 Are there times when DCS does not review an order which would otherwise qualify for review?

The division of child support (DCS) does not review an order under this section when the community services office (CSO) has notified DCS that the custodial parent (CP) has claimed good cause under WAC 388-422-0020, unless the CP requests the review.

History

Statutory Authority: RCW 74.08.090, 45 C.F.R. 302.70, 45 C.F.R. 303.7, 45 C.F.R. 303.8. WSR 01-03-089, § 388-14A-3906, filed 1/17/01, effective 2/17/01. Formerly WAC 388-11-143.

Wash. Admin. Code § 388-14A-3907 DCS uses the Washington state child support schedule for reviewing orders for modification.

(1) DCS applies the Washington state child support schedule when reviewing support orders under this section. All deviations available under chapter 26.19 RCW are available in the review and modification process under this section.

(2) For the purpose of this section and WAC 388-14A-3900 through 388-14A-3906, the term "party" means a party to a superior court order, or a noncustodial parent or a custodial parent entitled to petition for modification under RCW 74.20A.059.

History

Statutory Authority: RCW 74.08.090, chapter 26.19 RCW, 45 C.F.R. 302.70, 45 C.F.R. 303.7, 45 C.F.R. 303.8. WSR 01-03-089, § 388-14A-3907, filed 1/17/01, effective 2/17/01. Formerly WAC 388-11-143.

Wash. Admin. Code § 388-14A-3925 Who can ask to modify an administrative support order?

(1) The division of child support (DCS), the custodial parent (CP) or the noncustodial parent (NCP) may file a petition and request a hearing to prospectively modify an administrative order for child support. The request must be in writing and must state:

(a) Any circumstances that have changed;

(b) Any relief requested; and

(2) The petitioning party must file the request for modification with DCS.

(3) Acting as a responding jurisdiction, DCS may file a petition to prospectively modify an administrative order for child support on behalf of an initiating jurisdiction in an intergovernmental case.

(4) Office of Administrative Hearings serves a copy of the request for modification and notice of hearing on all other parties by regular mail at their last known address.

(5) DCS or the administrative law judge (ALJ):

(a) Prospectively modifies orders according to the terms of chapter 26.19 RCW and RCW 74.20A.059; and

(b) May only modify an order issued by a tribunal in another state according to the terms of RCW 26.21A.550.

(6) A request to add a requirement for the custodial parent (CP) to provide health care coverage, or to add a provision in the order to include the CP's share of uninsured medical expenses, is not by itself a sufficient basis for modification of the order.

(7) If the nonpetitioning party fails to appear at the hearing, the ALJ issues a default order based on the Washington state child support schedule and the worksheets submitted by the parties, considering the terms set out in the request for modification.

(8) If the petitioning party fails to appear at the hearing, the ALJ enters an order dismissing the petition for modification.

(9) If the petition for modification does not comply with the requirements of subsection (1)(a) and (b) of this section, the ALJ may:

(a) Dismiss the petition; or

(b) Continue the hearing to give the petitioning party time to amend according to WAC 388-14A-3275 or to complete the petition.

(10) The ALJ may set the effective date of modification as the date the order is issued, the date the request was made, or any time in between. If an effective date is not set in the order, the effective date is the date the modification order is entered.

(11) For purposes of abatement under this chapter, DCS, the CP, or the NCP may seek changes to a child support order to add abatement language under WAC 388-14A-3940.

History

Statutory Authority: RCW 26.09.916, 74.08.090, 74.20A.055. WSR 22-02-063, § 388-14A-3925, filed 1/4/22, effective 2/4/22. Statutory Authority: Part I of 2018 c 150 and RCW 26.09.105, 26.18.170, 26.23.050, 34.05.220 (1)(a), 34.05.350(1), 74.08.090, and 74.20.040(9). WSR 19-02-017, § 388-14A-3925, filed 12/21/18, effective 1/21/19. Statutory Authority: RCW 26.23.120, 34.05.350 (1)(b), 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310 and 45 C.F.R. Parts 301.1, 302.36, 303.7, 303.11, 305.63, and 308.2. WSR 13-01-075, § 388-14A-3925, filed 12/18/12, effective 1/18/13. Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-3925, filed 5/29/08, effective 7/1/08. Statutory Authority: RCW 34.05.220(2), 43.20A.550, 74.04.055, 74.08.090, 74.20.040, 74.20A.310. WSR 07-08-055, § 388-14A-3925, filed 3/29/07, effective 4/29/07. Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.055, 74.20A.056. WSR 02-06-098, § 388-14A-3925, filed 3/4/02, effective 4/4/02. Statutory Authority: RCW 74.08.090, 26.23.050, 74.20A.055, 74.20A.059. WSR 01-03-089, § 388-14A-3925, filed 1/17/01, effective 2/17/01. Formerly WAC 388-11-140.

Wash. Admin. Code § 388-14A-3935 What does DCS do with respect to abatement when it learns the noncustodial parent is an incarcerated parent?

(1) If the child support order contains abatement language, the division of child support (DCS) administers the abatement under WAC 388-14A-3945.

(2) If the child support order was entered in Washington state and does not contain abatement language, DCS refers the child support order to the appropriate tribunal for the limited purpose of adding abatement language under WAC 388-14A-3940, except as provided in subsection (3) of this section.

(3) DCS may review for modification under WAC 388-14A-3901 when the child support order does not contain abatement language and the department is paying public assistance for the child or children.

History

Statutory Authority: RCW 26.09.916, 74.08.090, 74.20A.055. WSR 22-02-063, § 388-14A-3935, filed 1/4/22, effective 2/4/22.

Wash. Admin. Code § 388-14A-3940 Who can ask to add abatement language to an administrative support order?

(1) The division of child support (DCS), the custodial parent (CP), or the noncustodial parent (NCP) may file a petition and request a hearing under chapter 26.09 RCW for the limited purpose of adding abatement language to an administrative order for child support.

(2) The petitioning party must submit the request to add abatement language to DCS.

(3) Acting as a responding jurisdiction, DCS may file a petition for the limited purposes of adding abatement language to an administrative order for child support on behalf of an initiating jurisdiction in an intergovernmental case.

(4) OAH serves a copy of the request to add abatement language and notice of hearing on all other parties by regular mail at their last known address.

(5) A hearing under this section:

(a) Is for the limited purpose of determining whether statutorily required abatement language under RCW 26.09.335 should be added to the administrative support order;

(b) Is separate from the administration of the abatement by DCS under WAC 388-14A-3945;

(d) Does not impact DCS's or any party's right to request a prospective modification of the administrative support order under WAC 388-14A-3925.

(e) Does not impact when DCS reviews a support order for modification under WAC 388-14A-3901.

(6) DCS may enter into an agreed settlement or consent order with the parties under WAC 388-14A-3600 to add abatement language to an administrative support order.

(7) If the nonpetitioning party fails to appear at the hearing, the ALJ issues a default order against that party.

(8) If the petitioning party fails to appear at the hearing, the ALJ enters an order dismissing the petition.

History

Statutory Authority: RCW 26.09.916, 74.08.090, 74.20A.055. WSR 22-02-063, § 388-14A-3940, filed 1/4/22, effective 2/4/22.

Wash. Admin. Code § 388-14A-3945 How does DCS administer abatement of an incarcerated person's child support order?

(1) The division of child support (DCS) abates a noncustodial parent's (NCP's) child support order under this chapter when it learns that the NCP is an incarcerated person and all of the following are true:

(a) The NCP is incarcerated for or begins serving a sentence of at least six months in confinement;

(b) The child support order contains abatement language; and

(c) DCS has reviewed its records and determines the NCP has no access to or possession of income or assets to pay child support while incarcerated.

(2) There is a rebuttable presumption that an incarcerated person has no access to or possession of income or assets to pay child support while incarcerated. DCS may assert it has rebutted the presumption. See WAC 388-14A-3955.

(3) When the requirements of subsection (1) of this section are met, the child support order is abated to ten dollars per month without regard to the number of children covered by that order.

(4) The first month support is abated is the date the NCP became confined or February 1, 2021, whichever is later.

(5) The abatement ends on the last day of the third full month following the NCP's release from confinement, unless an order entered in the court or administrative forum specifies a different date.

(6) DCS sends a notice of abatement to notify the custodial parent (CP) by regular mail to their last known address, with a copy to the NCP, that the abatement has been applied.

(7) If the CP disagrees with the notice of abatement, the CP may:

(a) Request a timely hearing within twenty days of the date of the notice of abatement (see WAC 388-14A-3965);

(b) Request an untimely hearing within one year of the date of the notice of abatement (see WAC 388-14A-3965); or

(c) Request in writing to terminate or reverse the abatement at any time during the period of abatement (see WAC 388-14A-3970).

(8) If the NCP disagrees with the notice of abatement, the NCP may request in writing to terminate or reverse the abatement at any time during the period of abatement (see WAC 388-14A-3960).

(9) If the abatement results in an overpayment by the NCP:

(a) Neither DCS nor the CP is required to refund any support collections or payments received by DCS prior to the date on which DCS learned of the incarceration; and

(b) The NCP is not entitled to a refund of any support collections or payments received by DCS prior to the date on which DCS learned of the incarceration.

(10) Abatement of a child support obligation of an incarcerated person does not constitute modification or adjustment of the order.

History

Statutory Authority: RCW 26.09.916, 74.08.090, 74.20A.055. WSR 22-02-063, § 388-14A-3945, filed 1/4/22, effective 2/4/22.

Wash. Admin. Code § 388-14A-3950 What does DCS do to reinstate the support order when the NCP is released from confinement?

(1) Unless otherwise specified in a court or administrative order, the support order is automatically reinstated as follows:

(a) Effective the first day of the fourth full month after the NCP is released from confinement, support is reinstated at fifty percent of the support amount provided in the underlying order, but not less than the presumed minimum obligation of $50 per month per child; and

(b) Effective one year after release from confinement, support is reinstated at one hundred percent of the support amount provided in the underlying order.

(2) DCS informs the parties in writing at their last known address when reinstating support at fifty percent and one hundred percent.

(3) If the support order is modified under RCW 26.09.170 or RCW 74.20A.059 during the period of abatement, this provision regarding reinstatement of support at fifty percent in subsection (1) of this section does not apply. DCS enforces the modified support obligation.

History

Statutory Authority: RCW 26.09.916, 74.08.090, 74.20A.055. WSR 22-02-063, § 388-14A-3950, filed 1/4/22, effective 2/4/22.

Wash. Admin. Code § 388-14A-3955 What does DCS do when it determines an incarcerated person's support order should not be abated?

(1) If DCS reviews its records and determines the NCP has access to or possession of income or assets to pay child support while incarcerated, DCS sends a notice regarding non-abatement of child support, sometimes called the notice regarding non-abatement, to the NCP and a copy to the custodial parent (CP).

(a) There is a rebuttable presumption that an incarcerated person has no access to or possession of income or assets available to pay child support while incarcerated.

(b) The notice regarding non-abatement includes the reason or reasons DCS believes it has rebutted the presumption that the NCP is unable to pay their child support obligation while incarcerated.

(2) The parties may request an adjudicative proceeding if they disagree with the notice regarding non-abatement.

(a) The parties may request a timely hearing within twenty days of the date of the notice regarding non-abatement.

(b) The parties may request an untimely hearing within one year of the date of the notice regarding non-abatement.

(c) The parties may request a late hearing one year or more after the after the date of the notice regarding non-abatement but must demonstrate good cause.

(3) For purposes of this chapter, correctional industries compensation does not count as income or assets to pay child support.

History

Statutory Authority: RCW 26.09.916, 74.08.090, 74.20A.055. WSR 22-02-063, § 388-14A-3955, filed 1/4/22, effective 2/4/22.

Wash. Admin. Code § 388-14A-3960 What happens at a hearing on a notice regarding non-abatement of child support?

(1) The noncustodial parent (NCP) or custodial parent (CP) may request a hearing on a notice regarding non-abatement of child support, sometimes called the notice regarding non-abatement.

(2) The purpose of the hearing is for the administrative law judge (ALJ) to determine whether DCS's notice is upheld or dismissed.

(3) The ALJ must allow DCS to orally amend the notice regarding non-abatement at the hearing to conform to the evidence. The ALJ may grant a continuance, if necessary, to allow the parties additional time to present evidence or argument in response to the amendment.

(4) The administrative law judge issues an order:

(a) Upholding DCS's determination that support should not be abated because the NCP has access to or possession of income or assets to pay child support while incarcerated; or

(b) Dismissing the notice regarding non-abatement because the NCP does not have access to or possession of income or assets to pay child support while incarcerated.

(5) If the order says child support should be abated, DCS abates and sends a notice of abatement to the parties. See WAC 388-14A-3940.

History

Statutory Authority: RCW 26.09.916, 74.08.090, 74.20A.055. WSR 22-02-063, § 388-14A-3960, filed 1/4/22, effective 2/4/22.

Wash. Admin. Code § 388-14A-3965 What happens at a hearing on a notice of abatement?

(1) The custodial parent (CP) has the burden of proof to demonstrate to the administrative law judge (ALJ) that the NCP has access to or possession of income or assets to pay child support while incarcerated.

(2) Any party to the hearing may show good cause why the abatement should end and support reinstate at a date other than what is specified in WAC 388-14A-3945.

(3) The ALJ must allow DCS to orally amend the notice of abatement at the hearing to conform to the evidence. The ALJ may grant a continuance, if necessary, to allow the parties additional time to present evidence or argument in response to the amendment.

(4) The administrative law judge issues an order:

(a) Upholding the notice of abatement;

(b) Upholding the notice of abatement and, upon a finding of good cause, specifying the date abatement ends; or

(c) Dismissing the notice of abatement because the objecting party met the burden of proof to show that NCP has access to or possession of income or assets to pay child support while incarcerated.

History

Statutory Authority: RCW 26.09.916, 74.08.090, 74.20A.055. WSR 22-02-063, § 388-14A-3965, filed 1/4/22, effective 2/4/22.

Wash. Admin. Code § 388-14A-3970 Who may request to terminate or reverse an abatement?

(1) The division of child support (DCS), the custodial parent (CP), or the noncustodial parent (NCP) may submit a request to terminate or reverse an abatement at any time during the period of abatement. The request must be in writing.

(a) If DCS or the CP is the requesting party, they must include documents or other evidence demonstrating that the NCP has access to or possession of income or assets to pay child support while incarcerated.

(b) If the NCP is the requesting party, no supporting documents are required.

(2) The requesting party must file the request to terminate or reverse the abatement with DCS or the office of administrative hearings (OAH).

(3) Acting as a responding jurisdiction, DCS may file a request to terminate or reverse an abatement on behalf of an initiating jurisdiction in an intergovernmental case.

History

Statutory Authority: RCW 26.09.916, 74.08.090, 74.20A.055. WSR 22-02-063, § 388-14A-3970, filed 1/4/22, effective 2/4/22.

Wash. Admin. Code § 388-14A-3975 What happens at a hearing to terminate or reverse an abatement?

(1) If the requesting party was required to submit supporting documents and did not do so, any other party may file a motion to dismiss. The requesting party may ask for a continuance to provide supporting documents.

(2) If the hearing is dismissed because supporting documents were not submitted, the requesting party may file a petition to vacate the dismissal.

(3) If a hearing is held, the ALJ may reverse the abatement or terminate the abatement on a specific date upon a finding that the NCP has access to or possession of assets or income to provide support while incarcerated.

(4) If the requesting party fails to appear after being sent a notice of hearing, the request must be dismissed.

(5) Depending on the type of evidence provided at the hearing, the ALJ may order that the abatement of the support order be:

(a) Reversed, meaning that the determination that support should be abated is vacated and all amounts owed under the support order are reinstated; or

(b) Terminated, meaning that the abatement of support ends as of the date specified in the order.

History

Statutory Authority: RCW 26.09.916, 74.08.090, 74.20A.055. WSR 22-02-063, § 388-14A-3975, filed 1/4/22, effective 2/4/22.

Wash. Admin. Code § 388-14A-4000 When may the division of child support take collection action against a noncustodial parent?

(1) Chapters 26.18, 26.23, 74.20 and 74.20A RCW authorize the division of child support (DCS) to take actions enforcing and collecting support obligations.

(2) DCS may take collection action against the noncustodial parent's income and assets to collect a support debt even if the NCP is making payments under a support order, unless DCS agrees in writing to limit collection action.

(3) If the NCP fails to make the total support payment under an administrative order when it is due:

(a) The entire support debt becomes due in full; and

(b) The portion of the administrative order requiring periodic payments on the support debt is automatically vacated without modifying the order.

History

Statutory Authority: RCW 74.08.090, 45 C.F.R. 302.33 (a)(5). WSR 01-03-089, § 388-14A-4000, filed 1/17/01, effective 2/17/01. Formerly WAC 388-11-170.

Wash. Admin. Code § 388-14A-4010 Can I make the division of child support stop collection action against me?

(1) Once a noncustodial parent (NCP) fails to make payments when due, an administrative law judge may not stop collection action by DCS.

(2) The NCP may contest collection action by:

(a) Filing an action in superior court under RCW 74.20A.200 or other applicable statutes; or

(b) Requesting a conference board under WAC 388-14A-6400.

History

Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-4010, filed 1/17/01, effective 2/17/01.

Wash. Admin. Code § 388-14A-4020 What collection tools does the division of child support use?

WAC 388-14A-4020

The division of child support (DCS) uses any remedies available under state and federal law to enforce support obligations. These include, but are not limited to:

(1) Income withholding order under RCW 26.23.060;

(2) Order to withhold and deliver under RCW 74.20A.080;

(3) Wage assignment;

(4) License suspension under WAC 388-14A-4500;

(5) Federal income tax offset;

(6) Asset seizure;

(7) Liens;

(8) Medical insurance enrollment; and

(9) Contempt referral.

History

Statutory Authority: RCW 26.18.170, 26.23.035, 26.23.110, 43.20A.550, 74.04.055, 74.08.090, 74.20.040, 74.20A.310, and 74.20A.328. WSR 26-14-086, s 388-14A-4020, filed 6/29/26, effective 7/30/26. Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-4020, filed 1/17/01, effective 2/17/01.

Wash. Admin. Code § 388-14A-4030 How can the division of child support collect child support from my wages or other income source?

(1) The division of child support (DCS) uses a payroll deduction, order to withhold and deliver or wage assignment to collect support when the noncustodial parent (NCP) has a source of income.

(2) When an NCP does not have an identifiable employer or source of income, DCS uses any or all of the collection remedies available under chapters 26.23, 74.20 and 74.20A RCW.

(3) If the NCP's source of income is an Indian tribe or tribal enterprise, DCS may seek collection remedies through tribal court.

History

Statutory Authority: RCW 74.08.090, 45 C.F.R. 302.33(a)(5). WSR 01-03-089, § 388-14A-4030, filed 1/17/01, effective 2/17/01. Formerly WAC 388-11-170.

Wash. Admin. Code § 388-14A-4040 DCS can serve some collection actions by electronic service.

WAC 388-14A-4040

(1) An employer, or any other person, firm, corporation, or political subdivision, or any department of the state or federal government may agree with the division of child support (DCS) to accept electronic data transmission (EDT) as service of the following documents:

(a) Income withholding order under RCW 26.23.060;

(b) Order to withhold and deliver under RCW 74.20A.080;

(d) National Medical Support Notice (NMSN) under RCW 26.18.170;

(e) Releases of any of these collection documents; and

(f) Amendments in the amount to be withheld under any of these collection documents.

(2) Agreements for service by EDT must be in writing. The employer, person, firm, corporation, political subdivision, or department must agree to accept EDT as:

(a) Personal service of the withholding documents; and

(b) A written document for the purposes of chapters 26.23 and 74.20A RCW.

(3) DCS provides the party accepting EDT with copies of the current forms listed in subsection (2) of this section, as well as any updates to those forms. If DCS fails to provide an updated form, this does not excuse noncompliance with withholding documents served under the EDT agreement.

(4) An agreement to accept service by EDT does not alter the rights, duties, and responsibilities related to income withholding action under chapters 26.23, 74.20, or 74.20A RCW.

History

Statutory Authority: RCW 26.18.170, 26.23.035, 26.23.110, 43.20A.550, 74.04.055, 74.08.090, 74.20.040, 74.20A.310, and 74.20A.328. WSR 26-14-086, s 388-14A-4040, filed 6/29/26, effective 7/30/26. Statutory Authority: RCW 74.08.090, 74.20A.310, and 26.18.170, 42 U.S.C. 666 (a)(19), Child Support Performance and Incentives Act of 1998, 45 C.F.R. 303.31, and 45 C.F.R. 303.32. WSR 04-17-119, § 388-14A-4040, filed 8/17/04, effective 9/17/04. Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-4040, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-427.

Wash. Admin. Code § 388-14A-4100 How does the division of child support enforce my obligation to provide health care coverage for my children?

(1) If a child support order requires a parent to provide health care coverage for the children named in the order, the division of child support (DCS) attempts to enforce that requirement according to the terms of the order.

(2) A parent required to provide medical support or health care coverage for a child is called the obligated parent, and can be either the custodial parent (CP) or the noncustodial parent (NCP).

(3) WAC 388-14A-4111 and 388-14A-4112 describe when DCS may accept or decline a request to enforce a medical support obligation.

(4) When DCS is enforcing a support order which contains a specific dollar limit for the cost of health care coverage premiums or provides for coverage which is available at no cost to the obligated parent, DCS does not require the obligated parent to provide health care coverage if coverage is not available within the limitations of the order.

(5) When DCS is enforcing a support order entered in Washington on or after October 1, 2009, providing that either or both parents must provide coverage and/or a proportionate share of uninsured medical expenses as part of the medical support obligation under RCW 26.09.105, the rules in this subsection apply unless the support order specifies differently:

(a) The obligated parent must provide health care coverage for the dependent children covered by the order if coverage is:

(i) Available or becomes available through accessible health care coverage which is not provided through the obligated parent's employer or union; or

(ii) Available or becomes available through the obligated parent's employment or union at a cost that is not more than twenty-five percent of the obligated parent's basic support obligation.

(b) If the obligated parent does not provide proof of coverage or if coverage is not available, DCS may serve a notice of support owed under WAC 388-14A-3312 to determine the monthly amount that the obligated parent must pay as his or her proportionate share of any premium paid by the other parent or by the state on behalf of the children.

(6) When DCS is enforcing a support order entered in Washington between May 13, 1989 and September 30, 2009, unless the support order specifies differently, the obligated parent must provide health insurance for the dependent children if coverage is:

(a) Available or becomes available through the obligated parent's employment or union; and

(b) Available at a cost of not greater than twenty-five per cent of the obligated parent's basic support obligation.

(7) When DCS is enforcing a Washington support order entered prior to May 13, 1989, unless the support order specifies differently, the obligated parent must provide health insurance for the dependent children if coverage is available or becomes available through the obligated parent's employment or union:

(a) For a maximum of twenty-five dollars per month, if the order specifies that the obligated parent must provide coverage only if it is available at a reasonable cost; or

(b) For any premium amount whatsoever, if the order does not specify reasonable cost.

(8) DCS serves a notice of intent to enforce a health care coverage obligation if the support order:

(a) Requires the obligated parent either to provide health care coverage or prove that coverage is not available; and

(b) Does not inform the obligated parent that failure to provide health care coverage or prove it is not available may result in enforcement of the order without notice to the obligated parent.

(9) DCS serves the notice of intent to enforce a health care coverage obligation on the obligated parent by certified mail, return receipt requested, or by personal service.

(10) The notice advises the obligated parent that he or she must submit proof of coverage, proof that coverage is not available, or proof that the obligated parent has applied for coverage, within twenty days of the date of service of the notice.

(11) The notice advises the obligated parent that, if health care coverage is not yet available, the obligated parent must immediately notify DCS if health care coverage becomes available through the obligated parent's employer or union.

(12) When DCS enforces an obligated parent's health care coverage obligation, such enforcement may include asking the employer and the plan administrator to enroll the obligated parent in a health insurance plan available through the employer.

History

Statutory Authority: Part I of 2018 c 150 and RCW 26.09.105, 26.18.170, 26.23.050, 34.05.220 (1)(a), 34.05.350(1), 74.08.090, and 74.20.040(9). WSR 19-02-017, § 388-14A-4100, filed 12/21/18, effective 1/21/19. Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-4100, filed 5/19/11, effective 6/19/11. Statutory Authority: RCW 74.08.090, 74.20A.310, and 26.18.170, 42 U.S.C. 666 (a)(19), Child Support Performance and Incentives Act of 1998, 45 C.F.R. 303.31, and 45 C.F.R. 303.32. WSR 04-17-119, § 388-14A-4100, filed 8/17/04, effective 9/17/04. Statutory Authority: RCW 74.08.090, 26.18.170, 26.18.180, 74.20A.055. WSR 01-03-089, § 388-14A-4100, filed 1/17/01, effective 2/17/01. Formerly WAC 388-11-215 and 388-14-460.

Wash. Admin. Code § 388-14A-4110 If my support order requires me to provide medical support for my children, what do I have to do?

(1) Once a support order is entered requiring medical support, the obligated parent must take the following actions within twenty days:

(a) Provide health care coverage; and

(b) Provide proof of coverage to the other parent and to the division of child support (DCS), such as:

(i) The name of the insurer providing the health insurance coverage or the type of public health care coverage provided by the obligated parent;

(ii) The names of the beneficiaries covered;

(iii) The policy number;

(iv) That coverage is current; and

(v) The name and address of the obligated parent's employer.

(2) If private, union or employer-provided health insurance coverage that is accessible to the children named in the order is available, the obligated parent must:

(a) Provide for coverage for the children without waiting for an open enrollment period, as provided under RCW 48.01.235 (4)(a); and

(b) Submit proof of coverage as outlined in subsection (1)(b) above.

(3) If health insurance is not immediately available to the obligated parent, as soon as health insurance becomes available, the obligated parent must:

(a) Provide for coverage for the children named in the order; and

(b) Submit proof of coverage as outlined in subsection (1)(b) above.

(4) Providing public health care coverage for the children satisfies an obligated parent's requirement to provide for health care coverage, as long as the obligated parent also covers the children under any insurance available through his or her employer or union which is provided at no cost to the obligated parent.

(5) DCS may serve a notice of support owed for medical support under WAC 388-14A-3312 to establish either or both of the following:

(a) Either parent's share of uninsured medical expenses owed to the other parent; or

(b) Either parent's monthly payment toward the premium paid for coverage by the other parent or the state, if:

(i) Health insurance coverage is not available through the parent's employer or union or is not otherwise provided; and

(ii) The support order provides for the payment of a monthly payment toward the premium when the obligated parent does not provide coverage.

(6) See WAC 388-14A-4165 for a description of what happens when the combined total of a noncustodial parent's current support obligation, arrears payment and health insurance premiums to be withheld by the employer exceeds the fifty per cent limitation for withholding.

(7) Both parents must notify DCS any time there is a change to the health care coverage for the children named in the order.

(8) WAC 388-14A-4111 and 388-14A-4112 describe when DCS may accept or decline a request to enforce a medical support obligation.

History

Statutory Authority: Part I of 2018 c 150 and RCW 26.09.105, 26.18.170, 26.23.050, 34.05.220 (1)(a), 34.05.350(1), 74.08.090, and 74.20.040(9). WSR 19-02-017, § 388-14A-4110, filed 12/21/18, effective 1/21/19. Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-4110, filed 5/19/11, effective 6/19/11. Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-4110, filed 5/29/08, effective 7/1/08. Statutory Authority: RCW 74.08.090, 74.20A.310, and 26.18.170, 42 U.S.C. 666 (a)(19), Child Support Performance and Incentives Act of 1998, 45 C.F.R. 303.31, and 45 C.F.R. 303.32. WSR 04-17-119, § 388-14A-4110, filed 8/17/04, effective 9/17/04. Statutory Authority: RCW 74.08.090, 26.18.170, 26.18.180, 74.20A.055. WSR 01-03-089, § 388-14A-4110, filed 1/17/01, effective 2/17/01. Formerly WAC 388-11-215.

Wash. Admin. Code § 388-14A-4111 When may DCS decline a request to enforce a medical support obligation?

The division of child support (DCS) may decline to enforce a medical support obligation using the remedies available under RCW 26.09.105, 26.18.170, and 26.23.110 if one or more of the following apply:

(1) The medical support obligation is imposed by a child support order that was not entered in a court or administrative forum of the state of Washington;

(2) The department of social and health services is not paying public assistance;

(3) The department of children, youth, and families is not providing services for a child in residential care (foster care);

(4) The party requesting enforcement of the medical support obligation does not have an open IV-D case with DCS for the child;

(5) The party requesting enforcement of the medical support obligation is not a parent of the child for whom the medical support obligation was established;

(6) The party is requesting reimbursement of the obligated parent's proportionate share of medical premium costs, and the obligated parent is currently providing accessible health care coverage for the child;

(7) The party requesting enforcement of the medical support obligation is not a former recipient of public assistance as described in WAC 388-14A-2000 (2)(d);

(8) DCS has not received a request for services from a child support agency in another state or a child support agency of an Indian tribe or foreign country;

(9) The party requesting enforcement of the medical support obligation has not applied for full support enforcement services;

(10) The party requesting enforcement of the medical support obligation does not qualify as a party who can receive child support enforcement services from DCS under WAC 388-14A-2000;

(11) The case does not meet the requirements for provision of support enforcement services from DCS under WAC 388-14A-2010;

(12) DCS denies the application under WAC 388-14A-2020;

(13) The party requesting enforcement of the medical support obligation does not provide proof of payment, any required forms, or the declaration under penalty of perjury required under WAC 388-14A-3312;

(14) The case meets one or more of the reasons set out in WAC 388-14A-4112(2) that DCS does not enforce a custodial parent's obligation to provide medical support.

History

Statutory Authority: RCW 26.09.105, 26.18.170, 26.23.050, 26.23.110, 26.23.120, 34.05.020, 34.05.060, 74.08.090, 74.20.040, 74.20A.055, and 74.20A.056. WSR 24-15-143, § 388-14A-4111, filed 7/23/24, effective 8/23/24. Statutory Authority: Part I of 2018 c 150 and RCW 26.09.105, 26.18.170, 26.23.050, 34.05.220 (1)(a), 34.05.350(1), 74.08.090, and 74.20.040(9). WSR 19-02-017, § 388-14A-4111, filed 12/21/18, effective 1/21/19. Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-4111, filed 5/19/11, effective 6/19/11.

Wash. Admin. Code § 388-14A-4112 When does the division of child support enforce a custodial parent's obligation to provide medical support?

(1) A noncustodial parent (NCP) may file an application for full child support enforcement services and specifically request that the division of child support (DCS) enforce the medical support obligation of the custodial parent (CP). WAC 388-14A-4111 describes when DCS may accept or decline a request to enforce a medical support obligation.

(2) DCS does not enforce the CP's medical support obligation unless the NCP files an application for nonassistance support enforcement services under WAC 388-14A-2000 (2)(c). The NCP must specify whether he or she is requesting that DCS enforce the CP's obligation to provide:

(a) The CP's proportionate share of uninsured medical expenses;

(b) Health care coverage (including the possibility of a monthly payment toward the premium paid by the NCP for coverage of the children named in the order when appropriate); or

(3) A medical support obligation includes providing health care coverage or contributing a monthly payment toward the premium paid for coverage when appropriate, and paying a proportionate share of any uninsured medical expenses for the children.

(a) DCS may enforce the CP's obligation to pay a proportionate share of any uninsured medical expenses for the children under WAC 388-14A-3312.

(b) DCS may decide whether it is appropriate to enforce the CP's obligation to provide health care coverage or contribute a monthly payment toward the premium paid for coverage under subsection (4) of this section.

(4) DCS does not enforce a custodial parent's obligation to provide health care coverage or pay a monthly payment toward the premium paid for coverage when:

(a) The support order does not include a medical support obligation which includes providing health care coverage or paying monthly payment toward the premium paid for coverage for the CP.

(b) The NCP is already providing health care coverage for the children covered by the order.

(c) The amount that the CP would have to pay for the premium for health care coverage exceeds the NCP's monthly support obligation for the children.

(d) The children are covered by health care coverage provided by someone else.

(e) The children are receiving medicaid or another kind of public health care coverage.

(f) The children are receiving TANF.

(g) The CP does not reside in Washington state.

(h) The CP is a tribal member living on or near the reservation.

(i) The CP is receiving child support enforcement services through a tribal IV-D program.

(5) DCS does not enforce a CP's obligation to pay a proportionate share of medical expenses incurred by an NCP when the support order does not include an obligation for the CP to pay a proportionate share of uninsured medical expenses.

(6) If none of the conditions under subsection (4) exist, DCS may enforce the CP's obligation to provide health insurance coverage when the CP has health insurance available at a reasonable cost through the CP's employer or union.

(7) A "reasonable cost" for health insurance coverage is defined as twenty-five percent of the basic support obligation for the children covered by the order, unless the support order provides a different limitation.

History

Statutory Authority: Part I of 2018 c 150 and RCW 26.09.105, 26.18.170, 26.23.050, 34.05.220 (1)(a), 34.05.350(1), 74.08.090, and 74.20.040(9). WSR 19-02-017, § 388-14A-4112, filed 12/21/18, effective 1/21/19. Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-4112, filed 5/19/11, effective 6/19/11. Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-4112, filed 5/29/08, effective 7/1/08.

Wash. Admin. Code § 388-14A-4115 Can my support order reduce my support obligation if I pay for health insurance?

(1) Some support orders reduce the noncustodial parent's transfer payment based on health insurance premiums paid by the noncustodial parent (NCP).

(2) An NCP is entitled to the reduction for premiums paid only if the NCP submits proof of the cost of coverage which is actually being provided at the time the support order is entered, so that the amounts can be included in the worksheet calculation.

(3) If health insurance coverage terminates or if the amount of the premium changes, this does not mean that the transfer payment is automatically increased or decreased. However, such a change may constitute the basis for a petition to modify the support order.

History

Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-4115, filed 5/19/11, effective 6/19/11. Statutory Authority: RCW 74.08.090, 26.18.170, 26.18.180, 74.20A.055. WSR 01-03-089, § 388-14A-4115, filed 1/17/01, effective 2/17/01. Formerly WAC 388-11-215.

Wash. Admin. Code § 388-14A-4119 How soon after a noncustodial parent is listed in the state directory of new hires must the division of child support send a National Medical Support Notice to the employer?

The division of child support (DCS) must send a National Medical Support Notice (NMSN) to the employer of a noncustodial parent (NCP) within two business days of the date the NCP's information is entered into the state directory of new hires (SDNH).

History

Statutory Authority: RCW 74.20A.310 and 45 C.F.R. 303.32, 45 C.F.R. 303.30, 45 C.F.R. 303.31. WSR 05-08-060, § 388-14A-4119, filed 3/31/05, effective 5/1/05.

Wash. Admin. Code § 388-14A-4120 DCS uses the National Medical Support Notice to enforce an obligation to provide health insurance coverage.

(1) The division of child support (DCS) uses a notice of enrollment called the National Medical Support Notice (NMSN) to enforce an obligated parent's obligation to provide health insurance coverage under chapter 26.18 RCW.

(2) DCS sends the NMSN to the obligated parent's employer in one of the following ways:

(a) In the same manner as a summons in a civil action,

(b) By certified mail, return receipt requested,

(d) By electronic means as provided in WAC 388-14A-4040 (1)(d).

(3) DCS sends the NMSN without notice to the obligated parent, who could be either the noncustodial parent (NCP) or the custodial parent (CP) when:

(a) A court or administrative order requires the obligated parent to provide coverage for a dependent child;

(b) The obligated parent fails to provide health insurance (either by not covering the child or by letting the coverage lapse) or fails to provide proof of coverage;

(d) DCS has reason to believe that coverage is available through the obligated parent's employer or union.

(4) If sending the NMSN does not result in coverage for the child, DCS may seek to enforce the obligated parent's medical support obligation by other means, as provided in RCW 26.18.170 and WAC 388-14A-4100.

History

Statutory Authority: Part I of 2018 c 150 and RCW 26.09.105, 26.18.170, 26.23.050, 34.05.220 (1)(a), 34.05.350(1), 74.08.090, and, 74.20.040(9). WSR 19-02-017, § 388-14A-4120, filed 12/21/18, effective 1/21/19. Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-4120, filed 5/19/11, effective 6/19/11. Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-4120, filed 5/29/08, effective 7/1/08. Statutory Authority: RCW 74.08.090, 74.20A.310, and 26.18.170, 42 U.S.C. 666 (a)(19), Child Support Performance and Incentives Act of 1998, 45 C.F.R. 303.31, and 45 C.F.R. 303.32. WSR 04-17-119, § 388-14A-4120, filed 8/17/04, effective 9/17/04. Statutory Authority: RCW 74.08.090, 26.18.170, 26.18.180, 74.20A.055. WSR 01-03-089, § 388-14A-4120, filed 1/17/01, effective 2/17/01. Formerly WAC 388-11-215 and 388-14-480.

Wash. Admin. Code § 388-14A-4121 Can a Washington employer assume that every National Medical Support Notice that the employer receives is from the division of child support?

(1) The National Medical Support Notice (NMSN) is a federally mandated form which is used by child support enforcement agencies all over the United States, not just the division of child support (DCS).

(2) Each NMSN form contains information advising the employer which child support enforcement agency sent the NMSN.

History

Statutory Authority: RCW 74.08.090, 74.20A.310, and 26.18.170, 42 U.S.C. 666 (a)(19), Child Support Performance and Incentives Act of 1998, 45 C.F.R. 303.31, and 45 C.F.R. 303.32. WSR 04-17-119, § 388-14A-4121, filed 8/17/04, effective 9/17/04.

Wash. Admin. Code § 388-14A-4122 What kind of information is included in the National Medical Support Notice?

The National Medical Support Notice (NMSN) and its cover letter advise the obligated parent's employer and the plan administrator that:

(1) The obligated parent is required to provide health insurance coverage for the children named in the notice;

(2) Information regarding the custodial parent and children, especially address information, is confidential and may not be released to anyone, including the noncustodial parent (NCP);

(3) Within twenty business days of the date on the notice, the employer must either:

(a) Respond to the NMSN by completing the response form and returning it to DCS; or

(b) Forward Part B of the NMSN to the plan administrator.

(4) The employer or plan administrator is required to enroll the children in a health insurance plan offered by the employer or the union if insurance the children can use is or will become available as provided in WAC 388-14A-4130;

(5) The employer or plan administrator must provide:

(a) Information about the health insurance plan and policy as requested in the notice; and

(b) Any necessary claim forms or membership cards as soon as they are available.

(6) The employer or union must withhold premiums from the obligated parent's net earnings if the obligated parent is required to pay part or all of the premiums for coverage under the health insurance plan.

(7) Noncompliance with the NMSN subjects the employer or union to a fine of up to one thousand dollars under RCW 26.18.180. See WAC 388-14A-4123 for a description of noncompliance penalties.

History

Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-4122, filed 5/29/08, effective 7/1/08. Statutory Authority: RCW 74.08.090, 74.20A.310, and 26.18.170, 42 U.S.C. 666 (a)(19), Child Support Performance and Incentives Act of 1998, 45 C.F.R. 303.31, and 45 C.F.R. 303.32. WSR 04-17-119, § 388-14A-4122, filed 8/17/04, effective 9/17/04.

Wash. Admin. Code § 388-14A-4123 What can happen if the employer fails to comply with the terms of the National Medical Support Notice?

(1) If an employer fails to comply with the terms of a National Medical Support Notice (NMSN) sent by the division of child support (DCS), the employer may be liable for a fine of up to one thousand dollars under RCW 74.20A.350.

(2) DCS may take action under RCW 74.20A.350 to impose fines if the employer fails to comply with the terms of the NMSN. For each failure to comply, DCS may assess a fine of:

(a) Two hundred dollars for the first month in which the employer or union fails to comply;

(b) Three hundred dollars for the second month of noncompliance; and

(d) The maximum fine based on a single notice of enrollment is one thousand dollars.

History

Statutory Authority: RCW 74.08.090, 74.20A.310, and 26.18.170, 42 U.S.C. 666 (a)(19), Child Support Performance and Incentives Act of 1998, 45 C.F.R. 303.31, and 45 C.F.R. 303.32. WSR 04-17-119, § 388-14A-4123, filed 8/17/04, effective 9/17/04.

Wash. Admin. Code § 388-14A-4124 Who are the parties involved with the National Medical Support Notice?

(1) The National Medical Support Notice (NMSN) is a federally mandated form used by child support enforcement agencies to enforce an obligated parent's medical support obligation. The division of child support (DCS) uses the NMSN as provided in WAC 388-14A-4120.

(2) DCS sends an NMSN when there is a support order requiring the obligated parent to provide health insurance coverage for the children.

(3) DCS sends the NMSN to the obligated parent's employer.

(4) If the employer provides health insurance coverage, the employer forwards the NMSN to the appropriate plan administrator.

(5) The plan administrator is the entity which handles the ministerial functions for the group health plan maintained by the employer or a group health plan to which the employer contributes.

(6) In some cases, the employer performs the duties of the plan administrator.

(7) In some cases, the obligated parent's union either acts as or contracts with the plan administrator.

(8) The plan administrator sends coverage information to both DCS and the custodial parent (CP). In cases where the CP is the obligated parent, DCS sends coverage information to the noncustodial parent (NCP).

History

Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-4124, filed 5/29/08, effective 7/1/08. Statutory Authority: RCW 74.08.090, 74.20A.310, and 26.18.170, 42 U.S.C. 666 (a)(19), Child Support Performance and Incentives Act of 1998, 45 C.F.R. 303.31, and 45 C.F.R. 303.32. WSR 04-17-119, § 388-14A-4124, filed 8/17/04, effective 9/17/04.

Wash. Admin. Code § 388-14A-4125 What must an employer do after receiving a National Medical Support Notice?

(1) Within twenty business days after the date on the National Medical Support Notice (NMSN), the employer must either send Part B to the plan administrator or send the employer response to the division of child support (DCS).

(2) The employer need take no action beyond responding to the NMSN if:

(a) The employer does not maintain or contribute to plans providing dependent or family health care coverage;

(b) The employee is among a class of employees (for example, part-time or nonunion) that are not eligible for family health coverage under any group health plan maintained by the employer or to which the employer contributes; or

(3) If subsection (2) of this section does not apply, the employer must respond to the NMSN and must:

(a) Forward Part B of the NMSN to the plan administrator of each group health plan identified by the employer to enroll the obligated parent's eligible children (see WAC 388-14A-4130 for what the plan administrator must do after receiving an NMSN); and

(b) When notified by the plan administrator that the children are enrolled:

(i) Withhold any employee contributions required for health insurance premiums and transfer those premiums to the appropriate plan; or

(ii) Notify DCS that enrollment cannot be completed because the noncustodial parent's net earnings are not high enough to allow withholding of child support and health insurance premiums; in this situation, the employer must notify DCS of the amount of the premium required to cover the children.

(c) When notified by the plan administrator that the obligated parent is subject to a waiting period, notify the plan administrator when the obligated parent is eligible to enroll in the plan, and that the NMSN requires the enrollment of the children named in the NMSN.

History

Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-4125, filed 5/29/08, effective 7/1/08. Statutory Authority: RCW 74.08.090, 74.20A.310, and 26.18.170, 42 U.S.C. 666 (a)(19), Child Support Performance and Incentives Act of 1998, 45 C.F.R. 303.31, and 45 C.F.R. 303.32. WSR 04-17-119, § 388-14A-4125, filed 8/17/04, effective 9/17/04.

Wash. Admin. Code § 388-14A-4126 What kind of help is available for an employer or plan administrator who has questions about the National Medical Support Notice?

WAC 388-14A-4126

An employer or plan administrator who receives a National Medical Support Notice (NMSN) from the division of child support (DCS) may do one or more of the following to get help with the form:

(1) Visit the DCS website at https://dshs.wa.gov/esa/division-child-support/employer-resources;

(2) Call the DCS Employer Hotline at 1- 800-562-0479; or

(3) Contact the DCS field office that issued the NMSN.

History

Statutory Authority: RCW 26.18.170, 26.23.035, 26.23.110, 43.20A.550, 74.04.055, 74.08.090, 74.20.040, 74.20A.310, and 74.20A.328. WSR 26-14-086, s 388-14A-4126, filed 6/29/26, effective 7/30/26. Statutory Authority: RCW 74.08.090, 74.20A.310, and 26.18.170, 42 U.S.C. 666 (a)(19), Child Support Performance and Incentives Act of 1998, 45 C.F.R. 303.31, and 45 C.F.R. 303.32. WSR 04-17-119, § 388-14A-4126, filed 8/17/04, effective 9/17/04.

Wash. Admin. Code § 388-14A-4130 What must a plan administrator do after receiving a National Medical Support Notice from the division of child support?

(1) A plan administrator who receives a National Medical Support Notice (NMSN) must respond to the NMSN within forty business days after the date on the NMSN.

(2) If the obligated parent and the children are to be enrolled in a health insurance plan, the plan administrator must:

(a) Notify the obligated parent, each child, and the custodial parent (CP) (if the obligated parent is not the CP) that coverage of the children is or will become available (notifying the CP is considered the same as notifying the child if they live at the same address); and

(b) If not previously provided, send the CP a description of the coverage available, including the effective date of coverage, a summary plan description and any forms or information necessary to start coverage, and information on how to submit claims for benefits.

(3) If there is more than one option available under the plan and the obligated parent is not yet enrolled, the plan administrator must:

(a) Provide to the division of child support (DCS) copies of applicable summary plan descriptions for available coverage, including the additional participant contribution necessary to obtain coverage for the children under each option and whether any option has a limited service area; and

(b) If the plan has a default option, enroll the children in the plan's default option if the plan administrator has not received DCS' election within twenty business days of the date the plan administrator returned the response to DCS; or

(4) If the obligated parent is subject to a waiting period that expires within ninety days from the date the plan administrator receives the NMSN, the plan administrator must enroll the children named in the NMSN immediately.

(5) If the obligated parent is subject to a waiting period that expires more than ninety days from the date the plan administrator receives the NMSN, the plan administrator must notify the employer, DCS, the obligated parent and the CP (if the obligated parent is not the CP) of the waiting period. When the waiting period has expired, the plan administrator must:

(a) Enroll the obligated parent and the children named in the NMSN, as provided in subsection (2) or (3) above; and

(b) Notify the employer of enrollment so that the employer may determine if the NCP's income is sufficient to withhold health insurance premiums, and then either withhold accordingly or notify DCS, as provided in WAC 388-14A-4125 (3)(b).

(6) If the obligated parent is subject to a waiting period whose duration is determined by a measure other than the passage of time (for example, the completion of a certain number of hours worked), the plan administrator must notify the employer, DCS, the obligated parent and the CP (if the CP is not the obligated parent) of the waiting period. When the waiting period has expired, the plan administrator must:

(a) Enroll the obligated parent and the children named in the NMSN, as provided in subsection (2) or (3) above; and

(b) Notify the employer of enrollment so that the employer may determine if the obligated parent's income is sufficient to withhold health insurance premiums, and then either withhold accordingly or notify DCS, as provided in WAC 388-14A-4125 (3)(b).

(7) If the plan administrator determines that the NMSN does not constitute a qualified medical child support order as defined by ERISA, the plan administrator must:

(a) Notify DCS using the part of the NMSN called the plan administrator response; and

(b) Notify the obligated parent, the CP (if the CP is not the obligated parent) and the children of the specific reasons for the determination. A copy of the plan administrator response is considered sufficient notice under this section.

History

Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-4130, filed 5/29/08, effective 7/1/08. Statutory Authority: RCW 74.08.090, 74.20A.310, and 26.18.170, 42 U.S.C. 666 (a)(19), Child Support Performance and Incentives Act of 1998, 45 C.F.R. 303.31, and 45 C.F.R. 303.32. WSR 04-17-119, § 388-14A-4130, filed 8/17/04, effective 9/17/04. Statutory Authority: RCW 74.08.090, 26.18.170, 26.18.180, 74.20A.055. WSR 01-03-089, § 388-14A-4130, filed 1/17/01, effective 2/17/01. Formerly WAC 388-11-215.

Wash. Admin. Code § 388-14A-4135 What must the plan administrator do when the obligated parent has health insurance but the children are not included in the coverage?

(1) If the obligated parent is enrolled in a health insurance plan through the employer but has not enrolled the children named in the National Medical Support Notice (NMSN), the plan administrator must follow the steps outlined in WAC 388-14A-4130(2) and:

(a) Enroll the child(ren) named in the NMSN under the obligated parent's health insurance plan; and

(b) Notify the employer and the division of child support (DCS) that the child(ren) have been enrolled.

(2) Under RCW 48.01.235 (4)(a), the plan administrator must enroll a child who is otherwise eligible for the coverage without regard to any enrollment season restrictions.

(3) WAC 388-14A-4145 discusses what the plan administrator must do if the obligated parent's health insurance plan is not accessible to the children.

History

Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-4135, filed 5/29/08, effective 7/1/08. Statutory Authority: RCW 74.08.090, 74.20A.310, and 26.18.170, 42 U.S.C. 666 (a)(19), Child Support Performance and Incentives Act of 1998, 45 C.F.R. 303.31, and 45 C.F.R. 303.32. WSR 04-17-119, § 388-14A-4135, filed 8/17/04, effective 9/17/04.

Wash. Admin. Code § 388-14A-4140 What must the plan administrator do when the obligated parent is eligible for health insurance but is not yet enrolled?

(1) If the obligated parent is eligible for health insurance through the employer but has not enrolled on his or her own, the plan administrator must proceed under WAC 388-14A-4130(3) and:

(a) Enroll the obligated parent and the children in the least expensive plan which provides accessible coverage for the children named in the National Medical Support Notice (NMSN); and

(b) Notify the employer and the division of child support (DCS) that the obligated parent and the children have been enrolled.

(2) The plan administrator notifies DCS of all health insurance plans for which the obligated parent is eligible, and notifies DCS which plan is the default option.

(3) If DCS does not specify otherwise within twenty business days of the date the plan administrator responds to DCS, the plan administrator must enroll the obligated parent and the children in the default plan.

(4) Under RCW 48.01.235 (4)(a), the plan administrator must enroll, under the family coverage, a child who is otherwise eligible for the coverage without regard to any enrollment season restrictions. In order to obtain coverage for the children, the plan administrator must enroll an otherwise eligible obligated parent without regard to any enrollment season restrictions.

History

Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-4140, filed 5/29/08, effective 7/1/08. Statutory Authority: RCW 74.08.090, 74.20A.310, and 26.18.170, 42 U.S.C. 666 (a)(19), Child Support Performance and Incentives Act of 1998, 45 C.F.R. 303.31, and 45 C.F.R. 303.32. WSR 04-17-119, § 388-14A-4140, filed 8/17/04, effective 9/17/04.

Wash. Admin. Code § 388-14A-4143 What must the plan administrator do when the employer provides health insurance but the obligated parent is not yet eligible for coverage?

If the obligated parent is subject to a waiting period before being eligible for coverage under a health insurance plan provided by the employer, the plan administrator must proceed as follows:

(1) If the obligated parent is subject to a waiting period that expires ninety days or less from the date of receipt of the National Medical Support Notice (NMSN), see WAC 388-14A-4130(4);

(2) If the obligated parent is subject to a waiting period that expires more than ninety days from the date of receipt of the NMSN, see WAC 388-14A-4130(5); and

(3) If the obligated parent is subject to a waiting period whose duration is determined by a measure other than the passage of time, see WAC 388-14A-4130(6).

History

Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-4143, filed 5/29/08, effective 7/1/08. Statutory Authority: RCW 74.08.090, 74.20A.310, and 26.18.170, 42 U.S.C. 666 (a)(19), Child Support Performance and Incentives Act of 1998, 45 C.F.R. 303.31, and 45 C.F.R. 303.32. WSR 04-17-119, § 388-14A-4143, filed 8/17/04, effective 9/17/04.

Wash. Admin. Code § 388-14A-4145 What must the plan administrator do when the insurance plan in which the obligated parent is enrolled does not provide coverage which is accessible to the children?

(1) If more than one insurance plan is offered by the employer or union, and each plan may be extended to cover the child, then the plan administrator must enroll the children named in the national medical support notice (NMSN) in the plan in which the obligated parent is enrolled.

(2) If the obligated parent's plan does not provide coverage which is accessible to the child, the plan administrator:

(a) May give the obligated parent the opportunity to change plans so that obligated parent and the children may be enrolled in a plan which provides accessible coverage for the children; but

(b) Is not required to change the obligated parent's plan to one which provides accessible coverage for the children.

History

Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-4145, filed 5/29/08, effective 7/1/08. Statutory Authority: RCW 74.08.090, 74.20A.310, and 26.18.170, 42 U.S.C. 666 (a)(19), Child Support Performance and Incentives Act of 1998, 45 C.F.R. 303.31, and 45 C.F.R. 303.32. WSR 04-17-119, § 388-14A-4145, filed 8/17/04, effective 9/17/04.

Wash. Admin. Code § 388-14A-4150 What must the plan administrator do when the obligated parent has more than one family?

(1) When an obligated parent has a health insurance obligation for more than one family, the division of child support (DCS) sends one National Medical Support Notice (NMSN) for each family to the obligated parent's employer.

(2) If the obligated parent is already enrolled in a health insurance plan, the plan administrator must attempt to enroll all children named in all of the NMSNs in the obligated parent's plan.

(3) If the obligated parent is not already enrolled in a health insurance plan, and the employer offers a health insurance plan which would cover all children named in all of the NMSNs, the plan administrator must enroll the children in that plan. See WAC 388-14A-4140.

(4) If the employer offers only one health insurance plan, or multiple plans which would cover some, but not all of the children named in the NMSNs, the plan administrator must so notify DCS.

(5) DCS chooses the appropriate health insurance plan by considering the following factors:

(a) The wishes of the custodial parent of each family;

(b) The premium limits set by the support orders;

(d) How many of the obligated parent's children live in Washington and how many live elsewhere;

(e) How many of the obligated parent's children receive medicaid;

(f) How many of the obligated parent's children are already covered by private health insurance;

(g) Which plan covers the most children; and

(h) Other factors as may be developed in DCS policy.

(6) The factors listed in subsection (5) are not exclusive, nor are they equally weighted.

(7) Nothing in this section requires the plan administrator to take action to change the obligated parent's plan unless the obligated parent requests a change.

History

Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-4150, filed 5/29/08, effective 7/1/08. Statutory Authority: RCW 74.08.090, 74.20A.310, and 26.18.170, 42 U.S.C. 666 (a)(19), Child Support Performance and Incentives Act of 1998, 45 C.F.R. 303.31, and 45 C.F.R. 303.32. WSR 04-17-119, § 388-14A-4150, filed 8/17/04, effective 9/17/04.

Wash. Admin. Code § 388-14A-4160 Are there any limits on the amount an obligated parent may be required to pay for health insurance premiums?

(1) The National Medical Support Notice (NMSN) advises the employer of any limitations on the amount an obligated parent may be required to pay for health insurance premiums to cover the children.

(2) Often the support order which contains the health insurance obligation determines the limitation on premium amounts, or states that there is no limitation. See WAC 388-14A-4100 for a discussion of premium limitation amounts.

(3) The premium limitation amount stated in the NMSN:

(a) Describes the premium amount required to cover the children named in the notice; and

(b) May include any amounts required to cover the obligated parent, if DCS requires the employer or plan administrator to enroll the obligated parent in a health care coverage plan in order to obtain coverage for the obligated parent's children.

(4) Even if the medical insurance premium is within the limits set by the order or by WAC 388-14A-4100, the fifty percent limitation on withholding found in RCW 26.23.060(3) still applies. See WAC 388-14A-4165 for a description of what happens when the fifty percent limitation is exceeded.

(5) When calculating the fifty percent limitation for withholding purposes:

(a) The premium attributable to coverage for the children is always included in this calculation; but

(b) The premium attributable to coverage for the obligated parent is included only when DCS requires the employer or plan administrator to enroll the obligated parent in a health insurance plan in order to obtain coverage for the obligated parent's children. See also WAC 388-14A-4165(3).

History

Statutory Authority: Part I of 2018 c 150 and RCW 26.09.105, 26.18.170, 26.23.050, 34.05.220 (1)(a), 34.05.350(1), 74.08.090, and 74.20.040(9). WSR 19-02-017, § 388-14A-4160, filed 12/21/18, effective 1/21/19. Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-4160, filed 5/29/08, effective 7/1/08. Statutory Authority: RCW 74.08.090, 74.20A.310, and 26.18.170, 42 U.S.C. 666 (a)(19), Child Support Performance and Incentives Act of 1998, 45 C.F.R. 303.31, and 45 C.F.R. 303.32. WSR 04-17-119, § 388-14A-4160, filed 8/17/04, effective 9/17/04.

Wash. Admin. Code § 388-14A-4165 What happens when a noncustodial parent does not earn enough to pay child support plus the health insurance premium?

(1) Under RCW 26.23.060(3), a payroll deduction may not exceed fifty percent of the noncustodial parent's disposable earnings in each pay period.

(2) When the division of child support (DCS) enforces a child support obligation through an income withholding action and also enforces a health insurance obligation, the noncustodial parent's employer often must withhold amounts for:

(a) Current child support;

(b) Child support arrears; and

(3) When the employer or plan administrator must enroll the noncustodial parent (NCP) in a health insurance plan in order to enroll the children (see WAC 388-14A-4140), the premium amount for the NCP's coverage is included in the amounts to withhold under subsection (2) above. If the NCP is already enrolled in a plan, the premium amount for the NCP's coverage is not included the amounts to withhold under that subsection.

(4) If the combined amounts for current support, support arrears and health insurance premiums are more than fifty percent of the noncustodial parent's disposable earnings, the employer must notify DCS immediately.

(5) In certain circumstances, DCS may adjust the amount to be withheld for support arrears so that the total amount withheld does not exceed fifty percent of the noncustodial parent's disposable earnings.

(6) If the noncustodial parent's current support obligation plus health insurance premiums exceeds fifty percent of the noncustodial parent's disposable earnings, DCS:

(a) Enforces the child support obligation through income withholding; but

(b) Is not able to enforce the noncustodial parent's health insurance obligation at that time.

(7) In the situation described in subsection (6), DCS may establish a monthly payment toward the premium, as described in WAC 388-14A-3312, even if the combined amount for the current support obligation and the monthly payment toward the premium exceeds fifty percent of the NCP's disposable earnings.

History

Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-4165, filed 5/19/11, effective 6/19/11. Statutory Authority: RCW 74.08.090, 74.20A.310, and 26.18.170, 42 U.S.C. 666 (a)(19), Child Support Performance and Incentives Act of 1998, 45 C.F.R. 303.31, and 45 C.F.R. 303.32. WSR 04-17-119, § 388-14A-4165, filed 8/17/04, effective 9/17/04.

Wash. Admin. Code § 388-14A-4170 How long does a National Medical Support Notice or other notice of enrollment remain in effect?

(1) The National Medical Support Notice (NMSN) is a Qualified Medical Child Support Order.

(2) The NMSN or earlier notice of enrollment served by the division of child support (DCS) remains in effect until:

(a) DCS withdraws the notice in writing; or

(b) Health insurance coverage is no longer available through the employer or union.

History

Statutory Authority: RCW 74.08.090, 74.20A.310, and 26.18.170, 42 U.S.C. 666 (a)(19), Child Support Performance and Incentives Act of 1998, 45 C.F.R. 303.31, and 45 C.F.R. 303.32. WSR 04-17-119, § 388-14A-4170, filed 8/17/04, effective 9/17/04.

Wash. Admin. Code § 388-14A-4175 Who is required to notify the division of child support when health care coverage for the children ends?

(1) Once the division of child support (DCS) has notified an employer that a parent is obligated by a support order to provide health insurance coverage for the children named in the order, the National Medical Support Notice (NMSN) or other notice of enrollment remains in effect as specified in WAC 388-14A-4170.

(2) If coverage for the children is terminated, the employer must notify DCS within thirty days of the date coverage ends.

(3) A parent who is required by a child support order to provide health care coverage for his or her children must notify DCS and the other parent within thirty days of the date coverage for the children ends. This requirement applies whether the obligated parent is the custodial parent or the noncustodial parent.

History

Statutory Authority: Part I of 2018 c 150 and RCW 26.09.105, 26.18.170, 26.23.050, 34.05.220 (1)(a), 34.05.350(1), 74.08.090, and 74.20.040(9). WSR 19-02-017, § 388-14A-4175, filed 12/21/18, effective 1/21/19. Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-4175, filed 5/19/11, effective 6/19/11. Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-4175, filed 5/29/08, effective 7/1/08. Statutory Authority: RCW 74.08.090, 74.20A.310, and 26.18.170, 42 U.S.C. 666 (a)(19), Child Support Performance and Incentives Act of 1998, 45 C.F.R. 303.31, and 45 C.F.R. 303.32. WSR 04-17-119, § 388-14A-4175, filed 8/17/04, effective 9/17/04.

Wash. Admin. Code § 388-14A-4180 When must the division of child support communicate with the health care authority?

(1) The division of child support (DCS) must inform the health care authority (HCA) of the existence of a new or modified court or administrative order for child support when the order includes a requirement for medical support. The health care authority provides services for the state of Washington under Title XIX of the federal Social Security Act.

(2) DCS must provide HCA with the following information:

(a) Title IV-A case number, Title IV-E foster care case number, medicaid number or the individual's Social Security number;

(b) Name of the obligated parent;

(d) Name and Social Security number of the children named in the order;

(e) Home address of the obligated parent;

(f) Name and address of the obligated parent's employer;

(g) Information regarding the obligated parent's health insurance policy; and

(h) Whether the children named in the order are covered by the policy.

(3) DCS must periodically communicate with HCA to determine if there have been any lapses (stops and starts) in the obligated parent's health care coverage for medicaid applicants.

(4) Before DCS may serve a notice of support owed under WAC 388-14A-3312 (1)(b) to establish an obligated parent's monthly payment toward the premium paid by the state for coverage, HCA must provide information regarding the premium paid for each child covered by the notice.

(a) DCS distributes to HCA any collections based on the obligation established under WAC 388-14A-3312 (1)(b) when the children receive state-financed medical coverage through the department under chapter 74.09 RCW for which there is an assignment.

(b) Such collections are retained by HCA to reimburse the state, subject to the limitations in WAC 388-14A-2035(4).

History

Statutory Authority: Part I of 2018 c 150 and RCW 26.09.105, 26.18.170, 26.23.050, 34.05.220 (1)(a), 34.05.350(1), 74.08.090, and 74.20.040(9). WSR 19-02-017, § 388-14A-4180, filed 12/21/18, effective 1/21/19. Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-4180, filed 5/19/11, effective 6/19/11. Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-4180, filed 5/29/08, effective 7/1/08. Statutory Authority: RCW 74.20A.310 and 45 C.F.R. 303.32, 45 C.F.R. 303.30, 45 C.F.R. 303.31. WSR 05-08-060, § 388-14A-4180, filed 3/31/05, effective 5/1/05.

Wash. Admin. Code § 388-14A-4200 Do I get credit for dependent disability payments paid on my behalf to my children?

(1) When the department of labor and industries or a self-insurer pays compensation under chapter 51.32 RCW on behalf of or on account of the child or children of a noncustodial parent (NCP), the division of child support (DCS) treats the amount of compensation the department or self-insurer pays on behalf of the child or children as if the NCP paid the compensation toward the NCP's child support obligations.

(2) When the Social Security administration pays Social Security disability dependency benefits, retirement benefits, or survivors insurance benefits on behalf of or on account of the child or children of an NCP who is a disabled person, a retired person, or a deceased person, DCS treats the amount of benefits paid for the child or children as if the NCP paid the benefits toward the NCP's child support obligation for the period for which benefits are paid.

(3) When the veterans' administration (now known as the U.S. Department of Veterans Affairs) apportions a veteran's benefits to pay child support on behalf of or on account of the child or children of the veteran, DCS treats the amount of benefits paid for the child or children for all purposes as if the veteran paid the benefits toward the satisfaction of that person's child support obligation for the period for which benefits are paid.

(4) Under no circumstances does the NCP have a right to reimbursement of any compensation paid under subsection (1), (2), or (3) of this section.

History

Statutory Authority: 2015 c 124, RCW 26.23.030(3), 34.05.220 (1)(a), 34.05.322, and 74.08.090. WSR 16-03-024, § 388-14A-4200, filed 1/11/16, effective 2/11/16. Statutory Authority: RCW 26.18.190, 26.23.035, 74.08.090, and 74.20A.055. WSR 11-14-065, § 388-14A-4200, filed 6/30/11, effective 7/31/11. Statutory Authority: RCW 74.08.090, 26.18.190, 74.20A.055. WSR 01-03-089, § 388-14A-4200, filed 1/17/01, effective 2/17/01. Formerly WAC 388-11-280.

Wash. Admin. Code § 388-14A-4300 What can I do if I think I'm paying more than the custodial parent is spending for day care or other special expenses for my child?

(1) When a court or administrative child support order requires a noncustodial parent (NCP) to pay a fixed monthly amount for day care or special child rearing expenses, an NCP who has paid child support under a court or administrative order and believes that day care or special child rearing expenses were not actually incurred in the amount of the order may file a petition for reimbursement. This petition requests the division of child support (DCS) set an administrative hearing to determine if an overpayment of at least 20 percent has occurred and how the overpayment should be reimbursed.

(2) A petition for reimbursement must cover a 12-month period.

(a) The 12-month period may be:

(i) A calendar year; or

(ii) The 12-month period following the anniversary date of the support order; or

(iii) The 12-month period following an adjudication under this section.

(b) 12-month periods under this section may not overlap.

(3) The petition must be in writing and at a minimum state:

(a) The 12-month time period to be considered;

(b) The date of the order requiring the payment of day care or special child rearing expenses;

(c) The amounts required by the court or administrative order for day care or special child rearing expenses for that time period;

(d) The amounts actually paid by the NCP for that time period;

(e) The total amount of day care or special child rearing expenses which the NCP claims the custodial parent (CP) actually incurred for that time period;

(f) The NCP's proportionate share of the expenses actually incurred; and

(g) The amount of reimbursement for overpayment to which the NCP claims to be entitled for that time period.

(4) An NCP must file a petition for reimbursement within two years of the alleged overpayment in order to be entitled to reimbursement under WAC 388-14A-4300 through 388-14A-4304 and RCW 4.16.130. The effective date of the petition is the date DCS receives the written request.

(5) When a court or administrative child support order requires an NCP to pay variable day care or special child rearing expenses and the fixed monthly amount of day care or special child rearing expenses was calculated in a notice of support owed, an NCP who believes they overpaid such expenses:

(a) May request an annual review of the notice of support owed under WAC 388-14A-3330; and

(b) Is not entitled to a hearing on a petition for reimbursement under WAC 388-14A-4300 through 388-14A-4304.

History

Statutory Authority: RCW 26.23.035, 26.23.110, and 34.05.220. WSR 22-18-035, § 388-14A-4300, filed 8/29/22, effective 10/1/22. Statutory Authority: RCW 74.08.090, 34.05.220, 26.23.035, 74.20A.310. WSR 01-03-089, § 388-14A-4300, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-376.

Wash. Admin. Code § 388-14A-4301 Can I file a petition for reimbursement if I do not receive full support enforcement services?

The division of child support (DCS) considers a petition for reimbursement or an application for hearing under WAC 388-14A-4300 to be an application for full support enforcement services if there is not already an open support enforcement case.

History

Statutory Authority: RCW 74.08.090, 34.05.220, 26.23.035, 74.20A.310. WSR 01-03-089, § 388-14A-4301, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-376.

Wash. Admin. Code § 388-14A-4302 Who participates in a hearing on petition for reimbursement?

(1) The office of administrative hearings (OAH) sends notice of a hearing under this subsection to the noncustodial (NCP) and to the custodial parent (CP).

(2) The NCP and the CP participate in the hearing as independent parties with the same procedural rights.

History

Statutory Authority: RCW 26.23.035, 26.23.110, and 34.05.220. WSR 22-18-035, § 388-14A-4302, filed 8/29/22, effective 10/1/22. Statutory Authority: RCW 74.08.090, 34.05.220, 26.23.035, 74.20A.310. WSR 01-03-089, § 388-14A-4302, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-376.

Wash. Admin. Code § 388-14A-4303 What happens at a hearing on petition for reimbursement?

(1) The noncustodial parent (NCP) has the burden of proving the amounts actually paid by the NCP under the order.

(2) The custodial parent (CP) has the burden of proving the amounts actually incurred for day care and special child rearing expenses.

(3) The CP is not required to provide the address of the day care provider unless the administrative law judge (ALJ) finds that the information may be disclosed under the standards set forth in WAC 388-14A-2105 for the disclosure of the address of the CP.

(4) The division of child support (DCS) and the parties may enter a consent order or agreed settlement instead of proceeding to hearing any time a parent has requested a hearing on a petition for reimbursement. See WAC 388-14A-3600 for the rules regarding consent orders and agreed settlements.

(5) If the NCP fails to appear for the hearing, upon proof of service of the notice of hearing the ALJ issues an order of default against the NCP and dismisses the petition for reimbursement.

(6) If the CP fails to appear for the hearing, upon proof of service of the notice of hearing the ALJ issues an order of default against the CP and may either hold a hearing on the merits of the petition for reimbursement or issue a consent order.

(7) A hearing under this subsection is for the limited purpose of determining whether the amount paid by the NCP exceeds the NCP's proportionate share of the amount actually incurred for day care and special child rearing expenses.

(a) If the ALJ determines that the overpayment amounts to 20 percent or more of the NCP's share of annual day care and special child rearing expenses, the ALJ enters an order stating:

(i) The 12-month time period in question;

(ii) The amount of the overpayment; and

(iii) The method of reimbursement as set forth at WAC 388-14A-4304.

(b) If the ALJ determines that the overpayment amounts to less than 20 percent of the NCP's share of annual day care and child rearing expenses, the ALJ enters an order stating:

(i) Whether the NCP has overpaid or underpaid the day care and special child rearing expenses;

(ii) If an overpayment has occurred, by what percentage of the annual proportionate share; and

(iii) That reimbursement under this section is denied for that 12-month period.

History

Statutory Authority: RCW 26.23.035, 26.23.110, and 34.05.220. WSR 22-18-035, § 388-14A-4303, filed 8/29/22, effective 10/1/22. Statutory Authority: RCW 74.08.090, 34.05.220, 26.23.035, 74.20A.310. WSR 01-03-089, § 388-14A-4303, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-376.

Wash. Admin. Code § 388-14A-4304 What happens if the judge determines that I have paid too much for day care and special expenses?

(1) If at a hearing under WAC 388-14A-4303, the administrative law judge (ALJ) decides that the custodial parent (CP) has not incurred costs in the amount paid by the noncustodial parent (NCP), any ordered overpayment reimbursement may be applied as an offset to any nonassistance child support arrears owed by the NCP on that case only. If there is no nonassistance debt owed on the case, the reimbursement must be in the form of a credit against the NCP's future child support obligation:

(a) Spread equally over one 12-month period starting the month after the administrative order becomes final; or

(b) When the future support obligation will end under the terms of the order in less than 12 months, spread equally over the life of the order; or

(2) The NCP may not pay more than his or her proportionate share of day care or other special child rearing expenses in advance and then deduct the overpayment from future support transfer payments unless:

(a) Specifically agreed to by the CP; and

(b) Specifically agreed to in writing by DCS for periods when the CP or the dependent child receives public assistance.

History

Statutory Authority: RCW 26.23.035, 26.23.110, and 34.05.220. WSR 22-18-035, § 388-14A-4304, filed 8/29/22, effective 10/1/22. Statutory Authority: RCW 26.19.080, 34.05.220, 74.08.090, 74.20A.310. WSR 05-07-087, § 388-14A-4304, filed 3/16/05, effective 4/16/05. Statutory Authority: RCW 74.08.090, 34.05.220, 26.23.035, 74.20A.310. WSR 01-03-089, § 388-14A-4304, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-376.

Wash. Admin. Code § 388-14A-4500 What is the division of child support's license suspension program?

WAC 388-14A-4500

(1) RCW 74.20A.320 through 74.20A.326 provide that, in some circumstances, the division of child support (DCS) may certify for license suspension a noncustodial parent (NCP) who is not in compliance with a child support order. These statutes call the NCP "the responsible parent."

(a) "Certify" means to notify the department of licensing or other state licensing entities that the NCP is not in compliance with a child support order and to ask them to take appropriate action against licenses held by the NCP. Before DCS can certify an NCP, DCS serves a notice on the NCP as described in WAC 388-14A-4505 and 388-14A-4510. This notice is called the notice of noncompliance and intent to suspend licenses and is sometimes called the notice of noncompliance.

(b) "Responsible parent" is defined in 388-14A-1020. The responsible parent is also called the "noncustodial parent."

(2) "Noncompliance with a child support order" is defined in RCW 74.20A.020(18) and in WAC 388-14A-4510(3).

(3) When DCS certifies the NCP, the department of licensing or other licensing entities take action to deny, suspend, or refuse to renew the NCP's license, according to the terms of RCW 74.20A.320(4) and 74.20A.324.

(4) This section and sections WAC 388-14A-4505 through 388-14A-4530 cover the DCS license suspension program.

(5) DCS may certify an NCP who is not in compliance with a child support order to the department of licensing or any appropriate licensing entity. In determining which licensing entity receives the certification, DCS considers:

(a) The number and kind of licenses held by the parent; and

(b) The effect that suspension of a particular license will have in motivating the parent to pay support or to contact DCS to make appropriate arrangements for other relief.

(6) DCS may certify a parent to any licensing agency through which it believes the parent has obtained a license. DCS may certify a parent to as many licensing agencies as DCS feels necessary to accomplish the goals of the license suspension program.

(7) In certain circumstances spelled out in WAC 388-14A-4510 (2) and (3), DCS may serve the notice of noncompliance on a noncustodial parent but may stay the commencement of the objection period in WAC 388-14A-4505 (4)(b).

History

Statutory Authority: RCW 26.18.170, 26.23.035, 26.23.110, 43.20A.550, 74.04.055, 74.08.090, 74.20.040, 74.20A.310, and 74.20A.328. WSR 26-14-086, s 388-14A-4500, filed 6/29/26, effective 7/30/26. Statutory Authority: 2009 c 408, RCW 34.05.060, 43.20A.550, 74.04.055, 74.04.057, 74.20A.310, 74.20A.320(10), and 74.20A.350(14). WSR 10-03-029, § 388-14A-4500, filed 1/12/10, effective 2/12/10. Statutory Authority: RCW 74.20A.320. WSR 03-18-114, § 388-14A-4500, filed 9/2/03, effective 10/15/03. Statutory Authority: RCW 74.08.090, 74.20A.320. WSR 01-03-089, § 388-14A-4500, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-510.

Wash. Admin. Code § 388-14A-4505 The notice of noncompliance and intent to suspend licenses.

(1) Before certifying a noncustodial parent (NCP) for noncompliance, the division of child support (DCS) must serve the NCP with a notice of noncompliance and intent to suspend licenses. This notice tells the NCP that DCS intends to submit the NCP's name to the department of licensing and any other appropriate licensing entity as a licensee who is not in compliance with a child support order.

(2) The language of the underlying child support order determines the method by which DCS must serve the notice of noncompliance and intent to suspend licenses.

(3) If the support order establishing or modifying the child support obligation includes a statement required under RCW 26.23.050 that the NCP's privileges to obtain and maintain a license may not be renewed or may be suspended if the NCP is not in compliance with a support order, DCS may serve the notice by regular mail to the NCP's last known mailing address on file with the department.

(a) Notice by regular mail is deemed served three days from the date the notice was deposited with the United States Postal Service.

(b) DCS may choose to serve the notice by personal service.

(4) If the support order does not include a statement that the NCP's privileges to obtain and maintain a license may not be renewed or may be suspended if the NCP is not in compliance with a support order:

(a) DCS must serve the notice by certified mail, return receipt requested.

(b) If DCS is unable to serve the notice by certified mail, DCS must serve the notice by personal service, as provided in RCW 4.28.080.

(5) The notice must contain the information required by RCW 74.20A.320(2), including:

(a) The address and telephone number of DCS office that issued the notice;

(b) That in order to prevent DCS from certifying the NCP's name to the department of licensing or other licensing entity, the NCP has twenty days from receipt of the notice, or sixty days after receipt if the notice was served outside the state of Washington, to contact the department and:

(i) Pay the overdue support amount in full;

(ii) Request a hearing as provided in WAC 388-14A-4527;

(iii) Agree to a payment schedule as provided in WAC 388-14A-4520; or

(iv) File an action to modify the child support order with the appropriate court or administrative forum, in which case DCS will stay the certification process up to six months.

(c) That failure to contact DCS within twenty days of receipt of the notice (or sixty days if the notice was served outside of the state of Washington) will result in certification of the NCP's name to the department of licensing and any other appropriate licensing entity for noncompliance with a child support order. Upon receipt of the notice:

(i) The licensing entity will suspend or not renew the NCP's license and the department of licensing (DOL) will suspend or not renew any driver's license that the NCP holds until the NCP provides DOL or the other licensing entity with a release from DCS stating that the NCP is in compliance with the child support order;

(ii) The department of fish and wildlife will suspend a fishing license, hunting license, occupational licenses (such as a commercial fishing license), or any other license issued under chapter 77.32 RCW that the NCP may possess. In addition, suspension of a license by the department of fish and wildlife may also affect the NCP's ability to obtain permits, such as special hunting permits, issued by the department. Notice from DOL that an NCP's driver's license has been suspended shall serve a notice of the suspension of a license issued under chapter 77.32 RCW.

(d) That suspension of a license will affect insurability if the NCP's insurance policy excludes coverage for acts occurring after the suspension of a license; and

(e) If the NCP subsequently comes into compliance with the child support order, DCS will promptly provide the NCP and the appropriate licensing entities with a release stating the NCP is in compliance with the order.

(6) DCS is not required to include a copy of the NCP's child support order with the notice. Upon request from the NCP, DCS must provide a copy of the order or orders that serve as a basis for the notice of noncompliance.

History

Statutory Authority: 2017 c 269 is authorized under RCW 26.23.030, 34.05.220 (1)(a), 34.05.322, 34.05.350 (1)(a) and (b), 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310, and 74.20A.328. WSR 17-23-046, § 388-14A-4505, filed 11/8/17, effective 12/9/17. Statutory Authority: 2009 c 408, RCW 34.05.060, 43.20A.550, 74.04.055, 74.04.057, 74.20A.310, 74.20A.320(10), and 74.20A.350(14). WSR 10-03-029, § 388-14A-4505, filed 1/12/10, effective 2/12/10. Statutory Authority: RCW 74.20A.320. WSR 03-18-114, § 388-14A-4505, filed 9/2/03, effective 10/15/03. Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-4505, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-520.

Wash. Admin. Code § 388-14A-4510 Who is subject to the DCS license suspension program?

(1) The division of child support (DCS) may serve a notice of noncompliance on a noncustodial parent (NCP) who is not in compliance with a child support order.

(a) DCS may serve a notice of noncompliance on an NCP who meets the criteria of this section, even if the NCP is in jail or prison. Unless the NCP has other resources available while in jail or prison, DCS stays the commencement of the objection period set out in WAC 388-14A-4505 (5)(b) until the NCP has been out of jail or prison for thirty days.

(b) DCS may serve a notice of noncompliance on an NCP who meets the criteria of this section, even if the NCP is a public assistance recipient. DCS stays the commencement of the objection period in WAC 388-14A-4505 (5)(b) until the thirty days after the NCP's cash assistance grant is terminated.

(2) Compliance with a child support order for the purposes of the license suspension program means the NCP owes no more than six months' worth of child support.

(3) Noncompliance with a child support order for the purposes of the license suspension program means an NCP has:

(a) An obligation to pay child support under a court or administrative order; and

(b) Accumulated a support debt, also called an arrears or arrearage, totaling more than six months' worth of child support payments; or

(i) Make payments required by a court order or administrative order towards a support debt in an amount that is more than six months' worth of payments; or

(ii) Make payments to the Washington state support registry under a written agreement with DCS toward current support and arrearages and the arrearages still amount to more than six months' worth of child support payments.

(4) There is no minimum dollar amount required for license suspension, as long as the arrears owed by the NCP amount to more than six months' worth of support payments:

Example 1. Assume the child support order sets current support at one hundred dollars per month: The NCP has not made a single payment since the order was entered seven months ago. This NCP is more than six months in arrears.

Example 2. Assume the child support order sets current support at one hundred dollars per month: The NCP has paid for the last few months, but owes arrears of over six hundred dollars. This NCP is more than six months in arrears.

Example 3. Assume the child support order sets current support at one hundred dollars per month: The child is over eighteen, and no more current support is owed. However, the NCP has a debt of over one thousand two hundred dollars. This NCP is more than six months in arrears.

Example 4. Assume a judgment of three thousand dollars is entered by the court: The order requires the NCP to pay fifty dollars per month toward the arrears. The NCP has not made payments toward this obligation for eight months. This NCP is more than six months in arrears.

History

Statutory Authority: 2017 c 269 is authorized under RCW 26.23.030, 34.05.220 (1)(a), 34.05.322, 34.05.350 (1)(a) and (b), 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310, and 74.20A.328. WSR 17-23-046, § 388-14A-4510, filed 11/8/17, effective 12/9/17. Statutory Authority: 2009 c 408, RCW 34.05.060, 43.20A.550, 74.04.055, 74.04.057, 74.20A.310, 74.20A.320(10), and 74.20A.350(14). WSR 10-03-029, § 388-14A-4510, filed 1/12/10, effective 2/12/10. Statutory Authority: RCW 74.20A.320. WSR 03-18-114, § 388-14A-4510, filed 9/2/03, effective 10/15/03. Statutory Authority: RCW 74.08.090, 74.20A.320. WSR 01-03-089, § 388-14A-4510, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-530.

Wash. Admin. Code § 388-14A-4512 When may the division of child support certify a noncustodial parent for license suspension?

The division of child support (DCS) may certify a noncustodial parent (NCP) as being in noncompliance with a support order and may request the department of licensing (DOL) or any other licensing entity to suspend the NCP's license if:

(1) The NCP has failed to make a timely objection to a notice of noncompliance served under WAC 388-14A-4505. A timely objection must be filed within twenty days of receipt of the notice, or within sixty days of receipt if the notice was served outside of the state of Washington;

(2) The NCP has failed to file a motion with the appropriate court or administrative forum to modify the child support obligation within twenty days of service of the notice of noncompliance served under WAC 388-14A-4505 (or within sixty days if the notice was served outside of the state of Washington);

(3) The NCP has failed to comply with a payment agreement entered into under WAC 388-14A-4520;

(4) A hearing results in a final administrative order which determines that the NCP is not in compliance with a child support order and has not made a good faith effort to comply;

(5) The court enters a judgment on a petition for judicial review upholding an administrative order that determined that the NCP is not in compliance with a child support order and did not made a good faith effort to comply;

(6) The NCP has failed to comply with a payment schedule ordered by an administrative law judge (ALJ) under WAC 388-14A-4530; or

(7) The NCP failed to make satisfactory progress toward modification of the support order after a stay was granted under WAC 388-14A-4515(2).

History

Statutory Authority: 2009 c 408, RCW 34.05.060, 43.20A.550, 74.04.055, 74.04.057, 74.20A.310, 74.20A.320(10), and 74.20A.350(14). WSR 10-03-029, § 388-14A-4512, filed 1/12/10, effective 2/12/10.

Wash. Admin. Code § 388-14A-4515 How do I avoid having my license suspended for failure to pay child support?

WAC 388-14A-4515

(1) After service of the notice of noncompliance, the division of child support (DCS) stays (delays) certification action if the noncustodial parent (NCP) takes one of the following actions within 20 days of service, or within 60 days of service if the notice was served outside of Washington:

(a) Contacts DCS and makes arrangements to pay the support debt in full;

(b) Requests an administrative hearing as provided in WAC 388-14A-4527;

(i) Temporary assistance for needy families (TANF);

(ii) Aged, blind, or disabled cash assistance (ABD);

(iii) Housing and essential needs (HEN);

(iv) Pregnant women's assistance (PWA); or

(v) Supplemental security income (SSI);

(d) Provides proof that the NCP is currently incarcerated at a state or federal correctional facility;

(e) Provides proof that NCP has filed a proceeding to modify the support order; or

(f) Contacts DCS to negotiate and sign a written payment agreement as described in WAC 388-14A-4520.

(i) The stay for negotiation and obtaining signatures may last a maximum of 30 calendar days from the date the NCP contacts DCS; and

(ii) If no written payment agreement has been signed within 30 calendar days from the date the NCP contacted DCS, DCS schedules the matter for administrative hearing under WAC 388-14A-4530.

(2) If the NCP files a court or administrative action to modify the child support obligation, DCS stays the certification action.

(a) The stay for modification action may not exceed six months unless DCS finds good cause to extend the stay.

(b) The NCP must notify DCS that a modification proceeding is pending and must provide a copy of the motion or request for modification to DCS.

(3) A stay of certification does not require DCS to withdraw the notice of noncompliance.

(4) A stay of certification granted because the NCP is incarcerated, or because the NCP receives TANF, ABD, HEN, PWA, or SSI is lifted 30 days after the justification no longer applies to the NCP.

History

Statutory Authority: RCW 26.18.170, 26.23.035, 26.23.110, 43.20A.550, 74.04.055, 74.08.090, 74.20.040, 74.20A.310, and 74.20A.328. WSR 26-14-086, s 388-14A-4515, filed 6/29/26, effective 7/30/26. Statutory Authority: 2009 c 408, RCW 34.05.060, 43.20A.550, 74.04.055, 74.04.057, 74.20A.310, 74.20A.320(10), and 74.20A.350(14). WSR 10-03-029, § 388-14A-4515, filed 1/12/10, effective 2/12/10. Statutory Authority: RCW 74.20A.320. WSR 03-18-114, § 388-14A-4515, filed 9/2/03, effective 10/15/03. Statutory Authority: RCW 74.08.090, 74.20A.320. WSR 01-03-089, § 388-14A-4515, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-540.

Wash. Admin. Code § 388-14A-4520 Signing a payment agreement may avoid certification for noncompliance.

(1) If a noncustodial parent (NCP) signs a payment agreement, the division of child support (DCS) stays the certification action.

(2) The signing of a payment agreement does not require DCS to withdraw the notice of noncompliance.

(3) By signing a payment agreement, the NCP waives the right to an administrative hearing on any notice of noncompliance served before the date the NCP signs the agreement.

(4) The payment agreement must state that if the NCP fails to make payments under the terms of the agreement and the NCP owes a debt of more than six months' worth of child support payments, DCS may resume certification action with no further notice to the NCP.

(5) In proposing or approving a payment agreement, DCS must take into account:

(a) The amount of the arrearages.

(b) The amount of the current support order.

(d) The needs of all children who rely on the NCP for support.

(e) Any documented factors which make the NCP eligible for a monthly arrears payment less than the amount suggested in the table in subsection (8) of this section, including but not limited to:

(i) Special needs children; or

(ii) Uninsured health care expenses.

(f) Any documented factors which make the NCP eligible for an arrears payment higher than the amount suggested in the table in subsection (8) of this section, including but not limited to the factors listed in RCW 26.19.075 for deviation from the standard calculation for child support obligations.

(g) If the NCP does not supply sufficient financial information and documentation to allow DCS to analyze and document the NCP's current financial situation and requirements, DCS may not be able to tailor a payment plan to the individual circumstances of the NCP.

(6) The payment agreement must require timely payments of current support and on the arrears, but may in appropriate circumstances:

(a) Provide for the payment of less than the current monthly support obligation for a reasonable time without requiring any payment on the arrears; and

(b) Provide for the payment of current support only for a reasonable time without requiring any payment on the arrears; and

(c) Require a reasonable payment schedule on the arrears once the NCP is paying the entire current monthly support obligation.

(7) The payment agreement may, in appropriate cases, require the NCP to engage in employment-enhancing activities to attain a satisfactory payment level. These employment-enhancing activities must be tailored to the individual circumstances of the NCP.

(8)(a) A reasonable monthly arrears payment is defined as a percentage of the NCP's "adjusted net income," which is the NCP's net monthly income minus any current support obligation. Documented factors as specified in subsection (4) of this section may be the basis for adjustments to the amounts on this table in order to develop a payment agreement which is tailored to the individual financial circumstances of the NCP.

(b) The following table sets forth the suggested monthly payments on arrears:

| Monthly adjusted net income (ANI) | Monthly arrears payment = Percentage of ANI | | --- | --- | | $1,000 or less | 2% | | $1,001 to $1,200 | 3% | | $1,201 to $1,500 | 4% | | $1,501 to $1,900 | 5% | | $1,901 to $2,400 | 6% | | $2,401 to $3,000 | 7% | | $3,001 or more | 8% |

| (a) Monthly net income | = | $1,500 | | --- | --- | --- | | Current support | = | $300 | | Adjusted net income (ANI) | = | $1,200 | | Arrears payment = 3% of ANI | = | $36 | | (b) Monthly net income | = | $3,100 | | Current support | = | $-0- | | Adjusted net income (ANI) | = | $3,100 | | Arrears payment = 8% of ANI | = | $248 |

(9) If the NCP and DCS are unable to agree to a payment plan, DCS schedules the matter for an administrative hearing.

(10) If the NCP fails to make payments under the terms of the agreement, DCS may resume certification action with no further notice to the NCP.

History

Statutory Authority: 2009 c 408, RCW 34.05.060, 43.20A.550, 74.04.055, 74.04.057, 74.20A.310, 74.20A.320(10), and 74.20A.350(14). WSR 10-03-029, § 388-14A-4520, filed 1/12/10, effective 2/12/10. Statutory Authority: RCW 74.20A.320. WSR 03-18-114, § 388-14A-4520, filed 9/2/03, effective 10/15/03. Statutory Authority: RCW 74.08.090, 74.20A.320. WSR 01-03-089, § 388-14A-4520, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-550.

Wash. Admin. Code § 388-14A-4525 How to obtain a release of certification for noncompliance.

WAC 388-14A-4525

(1) After the division of child support (DCS) has certified a noncustodial parent (NCP) to a licensing entity for noncompliance, the NCP may obtain a release from DCS if one of the following occurs:

(a) NCP pays the support debt in full, in which case DCS withdraws the notice of noncompliance;

(b) NCP enters into a payment agreement under WAC 388-14A-4520;

(i) Temporary assistance for needy families;

(ii) Aged, blind, or disabled cash assistance;

(iii) Housing and essential needs;

(iv) Pregnant women's assistance; or

(v) Supplemental security income;

(d) DCS confirms that the NCP is currently incarcerated at a state or federal correctional facility;

(e) The prosecuting attorney determines that the NCP is substantially complying with a contempt repayment agreement and recommends release;

(f) DCS receives any type of recurring payment, including but not limited to:

(i) Employer payments;

(ii) Unemployment compensation;

(iii) Labor and industries benefits;

(iv) Social security benefits;

(v) Retirement account garnishments;

(g) DCS believes that release of the certification for noncompliance will facilitate the NCP seeking employment, modification of the child support order, or compliance with the current order;

(h) DCS certified the NCP because the NCP failed to make a timely objection to the notice of noncompliance and:

(i) The NCP filed a late request for hearing; and

(ii) The final administrative order entered under WAC 388-14A-4530 contains a finding that the NCP made a good faith effort to comply with the order and establishes a payment schedule.

(2) If the NCP and DCS are unable to reach a payment agreement that would lead to release of the certification, the NCP may request a conference board under WAC 388-14A-6400.

(3) By signing a payment agreement with DCS, the NCP waives the administrative hearing right associated with any notice of noncompliance under WAC 388-14A-4505 that was served before the agreement was signed.

(4) DCS retains the right to reinstate the suspension action if the NCP meets the conditions of reinstatement but:

(a) Fails to follow through in a timely fashion with any verbal or written agreement made with DCS; or

(b) Fails to comply with the payment schedule contained in an administrative order entered under WAC 388-14A-4530.

(5) DCS may reinstate the suspension action at any time after releasing the certification, as long as the NCP's case still meets qualifications for certification.

(6) Unless the NCP pays the support debt in full, DCS is not required to withdraw the notice of noncompliance.

(7) DCS must provide a copy of the release to any licensing entity to which DCS has certified the NCP.

(8) The NCP must comply with any requirements of the licensing entity to get the license reinstated or reissued.

History

Statutory Authority: RCW 26.18.170, 26.23.035, 26.23.110, 43.20A.550, 74.04.055, 74.08.090, 74.20.040, 74.20A.310, and 74.20A.328. WSR 26-14-086, s 388-14A-4525, filed 6/29/26, effective 7/30/26. Statutory Authority: 2009 c 408, RCW 34.05.060, 43.20A.550, 74.04.055, 74.04.057, 74.20A.310, 74.20A.320(10), and 74.20A.350(14). WSR 10-03-029, § 388-14A-4525, filed 1/12/10, effective 2/12/10. Statutory Authority: RCW 74.20A.320. WSR 03-18-114, § 388-14A-4525, filed 9/2/03, effective 10/15/03. Statutory Authority: RCW 74.08.090, 74.20A.320. WSR 01-03-089, § 388-14A-4525, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-560.

Wash. Admin. Code § 388-14A-4527 How does a noncustodial parent request an administrative hearing regarding license suspension?

(1) After service of a notice of noncompliance and intent to suspend licenses under WAC 388-14A-4505, the noncustodial parent (NCP) may request an administrative hearing, also known as an adjudicative proceeding, under chapter 34.05 RCW.

(a) Any objection to the notice of noncompliance is considered to be a request for hearing, no matter how the objection is phrased.

(b) An objection that does not lead to the signing of a payment agreement under WAC 388-14A-4520 is considered to be a request for hearing on the notice.

(c) Even if the NCP specifically makes a request for hearing, the division of child support (DCS) always attempts to negotiate a payment agreement under WAC 388-14A-4520.

(2) A hearing request may be made in writing or orally, and may be made in person or by phone.

(3) A timely request for hearing must be received by DCS within twenty days of service of the notice of noncompliance, or within sixty days if the notice was served outside of the state of Washington.

(4) The effective date of a written request for hearing is the day the request is received by DCS. A written request for hearing must include:

(a) The NCP's current mailing address; and

(b) The NCP's daytime phone number, if available.

(5) The NCP may make an oral request for hearing under WAC 388-14A-6100:

(a) The request must contain sufficient information for DCS to identify the NCP, the DCS action objected to, and the case or cases involved in the hearing request.

(b) The effective date of an oral request for hearing is the date that the NCP makes a complete oral request for hearing, to any DCS representative in person or by leaving a message on the automated voice mail system of any DCS field office.

(6) If the NCP makes a timely request for hearing, DCS stays (delays) the certification process until a final administrative order is entered.

(7) If the NCP makes a late request for hearing after DCS has already certified the NCP to a licensing agency based on NCP's failure to make a timely objection to the notice of noncompliance and the licensing agency has suspended the NCP's license, DCS schedules the matter for hearing with the office of administrative hearings, as provided in WAC 388-14A-4535.

(8) If DCS certified the NCP to a licensing agency based on NCP's failure to comply with a payment agreement or a payment schedule established by a final administrative order, the NCP does not have any additional hearing right on the original notice of noncompliance.

(a) If the NCP previously signed a payment agreement, the NCP waived the administrative hearing right associated with any notice of noncompliance which was served before the agreement was signed.

(b) If the NCP failed to comply with a payment schedule established by a final administrative order, the NCP has already exercised the hearing right associated with the underlying notice of noncompliance.

(c) The NCP may attempt to negotiate a payment agreement with DCS, and may request a conference board if negotiations are not successful, as provided in subsections (2) and (3) of WAC 388-14A-4525.

History

Statutory Authority: 2009 c 408, RCW 34.05.060, 43.20A.550, 74.04.055, 74.04.057, 74.20A.310, 74.20A.320(10), and 74.20A.350(14). WSR 10-03-029, § 388-14A-4527, filed 1/12/10, effective 2/12/10.

Wash. Admin. Code § 388-14A-4530 What can happen at an administrative hearing regarding license suspension?

WAC 388-14A-4530

(1) An administrative hearing on a notice of noncompliance under WAC 388-14A-4505 is limited to the following issues:

(a) Whether the person named in the child support order is the noncustodial parent (NCP);

(b) Whether the NCP is required to pay child support under a child support order;

(d) Whether the NCP has made a good faith effort to comply with the order.

(2) When determining whether the NCP has made a good faith effort to comply with the order, the administrative law judge (ALJ) must consider whether the NCP:

(a) Kept DCS informed of any changes in address or employment;

(b) Provided employer information when employed so that DCS could institute income withholding;

(c) Paid at least one month's worth of current support by voluntary payment during a period when the NCP was not employed; or

(d) Can show any other relevant fact-based factors on which the ALJ may base a finding of good faith.

(3) If the ALJ finds that the NCP is not in compliance with the support order but has made a good faith effort to comply, the ALJ must formulate a payment schedule after considering:

(a) The amount of the arrearages owed;

(b) The amount of the current support order;

(d) The needs of all children who rely on the NCP for support.

(4) The ALJ must:

(a) Consider the individual financial circumstances of the NCP in evaluating the parent's ability to pay; and

(b) Establish a fair and reasonable payment schedule tailored to the NCP's individual circumstances.

(5) The payment schedule may:

(a) Include a graduated payment plan as described in WAC 388-14A-4520(8);

(b) Require the NCP to engage in employment-enhancing activities in order to attain a satisfactory payment level; and

(6) Unless the NCP shows an ability to pay immediately, the payment schedule is not required to include a lump sum payment for the amount of the arrears.

(7) The administrative order must contain a provision stating that:

(a) If the NCP does not comply with the payment schedule, DCS may proceed with the certification process with no further notice to the NCP;

(b) The payment schedule is for the limited purpose of avoiding license suspension; and

(c) DCS's authority to collect any and all amounts authorized under chapters 26.18, 26.23, 74.20, and 74.20A RCW is not affected by the payment schedule.

(8) The administrative law judge (ALJ) is not required to calculate the outstanding support debt beyond determining whether the NCP is at least six months in arrears. Any debt calculation shall not be binding on the department or the NCP beyond the determination that there is at least six months of arrears.

(9) If the NCP requests a hearing on the notice of noncompliance under the circumstances spelled out in WAC 388-14A-4510 (1)(a) or (b), DCS asks the office of administrative hearings to schedule a hearing. If the hearing results in a finding that the NCP is not in compliance with the order, or that DCS is authorized to certify the NCP, DCS stays the certification process until 30 days after the NCP:

(a) Is released from jail or prison; or

(b) Stops receiving cash public assistance.

History

Statutory Authority: RCW 26.18.170, 26.23.035, 26.23.110, 43.20A.550, 74.04.055, 74.08.090, 74.20.040, 74.20A.310, and 74.20A.328. WSR 26-14-086, s 388-14A-4530, filed 6/29/26, effective 7/30/26. Statutory Authority: 2009 c 408, RCW 34.05.060, 43.20A.550, 74.04.055, 74.04.057, 74.20A.310, 74.20A.320(10), and 74.20A.350(14). WSR 10-03-029, § 388-14A-4530, filed 1/12/10, effective 2/12/10. Statutory Authority: RCW 74.20A.320. WSR 03-18-114, § 388-14A-4530, filed 9/2/03, effective 10/15/03. Statutory Authority: RCW 74.08.090, 74.20A.320. WSR 01-03-089, § 388-14A-4530, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-570.

Wash. Admin. Code § 388-14A-4535 Can the noncustodial parent file a late request for hearing if a license has already been suspended?

(1) The noncustodial parent (NCP) may file a late request for hearing if the division of child support (DCS) has certified the noncustodial parent (NCP) because of the NCP's failure to object to the notice of noncompliance as provided in WAC 388-14A-4512(1), even if the department of licensing (DOL) or other licensing entity has suspended the NCP's license.

(2) When an NCP files a late request for hearing, DCS does not release the certification until:

(a) The NCP pays the support debt in full;

(b) DCS and the NCP sign a payment agreement under WAC 388-14A-4520;

(c) There is a final administrative order entered establishing a payment schedule because the NCP made a good faith effort to comply with the order; or

(d) There is a final administrative order entered determining that the NCP did not owe more than six months worth of support and that license suspension was not appropriate at the time of the certification.

(3) If the late request for hearing is filed within one year of the date the notice was served, DCS schedules the matter for administrative hearing under WAC 388-14A-4530.

(4) If the late request for hearing is filed more than one year after the date the notice was served, DCS schedules the matter for administrative hearing under WAC 388-14A-4530. At the hearing:

(a) The NCP must show good cause for the late request for hearing.

(b) The administrative law judge (ALJ) must find that the NCP has made a showing of good cause before granting relief in an administrative order.

(5) DCS and the NCP may negotiate and sign a payment agreement under WAC 388-14A-4520 at any time during this process.

(6) If DCS certified the NCP to a licensing agency based on NCP's failure to comply with a payment agreement or a payment schedule established by a final administrative order, the NCP does not have any additional hearing right on the original notice of noncompliance.

(a) If the NCP previously signed a payment agreement, the NCP waived the administrative hearing right associated with any notice of noncompliance which was served before the agreement was signed. See WAC 388-14A-4525(3).

History

Statutory Authority: 2009 c 408, RCW 34.05.060, 43.20A.550, 74.04.055, 74.04.057, 74.20A.310, 74.20A.320(10), and 74.20A.350(14). WSR 10-03-029, § 388-14A-4535, filed 1/12/10, effective 2/12/10.

Wash. Admin. Code § 388-14A-4540 When is a DCS conference board available regarding license suspension issues?

(1) A noncustodial parent (NCP) may request a conference board under WAC 388-14A-6400 to resolve any complaints and problems concerning a division of child support (DCS) case.

(2) If the NCP and DCS are not successful in negotiating a payment agreement to avoid license suspension or to get a license reinstated, NCP may request a conference board at any time.

(a) A conference board is not available to the NCP regarding negotiations that occur immediately after the service of a notice of noncompliance under WAC 388-14A-4505.

(b) During that time period, the NCP has a right to an administrative hearing on the notice, and if the NCP is not able to negotiate a payment agreement, the appropriate remedy is an administrative hearing under WAC 388-14A-4530.

History

Statutory Authority: 2009 c 408, RCW 34.05.060, 43.20A.550, 74.04.055, 74.04.057, 74.20A.310, 74.20A.320(10), and 74.20A.350(14). WSR 10-03-029, § 388-14A-4540, filed 1/12/10, effective 2/12/10.

Wash. Admin. Code § 388-14A-4630 Employers must report certain bonuses or other lump sum payments to the division of child support.

(1) Under chapter 26.23 RCW, employers must report lump sum payments over $500 for employees subject to an income withholding for unpaid child support debt.

(2) The employer provides notice of the lump sum payment by reporting to:

(a) The electronic employer services portal provided by the federal office of child support services;

(b) The special collections unit at the division of child support (DCS); or

(3) Upon notice of a lump sum payment, DCS will respond to the employer within 14 calendar days by sending either:

(a) A written release of all or part of the payment which may be disbursed to the employee; or

(b) A revised supplemental income withholding order or other request specifying the remittance to DCS.

(4) Failure to provide timely notice of a lump sum payment as required may constitute noncompliance under RCW 74.20A.350.

(5) Employers may report lump sum payments in an amount of $500 or less to DCS.

(6) DCS and employers may establish a reporting process or agreement that meets or exceeds the lump sum payment reporting requirements under chapter 26.23 RCW.

History

Statutory Authority: RCW 26.23.050, 74.20.040, and 74.20A.310. WSR 25-17-054, s 388-14A-4630, filed 8/14/25, effective 9/14/25.

Wash. Admin. Code § 388-14A-4700 How do I ask the division of child support to prorate a child support obligation?

(1) As a general rule, if support is owed for any day of a given month, the entire monthly support obligation is owed for that month.

(2) Either party to a support order may request that the division of child support (DCS) prorate the monthly obligation under a child support order. The request must state the reason why the party is requesting proration of the monthly obligation.

(3) This request may be made in writing or orally, in person or by phone.

(4) DCS' response may be made in writing or orally, in person or by phone.

(5) This rule and WAC 388-14A-4705 through 388-14A-4715 apply only to the enforcement of a support obligation, not to the establishment of an obligation.

History

Statutory Authority: RCW 34.05.330, 26.21.016, 26.23.030, 74.08.090, and 74.20.040. WSR 06-06-077, § 388-14A-4700, filed 2/28/06, effective 3/31/06.

Wash. Admin. Code § 388-14A-4705 When does the division of child support prorate a monthly support obligation?

The division of child support (DCS) may prorate a monthly support obligation under the following circumstances:

(1) An order is entered terminating the noncustodial parent's (NCP's) support obligation and the order specifies that the NCP's obligation should be prorated;

(2) A superior or tribal court order is entered requiring that support for a given month be prorated; or

(3) When a conference board convened under WAC 388-14A-6400 decides that support for a given month should be prorated.

History

Statutory Authority: RCW 34.05.330, 26.21.016, 26.23.030, 74.08.090, and 74.20.040. WSR 06-06-077, § 388-14A-4705, filed 2/28/06, effective 3/31/06.

Wash. Admin. Code § 388-14A-4710 When does the division of child support not prorate a monthly support obligation?

(1) Unless a case fits the criteria outlined in WAC 388-14A-4705, the division of child support (DCS) does not prorate a monthly support obligation.

(2) When a support order provides that the noncustodial parent's support obligation for a particular child terminates as of the child's birthday or graduation date, the entire monthly support obligation is owed, no matter what day of the month the birthday or graduation falls on.

(3) If a conference board convened under WAC 388-14A-6400 decides that support for a given month should not be prorated, DCS does not prorate for that month.

History

Statutory Authority: RCW 34.05.330, 26.21.016, 26.23.030, 74.08.090, and 74.20.040. WSR 06-06-077, § 388-14A-4710, filed 2/28/06, effective 3/31/06.

Wash. Admin. Code § 388-14A-4715 What can I do if I don't agree with DCS' decision on whether or not to prorate support?

(1) If the noncustodial parent (NCP) or custodial parent (CP) asks the division of child support (DCS) to prorate support, DCS advises the parties of its decision whether to prorate or not to prorate support for a given month.

(2) If the NCP or the CP disagrees with DCS' decision, the aggrieved party may request a conference board under WAC 388-14A-6400.

(3) Either the NCP or the CP may proceed in superior court to seek an order stating whether support should be prorated.

History

Statutory Authority: RCW 34.05.330, 26.21.016, 26.23.030, 74.08.090, and 74.20.040. WSR 06-06-077, § 388-14A-4715, filed 2/28/06, effective 3/31/06.

Wash. Admin. Code § 388-14A-4800 When does a child support order contain an undifferentiated amount of child support?

(1) RCW 26.23.050 (5)(d) provides that every child support order must state the monthly child support obligation as a sum certain amount, but does not require that the support obligation be stated in a "per month per child" amount when more than one child is covered by the order.

(2) A support order which provides a monthly amount of child support for two or more children, but does not provide a specific support obligation for each child, may be a differentiated support order or an undifferentiated support order.

(a) To determine whether a support order is differentiated or undifferentiated, the division of child support (DCS) reviews the information contained in the support order, and, if necessary to interpret the intent of the order, may consider the worksheets associated with the order.

(b) When the order may justifiably be divided into per child amounts for each child, the division of child support (DCS) calls it a "differentiated support order."

(c) When the order does not contain enough information in either the order or the worksheets to justify dividing the monthly amount into per child amounts for each child, DCS calls it an "undifferentiated support order."

(d) The support amounts set by these orders are called either "differentiated support amounts" or "undifferentiated support amounts," respectively.

(3) When DCS is calculating a support obligation for more than one child in an administrative support obligation notice, DCS may set the monthly support obligation as an undifferentiated amount for the reasons listed in WAC 388-14A-3200(4).

(4) When DCS is enforcing a support order, WAC 388-14A-4810 through 388-14A-4830 address how DCS:

(a) Determines whether a support order which does not state a per month per child amount may justifiably be divided into a per child amount for each child covered by the support order; and

(b) Deals with a support order which does not contain enough information in either the order or the worksheets associated with the order to justify dividing the monthly amount into "per child" amounts for each child covered by the support order.

History

Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-4800, filed 5/19/11, effective 6/19/11.

Wash. Admin. Code § 388-14A-4810 How does DCS determine if a support order contains a differentiated or undifferentiated amount of support?

(1) When a child support order does not contain a per month per child amount, the division of child support (DCS) reviews the support order and other documents filed with the order in order to determine the amount of support due for each child. "Other documents" may include but are not limited to:

(a) The child support schedule worksheets which RCW 26.19.035(4) requires to be attached to or filed with the support order;

(b) Any residential schedule or parenting plan filed in the case where the support order was entered;

(d) Any other documents signed or approved by the tribunal which entered the child support order.

(2) DCS may consider the support amounts to be differentiated and determine a per-child amount to be paid by the noncustodial parent (NCP) if:

(a) The order or documents filed with the order reflect a per-child calculation and indicate the court intended to enter a per-child order, unless:

(i) There are expenses included in Part III of the child support schedule worksheet; or

(ii) The self-support reserve was applied, resulting in a monthly support obligation which is higher than the presumptive minimum support obligation; or

(iii) The forty-five percent limitation was applied in calculating the monthly support obligation; or

(iv) A deviation was granted because of children from other relationships; and

(b) The NCP's proportional share of all the per-child amounts equals the whole transfer payment amount.

(3) If DCS can determine a per-child amount of support, DCS determines the NCP's differentiated transfer payment by applying the NCP's proportional share of income (line six on the worksheet) to the basic support obligation for each child (line five on the worksheet). Example. Assume the support order states that NCP's transfer payment for three children is four hundred twenty dollars, but the order does not provide per-child support amounts. However, line six of the worksheet shows that the NCP's proportional share of income is .6 or sixty percent, and line five shows a basic support obligation of three hundred dollars for child number one, two hundred dollars for child number two and two hundred dollars for child number three. DCS can determine the NCP's support obligation to be one hundred eighty dollars (.6 x three hundred dollars) for child number one, and one hundred twenty dollars (.6 x two hundred dollars) each for child number two and child number three.

(4) When the NCP's support obligation for one or more, but not all, of the children covered by an undifferentiated support order is terminated for any reason, DCS determines whether the amount to be enforced for NCP's monthly support obligation under the order should change:

(a) If DCS is able to determine a per-month amount for each child, DCS may reduce the amount of the NCP's monthly obligation to be enforced by the per-month amount for each child who is no longer covered by the order.

(b) If DCS is unable to determine a per-month amount for each child, DCS continues to enforce the undifferentiated amount of support until there is no longer any child covered by the support order.

History

Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-4810, filed 5/19/11, effective 6/19/11.

Wash. Admin. Code § 388-14A-4820 What can I do if I don't agree with DCS' decision on whether my support order contains a differentiated or undifferentiated amount of support?

(1) If the noncustodial parent (NCP) or custodial parent (CP) claim that the NCP's support obligation for one or more, but not all, of the children covered by an undifferentiated support order is terminated for any reason, either party may ask the division of child support (DCS) to determine whether to adjust the amount enforced as the NCP's monthly support obligation.

(2) DCS reviews the order as provided in WAC 388-14A-4810 and then advises the parties of its decision.

(3) If either the NCP or the CP disagrees with DCS' interpretation of the order, the aggrieved party may request a conference board under WAC 388-14A-6400.

(4) Either the NCP or the CP may proceed in superior court to seek:

(a) An order clarifying the NCP's monthly support obligation;

(b) An order modifying the support order; or

History

Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-4820, filed 5/19/11, effective 6/19/11.

Wash. Admin. Code § 388-14A-4830 How does DCS divide support obligations between two or more cases when a support order does not contain a differentiated amount of support?

(1) If two or more children covered by the same child support order change residences so that more than one custodial parent (CP) is eligible to receive child support paid by the noncustodial parent (NCP):

(a) As long as the NCP's support obligation for all of the children has not been terminated, the NCP continues to owe the total amount of child support stated in the support order;

(b) The division of child support (DCS) allocates the NCP's support obligation between the various cases based on which children reside with each CP.

(2) To allocate the child support amounts between cases, DCS determines whether the support order states a per-child amount for each child covered by the order. If the support order contains an undifferentiated amount of support, DCS reviews the order under WAC 388-14A-4810.

(3) If DCS determines a per-child amount for each child, DCS allocates the per-child amounts to the appropriate cases.

(4) If DCS is unable to determine a per-child amount for each child because the order is undifferentiated, DCS divides the NCP's total monthly support obligation by the number of children and allocates each child's fractional share of the total support obligation to that child's case.

(a) DCS divides the undifferentiated support amount for administrative efficiency, and so that support can be disbursed to each CP.

(b) The fact that DCS allocates fractional shares between cases does not convert the undifferentiated order into a differentiated order.

(5) If either the NCP or the CP disagrees with DCS' decision, the aggrieved party may request a conference board under WAC 388-14A-6400.

(6) Either the NCP or one or more CPs may proceed in superior court to seek:

(a) An order clarifying the NCP's monthly support obligation;

(b) An order modifying the support order; or

History

Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-4830, filed 5/19/11, effective 6/19/11.

Wash. Admin. Code § 388-14A-4900 Insurers must report claim information to the division of child support and withhold payments if directed.

(1) Insurers must report certain insurance claims to the division of child support (DCS). Within 10 days after opening a tort liability claim for bodily injury or wrongful death, a workers' compensation claim, or a claim under a policy of life insurance, including an annuity, the insurer must report sufficient information to DCS to enable it to verify whether the claimant or other beneficiary owes child support. A claim is deemed opened when an insurer has sufficient information to:

(a) Identify the claimant;

(b) Determine that the claimant is entitled to payment of the insurance claim proceeds; and

(c) Make such payment. In the case of a claim that will be paid through periodic payments, the insurer must only report the claim before issuing the initial payment.

(2) Insurers can report information:

(a) To the federal office of child support services (OCSS) or the child support lien network (CSLN);

(b) Through an insurance claim data collection organization, which submits the required information to OCSS, CSLN, or the DCS special collections unit within the timeframes and in the manner required by law; or

(c) Directly to the DCS special collections unit, in writing or electronically, if the insurer does not have the capability to report through the above methods.

(3) The information reporting requirements are satisfied so long as the insurer provides minimum identifying information.

(a) OCSS and CSLN maintain their own standards for minimum identifying information.

(b) For the purposes of reporting directly to the DCS special collections unit, minimum identifying information about the claim includes:

(i) The claimant's full name and date of birth;

(ii) The claimant's current physical address;

(iii) The claimant's Social Security number, if full name, date of birth, and current physical address are not sufficient for DCS to identify the individual;

(iv) The insurer's name;

(v) The insurer's claims department address for lien receipt;

(vi) The insurer's claim number in the proper format for identification of the claim;

(vii) The insurer's claim date of loss;

(viii) The adjustor's name;

(ix) The adjustor's telephone number;

(x) The adjustor's email address; and

(xi) The insurer's fax number for receiving lien notices, if one exists.

(4) Upon receipt of claims information, DCS will determine whether a child support debt exists. If so, DCS will issue a notice to the insurer to withhold payment and remit to DCS. An insurer is not required to remit payment to DCS if the notice issued is received after the insurer has disbursed payment on the claim.

(5) DCS will give any lien, claim, or demand for reasonable claim-related attorneys' fees, property damage, and medical costs priority over any withholding of payment. These costs must be final costs after all reductions have been pursued with interested parties.

History

Statutory Authority: RCW 26.23.037, 26.23.110, 74.08.090, and 74.20A.055. WSR 24-16-134, § 388-14A-4900, filed 8/6/24, effective 9/6/24
WSR 21-24-077, § 388-14A-4900, filed 11/30/21, effective 12/31/21.

Wash. Admin. Code § 388-14A-5000 What is the difference between distribution and disbursement of child support collections?

(1) Distribution of child support collections refers to how the division of child support (DCS) applies or allocates collections within a child support case or between child support cases.

(2) Disbursement of child support collections refers to DCS sending out or paying support collections to the appropriate recipient.

(3) WAC 388-14A-5001 through 388-14A-5015 explain how DCS distributes and disburses child support collections.

History

Statutory Authority: RCW 26.18.170, 26.23.035, 26.23.050, [26.23.]110, 74.20.040, 74.20A.030, [74.20A.]055, [74.20A.]056, and 74.20A.310. WSR 09-02-059, § 388-14A-5000, filed 1/5/09, effective 1/27/09. Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-5000, filed 5/29/08, effective 7/1/08. Statutory Authority: RCW 26.23.035, 74.08.090, 74.20A.310, and 45 C.F.R. 303.72 (h)(5). WSR 05-06-014, § 388-14A-5000, filed 2/22/05, effective 3/25/05. Statutory Authority: RCW 74.08.090, 34.05.310 (4)(d), 26.23.035, 74.20A.057, 74.20A.310. WSR 03-20-072, § 388-14A-5000, filed 9/29/03, effective 10/30/03. Statutory Authority: RCW 74.08.090, 26.23.035, 74.20A.057, 74.20A.310. WSR 01-03-089, § 388-14A-5000, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-250, 388-14-270, and 388-14-273.

Wash. Admin. Code § 388-14A-5001 What procedures does DCS follow to distribute support collections?

(1) When distributing support collections, the division of child support (DCS) records collections in exact amounts of dollars and cents.

(2) DCS distributes support collections within two days of the date DCS receives the collection, unless DCS is unable to distribute the collection for one or more of the following reasons:

(a) DCS is unable to locate the payee and the payee has not signed up for electronic funds transfer (EFT) of disbursements;

(b) DCS does not have sufficient information to identify the accounts against which or to which it should distribute the money;

(c) An action is pending before a court or agency which has jurisdiction over the issue to determine whether child support is owed or how DCS should distribute the collection;

(d) DCS receives prepaid child support and is holding it for distribution in future months under WAC 388-14A-5008;

(e) DCS mails a notice of intent to distribute support money under WAC 388-14A-5050;

(f) DCS receives federal tax refund offset collections, which are distributed according to WAC 388-14A-5005 and 388-14A-5010;

(g) DCS may hold funds and not issue a check to the family for amounts under one dollar. DCS must give credit for the collection, but may delay disbursement of that amount until a future collection is received which increases the amount of the disbursement to the family to at least one dollar. If no future collections are received which increase the disbursement to the family to at least one dollar, DCS transfers the amount to the department of revenue under RCW 63.30.040. This subsection does not apply to disbursements which can be made by EFT; or

(h) Other circumstances exist which make a proper and timely distribution of the collection impossible through no fault or lack of diligence of DCS.

(3) DCS distributes support collections based on the date DCS receives the collection, except as provided under WAC 388-14A-5005. DCS distributes support collections based on the date of collection. DCS considers the date of collection to be the date that DCS receives the support collection, no matter when the money was withheld from the noncustodial parent (NCP).

(4) Under state and federal law, the division of child support (DCS) disburses support collections to the:

(a) Department when the department provides or has provided public assistance payments for the support of the family;

(b) Payee under the order, or to the custodial parent (CP) of the child according to WAC 388-14A-5050;

(c) Child support enforcement agency in another state or foreign country which submitted a request for support enforcement services;

(d) Indian tribe which has a TANF program, child support program, or a cooperative agreement regarding the delivery of child support services;

(e) Persons or entity making the payment when DCS is unable to identify the person to whom the support is payable after making reasonable efforts to obtain identification information.

(5) If DCS is unable to disburse a support collection because the location of the family or person is unknown, it must exercise reasonable efforts to locate the family or person. When the family or person cannot be located, DCS handles the collection in accordance with chapter 63.30 RCW, the Revised Uniform Unclaimed Property Act.

(6) WAC 388-14A-5000 through 388-14A-5015 contain the rules for the distribution of support collections by DCS.

(7) DCS changes the distribution rules based on changes in federal statutes and regulations. DCS may also change the distribution rules based on the state budget, but only to the extent allowed by federal law.

History

Statutory Authority: RCW 26.23.035 and 34.05.353 (1)(c). WSR 24-12-035, § 388-14A-5001, filed 5/30/24, effective 6/30/24. Statutory Authority: RCW 26.23.035 and 34.05.350 (1)(c). WSR 11-06-042, § 388-14A-5001, filed 2/28/11, effective 3/31/11. Statutory Authority: RCW 26.18.170, 26.23.035, 26.23.050, [26.23.]110, 74.20.040, 74.20A.030, [74.20A.]055, [74.20A.]056, and 74.20A.310. WSR 09-02-059, § 388-14A-5001, filed 1/5/09, effective 1/27/09. Statutory Authority: RCW 26.23.035, 74.08.090, 74.20A.310, and 45 C.F.R. 303.72 (h)(5). WSR 05-06-014, § 388-14A-5001, filed 2/22/05, effective 3/25/05. Statutory Authority: RCW 26.23.035, 74.08.090, 74.20A.188, 74.20A.310, 42 U.S.C. 666(a)14. WSR 01-24-078, § 388-14A-5001, filed 12/3/01, effective 1/3/02. Statutory Authority: RCW 74.08.090, 26.23.035, 74.20A.057, 74.20A.310. WSR 01-03-089, § 388-14A-5001, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-270 and 388-14-273.

Wash. Admin. Code § 388-14A-5002 How does DCS distribute support collections in a nonassistance case?

(1) A nonassistance case is one where the family has never received a cash public assistance grant.

(2) Subject to the exceptions provided under WAC 388-14A-5005, the division of child support (DCS) applies support collections within each Title IV-D nonassistance case:

(a) First, to satisfy the current support obligation for the month DCS received the collection;

(b) Second, to the noncustodial parent's support debts owed to the family;

(3) DCS uses the fee retained under WAC 388-14A-2200 to offset the fee amount charged by the federal government for IV-D cases that meet the fee criteria in WAC 388-14A-2200(1).

History

Statutory Authority: RCW 26.23.035 and 34.05.350 (1)(c). WSR 11-06-042, § 388-14A-5002, filed 2/28/11, effective 3/31/11. Statutory Authority: RCW 26.18.170, 26.23.035, 26.23.050, [26.23.]110, 74.20.040, 74.20A.030, [74.20A.]055, [74.20A.]056, and 74.20A.310. WSR 09-02-059, § 388-14A-5002, filed 1/5/09, effective 1/27/09. Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-5002, filed 5/29/08, effective 7/1/08. Statutory Authority: RCW 74.08.090, 26.23.035, 74.20A.057, 74.20A.310. WSR 01-03-089, § 388-14A-5002, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-270.

Wash. Admin. Code § 388-14A-5003 How does DCS distribute support collections in an assistance case?

(1) An assistance case is one where the family is currently receiving a TANF grant.

(2) Subject to the exceptions provided under WAC 388-14A-5005, the division of child support (DCS) distributes support collections within each Title IV-D assistance case:

(a) First, to satisfy the current support obligation for the month DCS received the collection;

(b) Second, to satisfy support debts which are permanently assigned to the department to reimburse the cumulative amount of assistance which has been paid to the family;

(i) To satisfy support debts which are temporarily assigned to the department to reimburse the cumulative amount of assistance paid to the family; or

(ii) To satisfy support debts which are conditionally assigned to the department. Support collections distributed to conditionally assigned arrears are disbursed according to WAC 388-14A-2039.

(d) Fourth, to satisfy support debts owed to the family;

(e) Fifth, to prepaid support as provided for under WAC 388-14A-5008.

History

Statutory Authority: RCW 26.23.035 and 34.05.350 (1)(c). WSR 11-06-042, § 388-14A-5003, filed 2/28/11, effective 3/31/11. Statutory Authority: RCW 26.18.170, 26.23.035, 26.23.050, [26.23.]110, 74.20.040, 74.20A.030, [74.20A.]055, [74.20A.]056, and 74.20A.310. WSR 09-02-059, § 388-14A-5003, filed 1/5/09, effective 1/27/09. Statutory Authority: RCW 26.23.035, 74.08.090, 74.20A.188, 74.20A.310, 42 U.S.C. 666(a)14. WSR 01-24-078, § 388-14A-5003, filed 12/3/01, effective 1/3/02. Statutory Authority: RCW 74.08.090, 26.23.035, 74.20A.057, 74.20A.310. WSR 01-03-089, § 388-14A-5003, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-270.

Wash. Admin. Code § 388-14A-5004 How does DCS distribute support collections in a former assistance case?

(1) A former assistance case is one where the family is not currently receiving a TANF grant, but has at some time in the past.

(2) Subject to the exceptions provided under WAC 388-14A-5005, the division of child support (DCS) distributes support collections within each Title IV-D former-assistance case:

(a) First, to satisfy the current support obligation for the month DCS received the collection;

(b) Second, to satisfy support debts owed to the family;

(c) Third, to satisfy support debts which are conditionally or temporarily assigned to the department. These collections are disbursed according to WAC 388-14A-2039;

(d) Fourth, to satisfy support debts which are permanently assigned to the department to reimburse the cumulative amount of assistance which has been paid to the family; and

(e) Fifth, to prepaid support as provided for under WAC 388-14A-5008.

History

Statutory Authority: RCW 26.23.035 and 34.05.350 (1)(c). WSR 11-06-042, § 388-14A-5004, filed 2/28/11, effective 3/31/11. Statutory Authority: RCW 26.18.170, 26.23.035, 26.23.050, [26.23.]110, 74.20.040, 74.20A.030, [74.20A.]055, [74.20A.]056, and 74.20A.310. WSR 09-02-059, § 388-14A-5004, filed 1/5/09, effective 1/27/09. Statutory Authority: RCW 74.08.090, 26.23.035, 74.20A.057, 74.20A.310. WSR 01-03-089, § 388-14A-5004, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-270.

Wash. Admin. Code § 388-14A-5005 How does DCS distribute federal tax refund offset collections?

WAC 388-14A-5005

The division of child support (DCS) distributes federal tax refund offset collections in accordance with 42 U.S.C. Sec. 657 and 42 U.S.C. Sec. 654(34), as follows:

(1) DCS distributes federal tax refund offset collections to arrears only, and not to current support.

(2) DCS distributes federal tax refund offset collections within an individual case depending on the type of case to which the collection is distributed:

(a) In a never assistance case, all amounts are distributed to family arrears, meaning those arrears that have never been assigned.

(b) In a former assistance case, all amounts are distributed first to permanently assigned arrears, then to conditionally assigned arrears, then to family arrears.

(c) In a current assistance case, all amounts are distributed first to permanently assigned arrears, then to temporarily assigned arrears, then to conditionally assigned arrears, and then to family arrears.

(3) Federal tax refund offset collections distributed to assigned support are retained by the state to reimburse the cumulative amount of assistance that has been paid to the family.

(4) DCS may distribute federal tax refund offset collections only to certified support debts. DCS must refund any excess to the noncustodial parent (NCP).

(5) DCS may retain the $35 annual fee required under RCW 74.20.040 from federal tax refund offset collections distributed to nonassistance cases.

(6) When the Secretary of the Treasury, through the federal Office of Child Support Enforcement (OCSE), notifies DCS that a collection from a federal tax refund offset is from a tax refund based on a joint return, DCS follows the procedures set forth in WAC 388-14A-5010.

History

Statutory Authority: RCW 26.18.170, 26.23.035, 26.23.110, 43.20A.550, 74.04.055, 74.08.090, 74.20.040, 74.20A.310, and 74.20A.328. WSR 26-14-086, s 388-14A-5005, filed 6/29/26, effective 7/30/26. Statutory Authority: RCW 26.23.035 and 34.05.350 (1)(c). WSR 11-06-042, § 388-14A-5005, filed 2/28/11, effective 3/31/11. Statutory Authority: RCW 26.18.170, 26.23.035, 26.23.050, [26.23.]110, 74.20.040, 74.20A.030, [74.20A.]055, [74.20A.]056, and 74.20A.310. WSR 09-02-059, § 388-14A-5005, filed 1/5/09, effective 1/27/09. Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-5005, filed 5/29/08, effective 7/1/08. Statutory Authority: RCW 26.23.035, 74.08.090, 74.20A.310, and 45 C.F.R. 303.72 (h)(5). WSR 05-06-014, § 388-14A-5005, filed 2/22/05, effective 3/25/05. Statutory Authority: RCW 74.08.090, 26.23.035, 74.20A.057, 74.20A.310. WSR 01-03-089, § 388-14A-5005, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-270.

Wash. Admin. Code § 388-14A-5006 How does DCS distribute support collections when the paying parent has more than one case?

Subject to the exceptions provided under WAC 388-14A-5005, the division of child support (DCS) distributes support collections in the following manner when the noncustodial parent (NCP) has more than one Title IV-D case:

(1) First, to the current support obligation on each Title IV-D case, in proportion to the amount of the current support order on each case; and

(2) Second, to the total of the support debts whether owed to the family or to the department for the reimbursement of public assistance on each Title IV-D case, in proportion to the amount of support debt owed by the NCP on each case; and

(3) Third, within each Title IV-D case according to WAC 388-14A-5002, 388-14A-5003, or 388-14A-5004.

History

Statutory Authority: RCW 26.23.035 and 34.05.350 (1)(c). WSR 11-06-042, § 388-14A-5006, filed 2/28/11, effective 3/31/11. Statutory Authority: RCW 26.18.170, 26.23.035, 26.23.050, [26.23.]110, 74.20.040, 74.20A.030, [74.20A.]055, [74.20A.]056, and 74.20A.310. WSR 09-02-059, § 388-14A-5006, filed 1/5/09, effective 1/27/09. Statutory Authority: RCW 26.23.035, 74.08.090, 74.20A.188, 74.20A.310, 42 U.S.C. 666(a)14. WSR 01-24-078, § 388-14A-5006, filed 12/3/01, effective 1/3/02. Statutory Authority: RCW 74.08.090, 26.23.035, 74.20A.057, 74.20A.310. WSR 01-03-089, § 388-14A-5006, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-270.

Wash. Admin. Code § 388-14A-5007 If the paying parent has more than one case, can DCS apply support money to only one specific case?

(1) The division of child support (DCS) applies amounts to a support debt owed for one family or household and distributes the amounts accordingly, rather than make a proportionate distribution between support debts owed to different families, when:

(a) Proportionate distribution is administratively inefficient; or

(b) The collection resulted from the sale or disposition of a specific piece of property against which a court awarded the custodial parent (CP) a judgment lien for child support;

(c) The collection is the result of a contempt order which provides that DCS must distribute the amounts to a particular case; or

(d) An Indian tribe has designated that funds withheld from a tribal benefit should not be applied to all of the cases of a particular noncustodial parent (NCP), but rather should be distributed based on a tribal court order, tribal law, or tribal custom.

(2) If the collection is the result of an automated enforcement of interstate (AEI) transaction under RCW 74.20A.188, DCS applies the payment as provided in WAC 388-14A-5006, even if the requesting state wants the payment applied to a specific case.

History

Statutory Authority: RCW 26.23.035 and 74.08.090. WSR 18-11-047, § 388-14A-5007, filed 5/9/18, effective 7/1/18. Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-5007, filed 5/19/11, effective 6/19/11. Statutory Authority: RCW 26.23.035, 74.08.090, 74.20A.188, 74.20A.310, 42 U.S.C. 666(a)14. WSR 01-24-078, § 388-14A-5007, filed 12/3/01, effective 1/3/02. Statutory Authority: RCW 74.08.090, 26.23.035, 74.20A.057, 74.20A.310. WSR 01-03-089, § 388-14A-5007, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-270.

Wash. Admin. Code § 388-14A-5008 Can the noncustodial parent prepay support?

(1) If the division of child support (DCS) receives or collects support money representing payment on the required support obligation for future months, DCS must:

(a) Apply the support money to future months only if the support debt is paid in full;

(b) Distribute the support money on a monthly basis when payments become due in the future; and

(2) The notice in subsection (1)(c) above informs the person entitled to receive support money that:

(a) DCS received prepaid support money;

(b) DCS intends to distribute the prepaid money as support payments become due in the future; and

(c) The person may request a conference board under WAC 388-14A-6400 to determine if DCS should immediately distribute the prepaid support money.

(d) DCS does not mail the notice referred to in subsection (1)(c) of this section if the prepaid support is equal to or less than one month's support obligation.

History

Statutory Authority: RCW 26.23.035, 74.08.090, 74.20A.310, and 45 C.F.R. 303.72 (h)(5). WSR 05-06-014, § 388-14A-5008, filed 2/22/05, effective 3/25/05. Statutory Authority: RCW 74.08.090, 34.05.310 (4)(d), 26.23.035, 74.20A.057, 74.20A.310. WSR 03-20-072, § 388-14A-5008, filed 9/29/03, effective 10/30/03. Statutory Authority: RCW 74.08.090, 26.23.035, 74.20A.057, 74.20A.310. WSR 01-03-089, § 388-14A-5008, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-270.

Wash. Admin. Code § 388-14A-5009 What happens when an employer or other entity overcollects support from the noncustodial parent based on a DCS withholding order?

(1) When an employer or other entity overcollects support from a noncustodial parent (NCP) based on a withholding order issued by the division of child support (DCS), DCS evaluates what to do with the overpayment on a case by case basis.

(2) Depending on the facts of the case and the wishes of the NCP, DCS may take one of the following actions:

(a) Refund the excess money to the NCP upon request;

(b) Hold the excess money in suspense to be applied to the next month's support obligation; or

(c) Any other action which comports with the requirements of this chapter and the federal regulations concerning distribution of support payments.

History

Statutory Authority: RCW 26.23.035, 74.08.090, 74.20A.310, and 45 C.F.R. 303.72 (h)(5). WSR 05-06-014, § 388-14A-5009, filed 2/22/05, effective 3/25/05.

Wash. Admin. Code § 388-14A-5010 How does the division of child support distribute federal tax refund offset collections from joint returns?

(1) The division of child support (DCS) collects child support through the interception of federal tax refunds. This section deals with the issues that arise when the Secretary of the Treasury intercepts a tax refund based on a joint tax return filed by a noncustodial parent (NCP) and the NCP's spouse who does not owe child support.

(2) When the Secretary of the Treasury, through the federal Office of Child Support Enforcement (OCSE), notifies DCS that a collection on behalf of an NCP is from an intercepted tax refund based on a joint return, DCS may distribute fifty percent of that collection as provided in WAC 388-14A-5005 and hold the remainder for up to six months in case the NCP's spouse is entitled to a share of the federal tax refund.

(3) DCS distributes fifty percent of the collection according to WAC 388-14A-5005.

(4) DCS holds the other fifty percent of the collection in suspense until the earlier of the following:

(a) DCS is notified by OCSE or the Secretary of the Treasury whether DCS must pay back the unobligated spouse's portion of the refund; or

(b) For a period not to exceed six months from notification of the offset.

(5) After DCS holds part of a collection under subsection (4) of this section, DCS distributes the remainder of the collection to the NCP's support arrears according to WAC 388-14A-5005, unless DCS is required to return the unobligated spouse's portion of the refund. The CP may:

(a) Request that DCS distribute the payment to the NCP's support obligation sooner upon a showing of hardship to the CP; and

(b) Request a conference board if the CP disagrees with DCS' denial of a hardship claim.

History

Statutory Authority: RCW 26.23.035 and 34.05.350 (1)(c). WSR 11-06-042, § 388-14A-5010, filed 2/28/11, effective 3/31/11. Statutory Authority: RCW 26.18.170, 26.23.035, 26.23.050, [26.23.]110, 74.20.040, 74.20A.030, [74.20A.]055, [74.20A.]056, and 74.20A.310. WSR 09-02-059, § 388-14A-5010, filed 1/5/09, effective 1/27/09. Statutory Authority: RCW 26.23.035, 74.08.090, 74.20A.310, and 45 C.F.R. 303.72 (h)(5). WSR 05-06-014, § 388-14A-5010, filed 2/22/05, effective 3/25/05.

Wash. Admin. Code § 388-14A-5015 What is a pass-through payment?

(1) Between October 1, 2008 and April 30, 2011 and beginning again on February 1, 2021, the division of child support (DCS) passes through a portion of child support collections to a family receiving TANF.

(2) A pass-through payment is the portion of a support collection applied to assigned support that the state elects to pay to a family receiving TANF at the time the collection is received.

(3) Between October 1, 2008 and April 30, 2011, the pass-through payment was paid in the following amounts:

(a) Up to one hundred dollars per month to a family with one child in the assistance unit.

(b) Up to two hundred dollars per month to a family with two or more children in the assistance unit.

(4) Beginning February 1, 2021, the pass-through payment is paid in the following amounts:

(a) Up to fifty dollars per month to a family with one child in the assistance unit.

(b) Up to one hundred dollars per month to a family with two or more children in the assistance unit.

(5) The pass-through is paid from collections distributed to either current support or assigned arrears.

(6) The pass-through amount for any month cannot exceed the amount collected in that month.

History

Statutory Authority: RCW 26.09.105(20), 26.18.170(21), 26.23.050, 26.23.110(14), 43.20A.550, 74.04.055, 74.04.057, 74.08.090, 74.20A.310. WSR 21-12-003, § 388-14A-5015, filed 5/19/21, effective 6/19/21. Statutory Authority: RCW 26.23.035 and 74.08.090. WSR 11-14-063, § 388-14A-5015, filed 6/30/11, effective 7/31/11. Statutory Authority: RCW 26.18.170, 26.23.035, 26.23.050, [26.23.]110, 74.20.040, 74.20A.030, [74.20A.]055, [74.20A.]056, and 74.20A.310. WSR 09-02-059, § 388-14A-5015, filed 1/5/09, effective 1/27/09.

Wash. Admin. Code § 388-14A-5050 When does DCS send a notice of intent to distribute support money?

(1) The division of child support (DCS) may distribute support money to a custodial parent (CP) who is not the payee under the support order if the CP signs a sworn statement that:

(a) The CP has physical custody of and is caring for the child; and

(b) The CP is not wrongfully depriving the payee of physical custody.

(2) Before DCS begins distributing support money to a CP who is not the payee under the support order, DCS sends the payee under the support order and the noncustodial parent (NCP) a notice of intent to distribute support money and a copy of the sworn statement of the CP to their last known addresses by first class mail. The notice states:

(a) DCS intends to distribute support money collected under the support order to the CP; and

(b) The name of the CP.

(3) DCS distributes support money to the CP when the notice of intent to distribute support money becomes final.

(a) A notice of intent to distribute support money served in the state of Washington becomes final unless the payee under the support order, within twenty days of the date of mailing of the notice, files a request with DCS for a hearing under subsection (4) of this section. The effective date of a hearing request is the date DCS receives the request.

(b) A notice of intent to distribute support money served in another state becomes final according to WAC 388-14A-7200.

(4) A hearing on a notice of intent to distribute support money is for the limited purpose of resolving who is entitled to receive the support money.

(5) A copy of the notice of any hearing scheduled under this section must be mailed to the alleged CP at the CP's last known address. The notice advises the CP of the right to participate in the proceeding as a witness or observer.

(6) The payee under the support order may file a late hearing request on a notice of intent to distribute support money.

(a) The payee under the support order does not need to show good cause for filing a late hearing request.

(b) DCS may not reimburse the payee under the support order for amounts DCS sent to the CP before the administrative order on a late hearing request becomes final.

(7) The payee under the support order must give DCS and the CP notice of any judicial proceeding to contest a notice of intent to distribute support money.

(8) If the support order is a court order, DCS files a copy of the notice of intent to distribute support money or the final administrative order entered on a notice of intent to distribute support money with the clerk of the court where the support order was entered.

History

Statutory Authority: RCW 74.08.090, 26.23.035, 74.20A.057, 74.20A.310. WSR 01-03-089, § 388-14A-5050, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-270 and 388-14-271.

Wash. Admin. Code § 388-14A-5100 How does the division of child support notify the custodial parent about support collections?

WAC 388-14A-5100

(1) The division of child support (DCS) mails a distribution and disbursement statement once each month to the last known address of a person for whom it received a support collection during the month, except as provided under subsection (6) of this section.

(2) DCS includes the following information in the distribution and disbursement statement:

(a) The amount of support collections DCS received and the date of collection;

(b) A description of how DCS distributed each support collection between current support and the support debt and any fees required by state or federal law;

(d) The amount kept by the state to repay public assistance paid to the family;

(e) The amount disbursed to the family as a pass-through payment under WAC 388-14A-5015;

(f) The amount disbursed to the family as a payment on support owed to the family;

(g) The amount kept by the state to pay the $35 annual fee, if applicable; and

(h) The amount kept by the state to repay child support paid to the family in error.

(3) The person to whom a distribution and disbursement statement is sent may file a request for a hearing under subsection (4) of this section within 90 days of the date of the statement to contest how DCS distributed the support collections, and must make specific objections to the statement. The effective date of a hearing request is the date DCS receives the request.

(4) A hearing under this section is for the limited purpose of determining if DCS correctly distributed the support money described in the contested statement.

(a) There is no hearing right regarding fees that have been charged on a case.

(b) If a custodial parent (CP) wants to request a hardship waiver of the fee, the CP may request a conference board under WAC 388-14A-6400.

(5) A person who requests a late hearing must show good cause for being late.

(6) This section does not require DCS to send a distribution and disbursement statement to a recipient of payment services only.

History

Statutory Authority: RCW 26.18.170, 26.23.035, 26.23.110, 43.20A.550, 74.04.055, 74.08.090, 74.20.040, 74.20A.310, and 74.20A.328. WSR 26-14-086, s 388-14A-5100, filed 6/29/26, effective 7/30/26. Statutory Authority: RCW 26.09.105(20), 26.18.170(21), 26.23.050, 26.23.110(14), 43.20A.550, 74.04.055, 74.04.057, 74.08.090, 74.20A.310. WSR 21-12-003, § 388-14A-5100, filed 5/19/21, effective 6/19/21. Statutory Authority: RCW 26.23.035 and 74.08.090. WSR 11-14-063, § 388-14A-5100, filed 6/30/11, effective 7/31/11. Statutory Authority: RCW 26.18.170, 26.23.035, 26.23.050, [26.23.]110, 74.20.040, 74.20A.030, [74.20A.]055, [74.20A.]056, and 74.20A.310. WSR 09-02-059, § 388-14A-5100, filed 1/5/09, effective 1/27/09. Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-5100, filed 5/29/08, effective 7/1/08. Statutory Authority: RCW 74.08.090, 26.23.035, 74.20A.057, 74.20A.310. WSR 01-03-089, § 388-14A-5100, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-270 and 388-14-274.

Wash. Admin. Code § 388-14A-5200 What is a "total versus total" notice?

(1) The division of child support (DCS) identifies cases needing a "total versus total" calculation, which compares amounts of public assistance paid to the family with amounts of support collected and uncollected support debt. DCS performs a total versus total calculation upon the request of the custodial parent (CP) or a DCS field office, usually only after the assistance grant has ended.

(a) The total versus total calculation allocates the uncollected support debt between the state and the CP, based on the amounts of public assistance paid to the family.

(b) The total versus total calculation indicates the amounts of support paid by each noncustodial parent (NCP) and how DCS distributed the support.

(2) When DCS completes a total versus total calculation at the request of the CP, DCS mails a total versus total notice to the last known address of the former assistance recipient.

(3) The person to whom DCS sends a total versus total notice may, within ninety days of the date of the notice, file a request for a conference board under WAC 388-14A-6400 to contest the distribution of support money and the allocation of uncollected support debt. The person must state specific objections to the total versus total notice. The effective date of a request conference board is the date DCS receives the request.

History

Statutory Authority: RCW 74.08.090, 26.23.035, 74.20A.057, 74.20A.310. WSR 01-03-089, § 388-14A-5200, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-276.

Wash. Admin. Code § 388-14A-5300 How does the division of child support recover a support payment which has already been distributed?

(1) The division of child support (DCS) may serve a notice to recover a support payment on the person who received the payment when DCS:

(a) Distributed the money in error;

(b) Distributed the money based on a check that is later dishonored;

(d) Distributed money under a support order that was later modified so as to create an overpayment.

(2) DCS serves a notice to recover a support payment like a summons in a civil action or by certified mail, return receipt requested.

(3) In the notice, DCS must identify the support payment DCS seeks to recover.

(4) DCS may take action to enforce the notice to recover a support payment without further notice once the notice becomes final.

(a) A notice to recover a support payment becomes final unless the person who received the payment requests a hearing under subsection (5) of this section within twenty days of service of the notice to recover a support payment in Washington. The effective date of a hearing request is the date DCS receives the request.

(b) A notice to recover a support payment may be served in another state to recover a payment disbursed by DCS under RCW 26.21A.290. A notice to recover a support payment served in another state becomes final according to WAC 388-14A-7200.

(5) A hearing on a notice to recover a support payment is for the limited purpose of resolving the existence and amount of the debt DCS is entitled to recover.

(6) A person who files a late request for a hearing on a notice to recover a support payment must show good cause for being late.

(7) In nonassistance cases and payment services only cases, DCS may recover a support payment under a final administrative order on a notice to recover a support payment by retaining ten percent of current support and one hundred percent of amounts collected on arrears in addition to any other remedy authorized by law.

(8) If a public assistance recipient receives a support payment directly from a noncustodial parent (NCP) and fails to remit it to DCS as required, DCS recovers the money as retained support under WAC 388-14A-5500.

(9) DCS may enforce the notice to recover a support payment as provided in subsection (7), or may act according to RCW 74.20A.270 as deemed appropriate.

History

Statutory Authority: RCW 34.05.220(2), 43.20A.550, 74.04.055, 74.08.090, 74.20.040, 74.20A.310. WSR 07-08-055, § 388-14A-5300, filed 3/29/07, effective 4/29/07. Statutory Authority: RCW 74.08.090, 26.23.035, 74.20A.057, 74.20A.310. WSR 01-03-089, § 388-14A-5300, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-272.

Wash. Admin. Code § 388-14A-5400 How does the division of child support tell the custodial parent when DCS adjusts the amount of debt owed on the case?

(1) The division of child support (DCS) mails a debt adjustment notice to the payee under a child support order within thirty days of the date DCS reduces the amount of the support debt it intends to collect if that reduction was due to:

(a) A mathematical error in the debt calculation;

(b) A typographical error in the stated debt;

(c) Proof that DCS should have suspended the support obligation for all or part of the time period involved in the calculation; or

(d) Proof the noncustodial parent (NCP) made payments that DCS had not previously credited against the support debt.

(2) The debt adjustment notice must contain the following information:

(a) The amount of the reduction;

(b) The reason DCS reduced the support debt, as provided under subsection (1) of this section;

(c) The name of the NCP and a statement that the NCP may attend and participate as an independent party in any hearing requested by the payee under this section; and

(d) A statement that DCS continues to provide support enforcement services whether or not the payee objects to the debt adjustment notice.

(3) A debt adjustment notice served in Washington becomes final unless the payee, within twenty days of service of the notice in Washington, files a request with DCS for a hearing under subsection (4) of this section. The effective date of a hearing request is the date DCS receives the request.

(4) A debt adjustment notice served in another state becomes final according to WAC 388-14A-7200.

(5) A hearing under this section is for the limited purpose of determining if DCS correctly reduced the support debt as stated in the notice of debt adjustment.

(6) A payee who requests a late hearing must show good cause for filing a late hearing request if it is filed more than one year after the date of the notice of debt adjustment.

History

Statutory Authority: RCW 26.23.030(3), 34.05.220 (1)(a), 34.05.322, 74.20.101, and 74.08.090. WSR 19-19-060, § 388-14A-5400, filed 9/16/19, effective 10/17/19. Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-5400, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-450.

Wash. Admin. Code § 388-14A-5500 How does the division of child support collect support debts owed by someone other than a noncustodial parent?

WAC 388-14A-5500

(1) Under RCW 74.20.320 and 74.20A.270, a custodian of children or other person who receives support money paid, in whole or in part, toward a support obligation under RCW 74.20.320, 74.20.330, or 74.20A.030 must remit that money to the division of child support (DCS) within eight days of receipt, and is indebted to the department for this amount of money.

(2) By not remitting support money described in subsection (1) of this section, a custodial parent (CP) or other person makes, without the necessity of signing any document, an irrevocable assignment to the department of an equal amount of any support debt not already assigned to the department, but owing to the CP or other person, or an equal amount of any support debt that may accrue in the future. DCS may use the collection procedures of chapter 74.20A RCW to collect this assigned delinquency, to satisfy a debt owed under subsection (1) of this section.

(3) DCS may also make a set-off to pay the debt under subsection (1) of this section from support money in DCS' possession or in the possession of a county clerk or other forwarding agent if that money was paid to satisfy a support delinquency.

(4) DCS may take action alternatively or simultaneously under subsections (1), (2), and (3) of this section but the department may not collect and retain more money than the debt described under subsection (1) of this section, refunding the excess, without deducting fees, to the CP.

(5) DCS must give the CP or other person an account of actions taken under subsections (2) or (3) of this section.

History

Statutory Authority: RCW 26.18.170, 26.23.035, 26.23.110, 43.20A.550, 74.04.055, 74.08.090, 74.20.040, 74.20A.310, and 74.20A.328. WSR 26-14-086, s 388-14A-5500, filed 6/29/26, effective 7/30/26. Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-5500, filed 1/17/01, effective 2/17/01.

Wash. Admin. Code § 388-14A-5505 DCS uses a notice of retained support to claim a debt owed to DCS.

The division of child support (DCS) serves a notice of retained support setting forth:

(1) The amount of support money claimed by the department as property of the department by assignment, subrogation or by operation of law or legal process under chapter 74.20A RCW;

(2) The legal basis for the claim of ownership by the department;

(3) A description of the person, firm, corporation, association, or political subdivision who is or has been in possession of the support moneys together with enough detail to identify the amounts in issue;

(4) A statement that, effective with the date of service of the notice, the department will impound and hold in trust all money not yet disbursed or spent and all similar money received in the future, pending answer to the notice and any hearing which is requested;

(5) A statement that the notice must be answered, under oath and in writing, within twenty days of the date of service of the notice;

(6) A statement that the answer to the notice must include true answers to the questions in the notice and must either acknowledge the department's right to the money or request an administrative hearing to determine ownership of the money;

(7) A statement that the burden of proof in a hearing on a notice of retained support debt under this section is on the department to establish ownership of the support money claimed;

(8) A statement that, if the person, firm, corporation, association, or political subdivision or officer or agent thereof does not answer or make a request for hearing in a timely manner, the department's claim will be assessed and determined and subject to collection action as a support debt according to chapter 74.20A RCW; and

(9) A statement that the department may collect a support debt, as assessed and determined, and that the property of the debtor, without further advance notice or hearing, is subject to lien and foreclosure, distraint, seizure and sale, or order to withhold and deliver to satisfy the debt. The department may not take collection action against a recipient of public assistance during the period of time the recipient remains on assistance except as provided in RCW 74.20A.270 and WAC 388-14A-2040.

History

Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-5505, filed 1/17/01, effective 2/17/01. Formerly WAC 388-13-090.

Wash. Admin. Code § 388-14A-5510 How does DCS serve a notice of retained support?

The division of child support (DCS) serves the notice of retained support on the person, firm, corporation, association, or political subdivision or any officer or agent thereof in the manner prescribed for the service of a summons in a civil action, or by certified mail, return receipt requested. The receipt is prima facie evidence of service.

History

Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-5510, filed 1/17/01, effective 2/17/01. Formerly WAC 388-13-030.

Wash. Admin. Code § 388-14A-5515 What happens if I don't respond to a notice of retained support or request a hearing?

(1) After service of a notice of retained support under WAC 388-14A-5510, if the person, firm, corporation, association, or political subdivision or any officer or agent thereof fails to answer in a timely manner, the claim of the department is final and subject to collection action as a support debt according to chapter 74.20A RCW.

(2) To be timely, a hearing request or response must be received by the division of child support within twenty days of service of the notice.

History

Statutory Authority: RCW 74.08.090, 34.05.220. WSR 01-03-089, § 388-14A-5515, filed 1/17/01, effective 2/17/01. Formerly WAC 388-13-040 and 388-13-110.

Wash. Admin. Code § 388-14A-5520 What happens if I make a timely objection to a notice of retained support?

(1) Any debtor who objects to all or any part of a notice of retained support may, within twenty days from the date of service of the notice, file an application for an administrative hearing. An objection under this section is the same thing as a general denial of liability to the department.

(2) The notice of retained support does not become final until there is a final administrative order.

(3) If the objection is timely, the department serves the notice of hearing on the appellant or the appellant's representative by first class mail.

(4) The department must notify the appellant that it is the appellant's responsibility to notify the department of the appellant's mailing address at the time the application is filed and also of any change of address after filing the application. Mailing by first class mail to the last address provided by the appellant constitutes service under chapters 74.20A and 34.05 RCW.

History

Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.055, 74.20A.056. WSR 02-06-098, § 388-14A-5520, filed 3/4/02, effective 4/4/02. Statutory Authority: RCW 74.08.090, 34.05.220. WSR 01-03-089, § 388-14A-5520, filed 1/17/01, effective 2/17/01. Formerly WAC 388-13-060.

Wash. Admin. Code § 388-14A-5525 What happens at the hearing on a notice of retained support?

(1) An administrative hearing on a notice of retained support is limited to the determination of the ownership of the amounts claimed in the notice or the reasonableness of a repayment agreement offered to a public assistance recipient for recovering child support under RCW 74.20A.270 and WAC 388-14A-5505.

(2) The department has the burden of proof to establish ownership of the support money claimed, including but not limited to amounts not yet disbursed or spent.

(3) The administrative law judge (ALJ) must allow the division of child support (DCS) to orally amend the notice of retained support at the hearing to conform to the evidence. The ALJ may grant a continuance, if necessary, to allow the debtor additional time to present evidence or argument in response to the amendment.

(4) The ALJ serves a copy of the initial decision on DCS and the debtor or the debtor's representative by first class mail to the last address provided by each party.

(5) If the debtor fails to appear at the hearing, the ALJ, upon a showing of valid service of the notice of retained support, enters an initial decision and order declaring that the amount of the support money claimed in the notice, is subject to collection action under chapter 74.20A RCW.

History

Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.055, 74.20A.056. WSR 02-06-098, § 388-14A-5525, filed 3/4/02, effective 4/4/02. Statutory Authority: RCW 74.08.090, 34.05.220. WSR 01-03-089, § 388-14A-5525, filed 1/17/01, effective 2/17/01. Formerly WAC 388-13-070 and 388-13-110.

Wash. Admin. Code § 388-14A-5530 Can I request a late hearing on a notice of retained support?

(1) Within one year from the date the division of child support (DCS) serves a notice of retained support, the person, firm, corporation, association, political subdivision or any officer or agent thereof may petition DCS for a hearing, upon a showing of any of the grounds listed in RCW 4.72.010 or CR 60.

(2) A copy of the objection must be served by first class mail on the district field office of DCS.

(3) The filing of the petition does not stay any collection action that DCS has taken, but the debtor may petition the secretary or the secretary's designee for an order staying collection action pending final decision of the secretary or the secretary's designee or the courts on an appeal made under chapter 34.05 RCW.

(4) Any money held or taken by collection action before any such stay and any support money claimed by the department, including amounts to be received in the future, to which the department may have a claim, must be held in trust pending the final decision and appeal, if any, to be disbursed in accordance with the final decision.

(5) If someone files a petition for a hearing, the department serves the notice of hearing on the appellant, the appellant's attorney, or other designated representative by first class mail.

(6) The department notifies the appellant that the appellant must notify the department of the appellant's mailing address at the time the petition is filed and also of any change of address after filing the petition. Mailing by first class mail to the last address provided by the appellant constitutes service under chapters 74.20A and 34.05 RCW.

History

Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.055, 74.20A.056. WSR 02-06-098, § 388-14A-5530, filed 3/4/02, effective 4/4/02. Statutory Authority: RCW 74.08.090, 34.05.220. WSR 01-03-089, § 388-14A-5530, filed 1/17/01, effective 2/17/01. Formerly WAC 388-13-050.

Wash. Admin. Code § 388-14A-5535 How does DCS collect a debt established on a notice of retained support?

The division of child support (DCS) may take action under chapter 74.20A RCW to collect debts determined under WAC 388-14A-5505.

History

Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-5535, filed 1/17/01, effective 2/17/01. Formerly WAC 388-13-085.

Wash. Admin. Code § 388-14A-5540 Can I just acknowledge that I owe money to the division of child support?

If you answer the notice of retained support acknowledging that the department owns the support payments in question, the division of child support (DCS) may take collection action under chapter 74.20A RCW if you fail to pay the debt within twenty-one days of the date DCS receives the answer.

History

Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-5540, filed 1/17/01, effective 2/17/01. Formerly WAC 388-13-100.

Wash. Admin. Code § 388-14A-6000 Which statutes and regulations govern the division of child support's hearing process?

(1) Hearings under this chapter are governed by:

(a) The Administrative Procedure Act, chapter 34.05 RCW, RCW 74.20A.055; and

(b) Chapter 388-02 WAC.

(2) If any provision in this chapter conflicts with or is inconsistent with chapter 388-02 WAC, the provision in this chapter governs.

History

Statutory Authority: RCW 74.08.090, 34.05.220. WSR 01-03-089, § 388-14A-6000, filed 1/17/01, effective 2/17/01. Formerly WAC 388-11-180 and 388-13-120.

Wash. Admin. Code § 388-14A-6100 The division of child support accepts oral requests for hearing or conference board.

(1) Except for the instances listed in subsections (8) and (9), the division of child support (DCS) accepts either a written or an oral request for hearing or conference board, even though other sections of this chapter or the relevant statutes may provide that objections and hearing requests should be in writing.

(2) The subject matter of the objection determines whether the matter is set as a conference board or hearing, unless there is a specific request for an administrative hearing under chapter 34.05 RCW.

(3) DCS processes oral and written requests for hearing in the same manner.

(4) An oral request for hearing is complete if it contains enough information to identify the person making the request, the DCS action, and the case or cases involved in the hearing request.

(5) The effective date of an oral request for hearing is the date that someone makes a complete oral request for hearing, to any DCS representative in person or by leaving a message on the automated voice mail system of any DCS field office.

(6) When making an oral request, you do not need to specify whether you want a hearing under chapter 34.05 RCW or a conference board under WAC 388-14A-6400.

(7) You can make an oral request for hearing or conference board on behalf of another person, if you have written authorization to act on their behalf. The effective date of an oral request for hearing or conference board made on behalf of another person is the later of the date of the complete oral request for hearing or the date that DCS receives the written authorization.

(8) There are three types of hearing requests which must be in writing:

(a) A petition for prospective modification under WAC 388-14A-3925;

(b) A petition for reimbursement for day care expenses under WAC 388-14A-4300; and

(9) You must also make the following requests in writing:

(a) A request for a determination of controlling order under the Uniform Interstate Family Support Act (UIFSA), chapter 26.21A RCW, as described in WAC 388-14A-7305; and

(b) An objection to the determination of controlling order contained in a notice of support debt and registration issued by DCS under WAC 388-14A-7325. WAC 388-14A-7335 describes how to make this objection.

History

Statutory Authority: RCW 26.09.916, 74.08.090, 74.20A.055. WSR 22-02-063, § 388-14A-6100, filed 1/4/22, effective 2/4/22. Statutory Authority: RCW 34.05.220(2), 43.20A.550, 74.04.055, 74.08.090, 74.20.040, 74.20A.310. WSR 07-08-055, § 388-14A-6100, filed 3/29/07, effective 4/29/07. Statutory Authority: RCW 74.08.090, 34.05.220. WSR 01-03-089, § 388-14A-6100, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-500.

Wash. Admin. Code § 388-14A-6105 What is the difference between an initial order and a final order in a hearing involving the division of child support?

WAC 388-14A-6105

(1) In an administrative hearing involving the DSHS division of child support (DCS), the administrative law judge (ALJ) enters either an initial order, which is subject to review by the DSHS board of appeals (BOA), or a final order, which is not subject to review by BOA.

(2) The terms "initial order","final order", and "review" are defined in WAC 388-02-0010, and those definitions are paraphrased here for ease of reference:

(a) "Initial order" is a hearing decision made by an ALJ that may be reviewed by a BOA review judge under WAC 388-02-0215(4). An initial order is sometimes called an "initial decision."

(b) "Final order" means an order that is the final DSHS decision.

(c) "Review" means the act of reviewing initial orders and making the final agency decision as provided by RCW 34.05.464.

(3) WAC 388-14A-6110 and 388-14A-6115 describe how to determine what kind of order is entered. Whether the ALJ enters an initial order or a final order does not depend on the date the hearing is held or the date the order is entered.

(4) WAC 388-14A-6120 describes what you can do if you disagree with an initial order or final order.

(5) WAC 388-14A-6125 describes when DCS may take enforcement action on an initial order or final order.

History

Statutory Authority: RCW 26.18.170, 26.23.035, 26.23.110, 43.20A.550, 74.04.055, 74.08.090, 74.20.040, 74.20A.310, and 74.20A.328. WSR 26-14-086, s 388-14A-6105, filed 6/29/26, effective 7/30/26. Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.056, 74.20A.310, 26.26.315, 26.26.320, 26.26.330, 26.26.335, 74.20A.055, 2002 c 302, and 2002 c 199. WSR 03-17-013, § 388-14A-6105, filed 8/12/03, effective 9/12/03.

Wash. Admin. Code § 388-14A-6110 When must an ALJ enter an initial order in a DCS hearing proceeding?

An administrative law judge (ALJ) must enter an initial order in a division of child support (DCS) hearing proceeding if:

(1) The case involves the disclosure of a party's address under WAC 388-14A-2114 through 388-14A-2140;

(2) A custodial parent (CP) or noncustodial parent (NCP) files a hearing request before November 15, 2002;

(3) A CP or NCP files a petition for modification with DCS or the office of administrative headings (OAH) before November 15, 2002; or

(4) DCS petitions for modification of an administrative order, and either the NCP or the CP is served with the notice of hearing before November 15, 2002.

History

Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.056, 74.20A.310, 26.26.315, 26.26.320, 26.26.330, 26.26.335, 74.20A.055, 2002 c 302, and 2002 c 199. WSR 03-17-013, § 388-14A-6110, filed 8/12/03, effective 9/12/03.

Wash. Admin. Code § 388-14A-6115 When must an ALJ enter a final order in a DCS hearing proceeding?

Except for cases regarding address disclosure under WAC 388-14A-2114 through 388-14A-2140, an administrative law judge (ALJ) must enter a final order in a DCS hearing proceeding if:

(1) A custodial parent (CP) or noncustodial parent (NCP) files a hearing request on or after November 15, 2002;

(2) An NCP or CP files a petition for modification with DCS or the office of administrative hearings (OAH) on or after November 15, 2002;

(3) DCS petitions for modification of an administrative order, and neither the NCP nor the CP is served before November 15, 2002.

History

Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.056, 74.20A.310, 26.26.315, 26.26.320, 26.26.330, 26.26.335, 74.20A.055, 2002 c 302, and 2002 c 199. WSR 03-17-013, § 388-14A-6115, filed 8/12/03, effective 9/12/03.

Wash. Admin. Code § 388-14A-6120 What can I do if I do not agree with an initial order or final order entered by an administrative law judge?

(1) Except for the DCS representative, any party to an initial order entered by an administrative law judge (ALJ) has the right to request review pursuant to chapter 388-02 WAC.

(2) No party may request administrative review of a final order entered by an ALJ.

(3) Any party to an initial order or a final order may petition to vacate an order of dismissal or default, pursuant to WAC 388-14A-3700 and 388-14A-6150.

(4) Any party to an initial order or final order may request correction of a clerical error in the order, pursuant to WAC 388-02-0540 through 388-02-0555.

(5) Any party to a final order may request reconsideration of the order, pursuant to WAC 388-02-0605 through 388-02-0635.

(6) Except for the DCS representative, any party to a final order may petition for judicial review, pursuant to RCW 34.05.510 through 34.05.598. You do not need to request reconsideration of the order before you petition for judicial review.

History

Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.056, 74.20A.310, 26.26.315, 26.26.320, 26.26.330, 26.26.335, 74.20A.055, 2002 c 302, and 2002 c 199. WSR 03-17-013, § 388-14A-6120, filed 8/12/03, effective 9/12/03.

Wash. Admin. Code § 388-14A-6125 When does an initial order or final order entered by an ALJ become enforceable?

(1) If no party requests review within twenty-one days of the date OAH mailed an initial order, the DSHS division of child support (DCS) may take enforcement action on the twenty-second day after OAH mailed the order.

(2) DCS may take enforcement action on a final order immediately upon entry of the order.

(a) Even if a party files a request for reconsideration, a request to correct a clerical error, a petition to vacate, or a petition for judicial review, DCS does not stop enforcement of the order.

(b) To stop DCS from enforcing a final order, you must obtain a court order staying (stopping) enforcement of the order.

History

Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.056, 74.20A.310, 26.26.315, 26.26.320, 26.26.330, 26.26.335, 74.20A.055, 2002 c 302, and 2002 c 199. WSR 03-17-013, § 388-14A-6125, filed 8/12/03, effective 9/12/03.

Wash. Admin. Code § 388-14A-6150 What can I do if there was a default order entered against me in an administrative hearing?

(1) Any party against whom the administrative law judge (ALJ) has entered an initial decision and order on default may petition the DSHS board of appeals for vacation of the default order, subject to the provisions, including time limits, of civil rule 60.

(2) Specific rules on administrative support establishment notices are in WAC 388-14A-3700.

(3) Upon receipt of a request to vacate a default order, the department must ask the office of administrative hearings (OAH) to:

(a) Schedule a hearing to determine whether or not the petitioner has good cause for vacating the default order; and

(b) Give any other parties to the hearing notice of the time and date of the hearing. The notice is sent to the party's last known address.

(4) In a hearing under this section, the ALJ must first determine if the petitioner has good cause for vacating the default order by applying civil rule 60 to determine whether the petition has good cause, in making this determination, the ALJ must consider the following factors:

(a) Whether there is substantial evidence to support a prima facie defense to the notice which was the subject of the hearing;

(b) Whether the petitioner's failure to appear at the hearing was due to mistake, inadvertance, surprise or excusable neglect;

(d) Whether vacating the initial decision would result in a substantial hardship to the parent who did appear for hearing.

(5) If the ALJ finds good cause to vacate the default order, the ALJ:

(a) Must conduct a hearing on the merits of the petitioner's objection to the notice that was the basis for the hearing at which the petitioner failed to appear; and

(b) May stay any further collection to the extent provided for under the rules governing the notice the party originally objected to.

(6) If the parent who did not appear at the hearing is unsuccessful in the motion to vacate the default order, the ALJ may treat the petition as a petition to modify the support order.

History

Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.055, 74.20A.056. WSR 01-24-081, § 388-14A-6150, filed 12/3/01, effective 1/3/02.

Wash. Admin. Code § 388-14A-6200 What remedies are available to contest the division of child support's seizure of my bank account?

(1) If the division of child support (DCS) takes collection action against a bank account, safe deposit box, or other property held by a bank, credit union, or savings and loan (collectively, "the account"), the noncustodial parent (NCP) or the joint owner of record of the account may contest the action.

(2) The effective date of an objection is the date DCS receives the request.

(3) The NCP or the joint owner must file the objection within 20 days of the date DCS mailed a copy of the order to withhold and deliver to the NCP's last known address for the objection to be considered timely.

(4) The NCP or joint owner of record must state in the objection the facts supporting the allegation that the account, or a portion of the account, is exempt from satisfaction of the NCP's child support obligation.

(5) If either the NCP or the joint owner of record submits a timely objection to the collection action, DCS schedules a hearing solely for the purpose of determining whether one of the following exemptions applies to the account attached by the order to withhold and deliver:

(a) Under RCW 26.16.200 and 74.20A.120, the property or funds in the community bank account, joint bank account, or safe deposit box, or a portion of the property or funds that can be identified as the earnings of the NCP's spouse who does not owe a support obligation to the NCP's child or children, are exempt from satisfaction of the child support obligation of the NCP;

(b) The funds in a bank account, or a portion of those funds can be identified as TANF, SSI benefits, or other kinds of funds that are legally exempt from collection action; or

(c) The funds or property attached by the order to withhold and deliver that can be identified as being solely owned by the joint owner of record of the bank account or safe deposit box who does not owe a child support obligation to the child or children of the NCP, are exempt from satisfaction of the NCP's child support obligation.

(6) If either the NCP or the joint owner of record submits an untimely or late objection to the collection action, the objection is treated as a request for a conference board under WAC 388-14A-6400 through 388-14A-6415.

History

Statutory Authority: RCW 26.23.035, 74.08.090, and 74.20A.310. WSR 26-12-075, s 388-14A-6200, filed 6/3/26, effective 7/4/26. Statutory Authority: RCW 74.08.090, 26.23.035, 34.05.220, 74.20A.310, 45 C.F.R. 303.106. WSR 01-24-079, § 388-14A-6200, filed 12/3/01, effective 1/3/02
WSR 01-03-089, § 388-14A-6200, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-390.

Wash. Admin. Code § 388-14A-6205 What happens at a hearing on an objection to seizure of a bank account?

(1) If either the noncustodial parent (NCP) or the joint owner of record submits a timely objection to a division of child support (DCS) collection action against a bank account, DCS schedules a hearing solely for the purpose of determining whether one of the following exemptions applies to the funds in the bank account, or to the other property attached by the order to withhold and deliver:

(b) The funds in the bank account, or a portion of those funds can be identified as TANF, SSI benefits, or other kinds of funds that are legally exempt from collection action; or

(c) The funds or property attached by the order to withhold and deliver can be identified as being solely owned by the joint owner of record of the bank account or safe deposit box who does not owe a child support obligation to the child or children of the NCP and are exempt from satisfaction of the NCP's child support obligation.

(2) The person challenging the collection action has the burden of tracing the funds and proving the property or funds in the bank account, or property in a safe deposit box, are exempt from satisfaction of the NCP's child support obligation.

(3) The administrative law judge (ALJ) is limited to the determination of whether the funds in the bank account, or the other property attached by the order to withhold and deliver, are exempt from satisfaction of the NCP's child support obligation.

History

Statutory Authority: RCW 26.23.035, 74.08.090, and 74.20A.310. WSR 26-12-075, s 388-14A-6205, filed 6/3/26, effective 7/4/26. Statutory Authority: RCW 74.08.090, 26.23.035, 34.05.220, 74.20A.310, 45 C.F.R. 303.106. WSR 01-24-079, § 388-14A-6205, filed 12/3/01, effective 1/3/02.

Wash. Admin. Code § 388-14A-6210 What happens to the seized money once an objection is filed?

(1) If the objection is timely, the division of child support (DCS) holds money or property withheld as a result of collection action taken against a bank account or safe deposit box and delivered to DCS at the time of an objection, pending the final administrative order or during any appeal to the courts.

(2) If DCS does not receive a timely objection, DCS distributes the seized money or property to the noncustodial parent's case or cases under WAC 388-14A-5000 through 388-14A-5008.

(3) If the objection is untimely or late, DCS holds the seized money or property still in its possession pending a conference board decision, after distribution of the funds required under WAC 388-14A-5000 through 388-14A-5008.

History

Statutory Authority: RCW 26.23.035, 74.08.090, and 74.20A.310. WSR 26-12-075, s 388-14A-6210, filed 6/3/26, effective 7/4/26. Statutory Authority: RCW 74.08.090, 26.23.035, 34.05.220, 74.20A.310, 45 C.F.R. 303.106. WSR 01-24-079, § 388-14A-6210, filed 12/3/01, effective 1/3/02.

Wash. Admin. Code § 388-14A-6215 What happens if the judge decides the seized money was exempt?

If the final decision of the department or courts on appeal is that the division of child support (DCS) has caused money or property that is exempt from satisfaction of the NCP's child support obligation to be withheld by the bank or delivered to the department, DCS must:

(1) Promptly release the order to withhold and deliver; or

(2) Refund the proportionate share of the funds having been identified as being exempt. The department is not liable for any interest accrued on any money withheld under RCW 74.20A.080.

History

Statutory Authority: RCW 74.08.090, 26.23.035, 34.05.220, 74.20A.310, 45 C.F.R. 303.106. WSR 01-24-079, § 388-14A-6215, filed 12/3/01, effective 1/3/02.

Wash. Admin. Code § 388-14A-6220 What remedies are available to contest the division of child support's seizure of my DOC inmate account?

If the division of child support (DCS) takes collection action against the inmate account of a noncustodial parent (NCP) who is an inmate of a department of corrections (DOC) facility, the NCP may contest the seizure of the inmate account in the same way an NCP could challenge a bank account seizure, as provided in WAC 388-14A-6200 through 388-14A-6215.

History

Statutory Authority: RCW 74.08.090, 26.23.035, 34.05.220, 74.20A.310, 45 C.F.R. 303.106. WSR 01-24-079, § 388-14A-6220, filed 12/3/01, effective 1/3/02.

Wash. Admin. Code § 388-14A-6300 Duty of the administrative law judge in a hearing to determine the amount of a support obligation.

(1) A support order entered under this chapter must conform to the requirements set forth in RCW 26.09.105, 26.18.170, 26.23.050, and 26.23.110. The administrative law judge (ALJ) must comply with the DSHS rules on child support and include a Washington state child support schedule worksheet when entering a support order.

(2) In hearings held under this chapter to contest a notice and finding of financial responsibility or a notice and finding of parental responsibility or other notice or petition, the ALJ must determine:

(a) The noncustodial parent's obligation to provide support under RCW 74.20A.057;

(b) The names and dates of birth of the children covered by the support order;

(d) The NCP's share of the basic support obligation and any adjustments to that share, according to his or her circumstances;

(e) Each parent's proportionate share of costs such as uninsured medical expenses, day care and special child rearing expenses;

(f) If requested by a party, the NCP's proportionate share of costs such as uninsured medical expenses or day care expenses in a sum certain amount per month;

(g) A statement that either or both parents are obligated to provide medical support under RCW 26.09.105 and 26.18.170, as provided in subsection (3) of this section, including but not limited to notice that if proof of health care coverage or proof that the coverage is unavailable is not provided to DCS within twenty days, DCS may seek direct enforcement through the obligated parent's employer or union without further notice to the parent;

(h) The NCP's accrued debt and order payments toward the debt in a monthly amount to be determined by the division of child support (DCS);

(i) The NCP's current and future monthly support obligation as a sum certain amount per month, and also as a "per month per child" amount if appropriate under WAC 388-14A-3200(4) and 388-14A-4800, and order payments in that amount.

(3) In determining the medical support obligation of the parents, the ALJ must:

(a) Require both parents to provide medical support for the children covered by the order. Medical support includes both:

(i) The obligation to provide health care coverage for the children:

(A) If coverage that can be extended to cover the children is or becomes available through the obligated parent's employer or union:

(B) If the obligated parent can enroll the children in public health care coverage; or

(C) When coverage is not available, to make a monthly contribution toward the premium paid for coverage by the other parent or the state; and

(ii) The obligation to pay his or her proportionate share of uninsured medical expenses.

(b) Determine whether one (but not both) of the parents should be excused from the obligation to provide coverage or contribute to a premium.

(i) The ALJ must state the reasons for excusing a parent from the coverage obligation.

(ii) The ALJ may not excuse that parent from the obligation to contribute his or her proportionate share of uninsured medical expenses.

(4) Having made the determinations required in subsection (2) above, the ALJ must order the NCP to make payments to the Washington state support registry (WSSR).

(5) The ALJ must allow DCS to orally amend the notice at the hearing to conform to the evidence. The ALJ may grant a continuance, when necessary, to allow the NCP or the CP additional time to present rebutting evidence or argument as to the amendment.

(6) The ALJ may not require DCS to produce or obtain information, documents, or witnesses to assist the NCP or CP in proof of defenses to liability. However, this rule does not apply to relevant, nonconfidential information or documents that DCS has in its possession.

(7) In a hearing held on a notice of support owed served on the NCP under WAC 388-14A-3310 or 388-14A-3311, the ALJ must comply with WAC 388-14A-3323 and 388-14A-3325 to determine, depending on what was requested in the notice:

(a) Whether a condition precedent in the order to begin or adjust the support obligation was met;

(b) The amount of monthly support as a fixed dollar amount;

(d) Any difference between the amount calculated in the order resulting from a previous notice of support owed and the actual amount of the NCP's obligation for the period covered by the order; and

(e) The amount of the NCP's share of daycare or child care expenses for the children, including:

(i) The amount that the NCP must pay each month as his or her ongoing share of daycare or child care expenses for the children; and

(ii) The amount of NCP's accrued debt for daycare or child care expenses.

(8) In a hearing held on a notice of support owed served on either the NCP or the CP issued under WAC 388-14A-3312, the ALJ must determine either or both of the following, depending on what was requested in the notice:

(a) The amount owed by the obligated parent to the other for unreimbursed medical expenses;

(b) The monthly amount to be paid by the obligated parent as his or her proportionate share of the health care coverage premium paid by the other parent or the state.

(9) Except as provided in WAC 388-14A-3324, the ALJ does not specify how the amounts owed by the obligated parent should be paid.

(10) In the event that DCS has served a notice of support owed under WAC 388-14A-3312 on both the NCP and the CP, the ALJ must issue a separate administrative order for each notice issued, and may not set off the debts against each other.

(11) An administrative final order on a notice of support owed must include a provision that any subsequent notice of support owed created for the purposes of reviewing the amounts established by the final order may be served on any party to the order by regular mail to their last known address.

History

Statutory Authority: RCW 26.09.105, 26.23.110, 74.04.055, 74.08.090, 74.20.040, and 74.20A.310. WSR 21-24-063, § 388-14A-6300, filed 11/29/21, effective 12/30/21. Statutory Authority: Part I of 2018 c 150 and RCW 26.09.105, 26.18.170, 26.23.050, 34.05.220 (1)(a), 34.05.350(1), 74.08.090, and 74.20.040(9). WSR 19-02-017, § 388-14A-6300, filed 12/21/18, effective 1/21/19. Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-6300, filed 5/19/11, effective 6/19/11. Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-6300, filed 5/29/08, effective 7/1/08. Statutory Authority: RCW 74.08.090, 34.05.220 (1)(a), 74.20A.055. WSR 07-06-053, § 388-14A-6300, filed 3/2/07, effective 4/2/07. Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.160. WSR 06-09-015, § 388-14A-6300, filed 4/10/06, effective 5/11/06. Statutory Authority: RCW 26.23.050, 34.05.220, 74.08.090, 74.20A.310. WSR 05-14-102, § 388-14A-6300, filed 6/30/05, effective 7/31/05. Statutory Authority: RCW 74.08.090, 26.23.050, 34.05.220, 74.20A.055, 74.20A.056, 45 C.F.R. 303.11, 45 C.F.R. 303.100. WSR 01-03-089, § 388-14A-6300, filed 1/17/01, effective 2/17/01. Formerly WAC 388-11-100 and 388-11-210.

Wash. Admin. Code § 388-14A-6400 The division of child support's grievance and dispute resolution method is called a conference board.

(1) The division of child support (DCS) provides conference boards for the resolution of complaints and problems regarding DCS cases, and for granting exceptional or extraordinary relief. A conference board is an informal review of case actions and of the circumstances of the parties and children related to a child support case.

(a) The term conference board can mean either of the following, depending on the context:

(i) The process itself, including the review and any meeting convened; or

(ii) The DCS staff who make up the panel which convenes the hearing and makes factual and legal determinations.

(b) A conference board chair is an attorney employed by DCS in the conference board unit. In accordance with section WAC 388-14A-6415, the conference board chair reviews a case, and:

(i) Issues a decision without a hearing, or

(ii) Sets a hearing to take statements from interested parties before reaching a decision.

(2) A person who disagrees with any DCS action related to establishing, enforcing or modifying a support order may ask for a conference board.

(3) DCS uses the conference board process to:

(a) Help resolve complaints and problems over agency actions;

(b) Determine when hardship in the paying parent's household, as defined in RCW 74.20A.160, justifies the release of collection action or the refund of a support payment;

(d) Set a repayment rate on a support debt; and

(e) Determine when it is appropriate to write off support debts owed to the department based on:

(i) Hardship to the paying parent or that parent's household;

(ii) Settlement by compromise of disputed claims;

(iii) Probable costs of collection in excess of the support debt; or

(iv) An error or legal defect that reduces the possibility of collection.

(4) A conference board is not a formal hearing under the Administrative Procedure Act, chapter 34.05 RCW.

(5) A conference board does not replace any formal hearing right created by chapters 388-14A WAC, or by chapters 26.23, 74.20 or 74.20A RCW.

(6) This section and WAC 388-14A-6405 through 388-14A-6415 govern the conference board process in DCS cases.

History

Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-6400, filed 5/29/08, effective 7/1/08. Statutory Authority: RCW 74.08.090, 26.23.035, 34.05.220, 74.20A.310. WSR 01-03-089, § 388-14A-6400, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-385.

Wash. Admin. Code § 388-14A-6405 How to apply for a conference board.

(1) A person may request a conference board, orally or in writing, at any division of child support (DCS) office.

(2) Oral requests for conference boards are governed by WAC 388-14A-6100.

(3) DCS may start conference board proceedings in appropriate circumstances.

History

Statutory Authority: RCW 74.08.090, 26.23.035, 34.05.220, 74.20A.310. WSR 01-03-089, § 388-14A-6405, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-386.

Wash. Admin. Code § 388-14A-6410 Explanation of the conference board process.

(1) An applicant for a conference board must make reasonable efforts to resolve the dispute with division of child support (DCS) staff before the conference board can act in the case.

(2) A conference board chair reviews each application to determine appropriate action:

(a) If there are questions of both law and fact or if the dispute involves only facts, the chair may schedule a conference board hearing to gather evidence;

(b) If the factual dispute would not provide a basis on which the conference board could grant relief, even if all facts were resolved in favor of the applicant, the chair may issue a decision without a hearing; or

(c) If the dispute can be resolved as a matter of law without relying upon disputed facts, the conference board chair may issue a decision without scheduling a hearing.

(3) If the conference board chair schedules a hearing, the conference board is made up of the conference board chair and staff from the DCS field office which handles the child support case, if needed.

(a) At the hearing, the conference board makes determinations of relevant disputed facts. Decisions on factual issues are made by a majority of the conference board.

(b) Decisions on issues of law are made by the conference board chair alone.

(4) The conference board chair prepares a decision, if necessary, and provides that decision to the parties to the conference board, and to the DCS staff responsible for the case.

(5) The director of DCS, or a person designated by the director, may review conference board decisions, and may alter, amend, vacate or remand decisions that are inconsistent with Washington law or DCS policy, or are grossly unfair.

History

Statutory Authority: RCW 74.08.090, 26.23.035, 34.05.220, 74.20A.310. WSR 01-03-089, § 388-14A-6410, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-387.

Wash. Admin. Code § 388-14A-6415 Scope of authority of conference board chair defined.

The conference board chair has the authority to:

(1) Subpoena witnesses and documents, administer oaths and take testimony;

(2) Grant relief by setting payment plans, writing off debt owed to the department, waiving fees, or refunding collected money;

(3) Adjust support debts based on evidence gathered during the conference board process;

(4) Direct distribution of collected support; and

(5) Take any action consistent with Washington law and DCS policy to resolve disputes, grant relief or address issues of equity.

History

Statutory Authority: 2007 c 143, §§ 1, 2, 3, 4, 5, 7, 8, and 9. WSR 08-12-029, § 388-14A-6415, filed 5/29/08, effective 7/1/08. Statutory Authority: RCW 74.08.090, 26.23.035, 34.05.220, 74.20A.310. WSR 01-03-089, § 388-14A-6415, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-388.

Wash. Admin. Code § 388-14A-6500 Can I use equitable estoppel as a defense in a hearing with the division of child support?

(1) Equitable estoppel is available in adjudicative proceedings conducted under this chapter.

(2) When a party raises, or the facts indicate, a claim that equitable estoppel applies to a party to the proceeding, the administrative law judge (ALJ) must:

(a) Consider equitable estoppel according to the precedents set by reported Washington state appellate case law, where not contrary to public policy; and

(b) Enter findings of fact and conclusions of law sufficient to determine if the elements of equitable estoppel are met and apply.

(3) The party asserting, or benefitting from, equitable estoppel must prove each element of that defense by clear, cogent and convincing evidence.

(4) The ALJ must consider on the record whether a continuance is necessary to allow the parties to prepare to argue equitable estoppel when:

(a) A party raises equitable estoppel; or

(b) The facts presented require consideration of equitable estoppel.

(5) When the ALJ orders a continuance under subsection (4) of this section, the ALJ enters an initial decision and order for current support if:

(a) Current support is an issue in the proceeding; and

(b) The claim for current support is unaffected by the equitable estoppel defense.

(6) The defense of equitable estoppel is not available to a party when the:

(a) Party raises the defense against the department's claim for reimbursement of public assistance; and

(b) Act or representation forming the basis for an estoppel claim:

(i) Was made by a current or former public assistance recipient;

(ii) Was made on or after the effective date of the assignment of support rights; and

(iii) Purported to waive, satisfy, or discharge a support obligation assigned to the department.

History

Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-6500, filed 1/17/01, effective 2/17/01. Formerly WAC 388-11-067.

Wash. Admin. Code § 388-14A-7000 The division of child support may register an order from a non-Washington jurisdiction for enforcement or modification.

(1) A child support order issued by a tribunal of another state, country, or jurisdiction is referred to in this chapter as a foreign order or an intergovernmental order. As described in subsection (3) of this section, there is a type of foreign order known as a convention order.

(2) Except for convention orders described in subsection (3) of this section, a child support order issued by a tribunal of another state or jurisdiction may be registered in this state for enforcement or modification at the request of a party to the order or at the request of the support enforcement agency of a tribe or of another state or country, using the notice of support debt and registration (NOSDR) as provided in WAC 388-14A-7100.

(3) Support orders issued by a tribunal in a foreign country which has ratified the convention of 23 November 2007 on the International Recovery of Child Support and Other Forms of Family Maintenance (known as the Hague Convention on Child Support) are known as convention orders. Convention orders may be registered in this state for enforcement or modification at the request of a party to the order or at the request of that country, using the Notice of Support Debt and Registration-Hague Convention on Child Support (NOSDR-HC) as provided in WAC 388-14A-7005.

(4) The Hague Convention on Child Support may, for the purposes of this chapter, also be known as the "Hague Convention."

History

Statutory Authority: RCW 26.21A.601 through 26.21A.630, 74.08.090. WSR 19-08-086, § 388-14A-7000, filed 4/3/19, effective 5/4/19.

Wash. Admin. Code § 388-14A-7005 The division of child support may register an order from a foreign country under the Hague Convention on Child Support for enforcement or modification.

(1) A child support order issued by a tribunal of a foreign country which has ratified the convention of 23 November 2007 on the International Recovery of Child Support and Other Forms of Family Maintenance (known as the Hague Convention on Child Support) may be registered in this state for enforcement pursuant to chapter 26.21A RCW at the request of a party to the convention order or at the request of the support enforcement agency of the foreign country.

(a) Such an order is, for the purposes of this chapter, known as a "convention order."

(b) At the option of the division of child support (DCS), a convention order may be registered with the superior court pursuant to RCW 26.21A.505 or it may be registered with the administrative tribunal according to subsection (2) of this section. Either method of registration is valid.

(d) DCS may enforce a registered convention order in the same manner and subject to the same procedures as an order issued by a tribunal of this state.

(e) DCS may assess and collect interest on amounts owed under convention orders entered or established in a jurisdiction other than the state of Washington as provided in WAC 388-14A-7110.

(f) DCS notifies the parties that it is enforcing a convention order using the Notice of Support Debt and Registration under the Hague Convention (NOSDR-HC) as provided in this section.

(2) DCS must give notice to the nonregistering party when it administratively registers a convention order. DCS gives this notice by using the Notice of Support Debt and Registration under the Hague Convention (NOSDR-HC).

(a) The notice must inform the nonregistering party:

(i) That a registered convention order is enforceable as of the date of registration in the same manner as an order issued by a tribunal of this state;

(ii) That if a party wants a hearing to contest the validity or enforcement of the registered convention order, the party must request a hearing within thirty days after service of the notice on the nonregistering party, or if the contesting party does not reside in the United States, the contest must be filed no later than sixty days after notice of the registration;

(iii) That failure to contest the validity or enforcement of the registered convention order in a timely manner will result in confirmation and enforcement of the convention order and any alleged arrearages and such failure to contest the notice precludes further contest of the convention order with respect to any matter that could have been asserted;

(iv) Of the amount of any alleged arrearages, including interest, if interest is being assessed under WAC 388-14A-7110; and

(v) Whether DCS has made a determination of controlling order under chapter 26.21A RCW, as described in WAC 388-14A-7325.

(b) The Notice of Support Debt and Registration under the Hague Convention (NOSDR-HC) must be:

(i) Served on the nonregistering party by certified or registered mail or by any means of personal service authorized by the laws of the state of Washington; and

(ii) Served on the registering party or entity by first class mail at the last known address; and

(iii) Accompanied by a copy of the registered convention order and any documents and relevant information accompanying the convention order submitted by the registering party.

(c) The effective date of a request for hearing to contest the validity or enforcement of the registered convention order is the date DCS receives the request.

(3) A party or support enforcement agency seeking to modify, or to modify and enforce, a child support order issued by a foreign country that has ratified the Hague Convention on Child Support may register the convention order in this state according to RCW 26.21A.613 through 26.21A.615.

(a) The convention order must be registered as provided in subsection (1)(b) if the order has not yet been registered.

(b) A petition for modification may be filed at the same time as a request for registration, or later. The petition must specify the grounds for modification.

(c) DCS may enforce a convention child support order registered for purposes of modification, as if a tribunal of this state had issued the order, but the registered convention order may be modified only if the requirements of RCW 26.21A.550 are met.

(4) Interpretation of the registered convention order is governed by RCW 26.21A.515.

History

Statutory Authority: RCW 26.21A.601 through 26.21A.630, 74.08.090. WSR 19-08-086, § 388-14A-7005, filed 4/3/19, effective 5/4/19.

Wash. Admin. Code § 388-14A-7010 What happens at a hearing on a notice of support debt and registration under the Hague Convention on Child Support?

(1) After the service of a Notice of Support Debt and Registration under the Hague Convention (NOSDR-HC) as described in WAC 388-14A-7005, either party to the convention order may object and request a hearing on the notice.

(2) A hearing under this section is for the limited purpose of determining if the nonregistering party (also called the contesting party for the purposes of this section) can prove one or more of the defenses listed in RCW 26.21A.617.

(3) If the contesting party presents evidence establishing a full or partial defense under 26.21A.617, the presiding officer must:

(a) Not limit the right of the division of child support (DCS) to enforce any severable parts of the convention order;

(b) Continue the proceeding to allow the parties to gather additional relevant evidence; or

(4) As provided in RCW 26.21A.620, DCS may enforce an uncontested portion of the registered convention order by all remedies available under the law of this state before there is a final administrative order.

(5) If the contesting party does not establish a defense under 26.21A.617 to the validity or enforcement of the convention order, the presiding officer must issue an order confirming the registered convention order.

(6) The other party to the convention order may participate as a party to any hearing under this section.

(7) The following grounds are the only grounds on which a tribunal of this state may refuse recognition and enforcement of a registered convention support order:

(a) Recognition and enforcement of the order is manifestly incompatible with public policy, including the failure of the issuing tribunal to observe minimum standards of due process, which include notice and an opportunity to be heard;

(b) The issuing tribunal lacked personal jurisdiction consistent with RCW 26.21A.100;

(d) The order was obtained by fraud in connection with a matter of procedure;

(e) A record transmitted in accordance with RCW 26.21A.613 lacks authenticity or integrity;

(f) A proceeding between the same parties and having the same purpose is pending before a tribunal of this state and that proceeding was the first to be filed;

(g) The order is incompatible with a more recent support order involving the same parties and having the same purpose if the more recent support order is entitled to recognition and enforcement under this chapter in this state;

(h) Payment, to the extent alleged arrears have been paid in whole or in part;

(i) In a case in which the respondent neither appeared nor was represented in the proceeding in the issuing foreign country:

(i) If the law of that country provides for prior notice of proceedings, the respondent did not have proper notice of the proceedings and an opportunity to be heard; or

(ii) If the law of that country does not provide for prior notice of the proceedings, the respondent did not have proper notice of the order and an opportunity to be heard in a challenge or appeal on fact or law before a tribunal; or

(j) The order was made in violation of RCW 26.21A.625.

(8) If the presiding officer does not recognize the convention support order under subsection (7)(b), (7)(d) or (7)(i) of this section, the presiding officer may not dismiss the proceeding without allowing a reasonable time for a party to request the establishment of a new convention support order.

(9) DCS must take all appropriate measures to request a child support order for the obligee if the application for recognition and enforcement was received under RCW 26.21A.607.

History

Statutory Authority: RCW 26.21A.601 through 26.21A.630, 74.08.090. WSR 19-08-086, § 388-14A-7010, filed 4/3/19, effective 5/4/19.

Wash. Admin. Code § 388-14A-7100 The division of child support may register an order from a tribe or another state or country for enforcement or modification.

(1) A child support order or an income-withholding order for support issued by a tribunal of another state or jurisdiction may be registered in this state for enforcement pursuant to chapter 26.21A RCW at the request of a party to the order or at the request of the support enforcement agency of an Indian tribe or of another state or country.

(a) At the option of the division of child support (DCS), the support order or income-withholding order may be registered with the superior court pursuant to RCW 26.21A.505 or it may be registered with the administrative tribunal according to subsection (2) of this section. Either method of registration is valid.

(b) A support order or income-withholding order issued in another state or jurisdiction is registered when the order is filed with the registering tribunal of this state.

(c) DCS may enforce a registered order issued in another state or jurisdiction in the same manner and subject to the same procedures as an order issued by a tribunal of this state.

(d) DCS may assess and collect interest on amounts owed under support orders entered or established in a jurisdiction other than the state of Washington as provided in WAC 388-14A-7110.

(e) DCS may notify the parties that it is enforcing a non-Washington support order using the notice of support debt and demand for payment under WAC 388-14A-3304 or using the notice of support debt and registration as provided in this section and in WAC 388-14A-7110. Either method of notice is valid.

(2) DCS must give notice to the nonregistering party when it administratively registers a support order or income-withholding order issued in another state or jurisdiction. DCS gives this notice with the notice of support debt and registration (NOSDR).

(a) The notice must inform the nonregistering party:

(i) That a registered order is enforceable as of the date of registration in the same manner as an order issued by a tribunal of this state;

(ii) That if a party wants a hearing to contest the validity or enforcement of the registered order, the party must request a hearing within twenty days after service of the notice on the nonregistering party within Washington state. If the nonregistering party was served with the notice outside of Washington state, the party has sixty days after service of the notice to request a hearing to contest the validity or enforcement of the registered order;

(iii) That failure to contest the validity or enforcement of the registered order in a timely manner will result in confirmation of the order and enforcement of the order and the alleged arrearages and precludes further contest of that order with respect to any matter that could have been asserted;

(iv) Of the amount of any alleged arrearages, including interest, if interest is being assessed under WAC 388-14A-7110; and

(v) Whether DCS has made a determination of controlling order under chapter 26.21A RCW, as described in WAC 388-14A-7325.

(b) The notice must be:

(i) Served on the nonregistering party by certified or registered mail or by any means of personal service authorized by the laws of the state of Washington; and

(ii) Served on the registering party by first class mail at the last known address; and

(iii) Accompanied by a copy of the registered order and any documents and relevant information accompanying the order submitted by the registering party.

(c) The effective date of a request for hearing to contest the validity or enforcement of the registered order is the date DCS receives the request.

(3) A party or support enforcement agency seeking to modify, or to modify and enforce, a child support order issued in another state or jurisdiction may register the order in this state according to RCW 26.21A.540 through 26.21A.550.

(a) The order must be registered as provided in subsection (1)(a) if the order has not yet been registered.

(b) A petition for modification may be filed at the same time as a request for registration, or later. The petition must specify the grounds for modification.

(c) DCS may enforce a child support order of another state or jurisdiction registered for purposes of modification, as if a tribunal of this state had issued the order, but the registered order may be modified only if the requirements of RCW 26.21A.550 are met.

(4) Interpretation of the registered order is governed by RCW 26.21A.515.

(5) For information about the registration of a child support order under the 23 November 2007 Convention on the International Recover of Child Support and Other Forms of Family Maintenance, see WAC 388-14A-7005.

History

Statutory Authority: RCW 26.21A.601 through 26.21A.630, 74.08.090. WSR 19-08-086, § 388-14A-7100, filed 4/3/19, effective 5/4/19. Statutory Authority: RCW 26.23.120, 34.05.350 (1)(b), 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310 and 45 C.F.R. Parts 301.1, 302.36, 303.7, 303.11, 305.63, and 308.2. WSR 13-01-075, § 388-14A-7100, filed 12/18/12, effective 1/18/13. Statutory Authority: RCW 26.23.120, 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310, and 45 C.F.R. Parts 301.1, 302.35, 302.36, 303.3, 303.7, 303.11, 303.20, 305.63, 307.13, and 308.2. WSR 11-22-116, § 388-14A-7100, filed 11/2/11, effective 12/3/11. Statutory Authority: RCW 34.05.220(2), 43.20A.550, 74.04.055, 74.08.090, 74.20.040, 74.20A.310. WSR 07-08-055, § 388-14A-7100, filed 3/29/07, effective 4/29/07. Statutory Authority: RCW 26.21.016. WSR 05-07-059, § 388-14A-7100, filed 3/11/05, effective 4/11/05. Statutory Authority: RCW 74.08.090, 26.23.035, 34.05.220, 74.20A.310. WSR 01-03-089, § 388-14A-7100, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-260 and 388-14-495.

Wash. Admin. Code § 388-14A-7110 The division of child support may enforce interest on amounts owed under support orders entered or established in a jurisdiction other than Washington state.

(1) The division of child support (DCS) may accept an intergovernmental request to enforce interest when:

(a) The request is from:

(i) Another state's IV-D agency;

(ii) An Indian tribe;

(iii) A foreign country which has entered into a reciprocal agreement with the United States of America or with the state of Washington;

(iv) A foreign country which has ratified the Hague Convention on Child Support; or

(v) A custodial parent (CP) or noncustodial parent (NCP) who resides outside of Washington state who has filed a petition under the Uniform Interstate Family Support Act (UIFSA), chapter 26.21A RCW.

(b) The party requesting that DCS enforce interest provides a calculation of the interest claimed which has been certified by a IV-D agency or a certified public accountant (CPA); and

(2) When a foreign support order has been submitted for enforcement under UIFSA, DCS may, at its option, either:

(a) Use the notice of support debt and demand for payment to enforce interest on an out-of-state support order. See WAC 388-14A-3304 for the rules regarding the notice of support debt and demand for payment; or

(b) Use a notice of support debt and registration to enforce interest on the foreign order. See WAC 388-14A-7100 and 388-14A-7005 for the rules regarding registration of a foreign order.

(3) When an out of state order has been submitted for registration for enforcement and modification under UIFSA, DCS uses a notice of support debt and registration to enforce interest on the out of state order. See WAC 388-14A-7100 and 388-14A-7005 for the rules regarding registration of a foreign support order.

(4) Any hearing held on a notice of support debt and registration which includes a claim for interest is conducted in accordance with WAC 388-14A-7125, 388-14A-7115, and 388-14A-7005.

(a) WAC 388-14A-7135 describes the procedures for confirmation of the registered order.

(b) WAC 388-14A-7135 describes the effect of confirmation of the registered order.

(5) At any time after the notice of support debt and registration becomes a final administrative order, DCS may update the amount of interest as provided in WAC 388-14A-7120.

History

Statutory Authority: RCW 26.21A.601 through 26.21A.630, 74.08.090. WSR 19-08-086, § 388-14A-7110, filed 4/3/19, effective 5/4/19. Statutory Authority: RCW 26.23.120, 34.05.350 (1)(b), 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310 and 45 C.F.R. Parts 301.1, 302.36, 303.7, 303.11, 305.63, and 308.2. WSR 13-01-075, § 388-14A-7110, filed 12/18/12, effective 1/18/13. Statutory Authority: RCW 26.23.120, 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310, and 45 C.F.R. Parts 301.1, 302.35, 302.36, 303.3, 303.7, 303.11, 303.20, 305.63, 307.13, and 308.2. WSR 11-22-116, § 388-14A-7110, filed 11/2/11, effective 12/3/11. Statutory Authority: RCW 34.05.220(2), 43.20A.550, 74.04.055, 74.08.090, 74.20.040, 74.20A.310. WSR 07-08-055, § 388-14A-7110, filed 3/29/07, effective 4/29/07. Statutory Authority: RCW 26.21.016. WSR 05-07-059, § 388-14A-7110, filed 3/11/05, effective 4/11/05.

Wash. Admin. Code § 388-14A-7115 Are there special rules for a hearing on a notice seeking to enforce interest on a support order?

(1) When the division of child support serves a notice of support debt and demand for payment or a notice of support debt and registration under WAC 388-14A-7110(2) and the notice becomes the subject of a hearing, this section applies to a determination of interest.

(2) The calculation of the amount of interest which has been certified by a IV-D agency, a certified public accountant (CPA) or a foreign country's equivalent of a CPA must be accepted as evidence at a hearing on a notice of support debt and demand for payment or on a notice of support debt and registration.

(a) Such certified calculation is prima facie evidence of the amount of interest owed by the NCP.

(b) Any party challenging the certified calculation has the burden of proving that the amount of interest claimed is incorrect.

(3) A party challenging the certified calculation may challenge the calculation for one or more of the following reasons:

(a) The amount of principal is incorrect because credit was not given for payments made;

(b) The amount of principal is incorrect because credit was given for payments which were not actually made; or

(c) The interest calculation was not properly done according to the law of the state, tribe or country issuing the order.

(4) If the administrative law judge (ALJ) finds that the party challenging the interest calculation has shown that the amount of principal is incorrect, the ALJ:

(a) Enters an order stating the correct amount of principal;

(b) Orders the party which submitted the original interest calculation to:

(i) Recalculate or have recalculated the interest based on the new principal amount; and

(ii) Submit the new certified calculation to the ALJ within a reasonable amount of time; and

(c) After receiving the new certified calculation, enters an order determining the amount of debt, including interest, for the period claimed in the notice.

(5) If the ALJ orders a new certified calculation, DCS may enforce any amounts of principal the ALJ found to be due and owing under the support order while the administrative order under subsection (4)(c) of this section is pending.

(6) A claim that the interest calculation was not properly done must be supported by an interest calculation which is certified by a IV-D agency, a CPA or the foreign equivalent. The ALJ then determines which calculation is best supported by the evidence.

(7) The division of child support does not perform certified interest calculations for use in a hearing under this section.

History

Statutory Authority: RCW 26.23.120, 34.05.350 (1)(b), 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310 and 45 C.F.R. Parts 301.1, 302.36, 303.7, 303.11, 305.63, and 308.2. WSR 13-01-075, § 388-14A-7115, filed 12/18/12, effective 1/18/13. Statutory Authority: RCW 26.23.120, 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310, and 45 C.F.R. Parts 301.1, 302.35, 302.36, 303.3, 303.7, 303.11, 303.20, 305.63, 307.13, and 308.2. WSR 11-22-116, § 388-14A-7115, filed 11/2/11, effective 12/3/11. Statutory Authority: RCW 26.21.016. WSR 05-07-059, § 388-14A-7115, filed 3/11/05, effective 4/11/05.

Wash. Admin. Code § 388-14A-7117 Are there special rules for a conference board on a notice seeking to assess and collect interest on a support order?

(1) When the division of child support serves a notice of support debt and demand for payment or a notice of support debt and registration under WAC 388-14A-7110(2) and the notice becomes the subject of a conference board under WAC 388-14A-6400, this section applies to a determination of interest.

(2) The calculation of the amount of interest which has been certified by a IV-D agency or a CPA must be accepted as evidence at a conference board on a notice of support debt and demand for payment or on a notice of support debt and registration.

(a) Such certified calculation is prima facie evidence of the amount of interest owed by the NCP.

(b) Any party challenging the certified calculation has the burden of proving that the amount of interest claimed is incorrect.

(3) A party challenging the certified calculation may challenge the calculation for one or more of the following reasons:

(a) The amount of principal is incorrect because credit was not given for payment made;

(b) The amount of principal is incorrect because credit was given for payments which were not actually made; or

(4) If the conference board determines that the amount of principal is incorrect, the conference board may request that the IV-D agency or a certified public accountant that performed the initial calculation provide a new calculation based on the new principal amount.

(5) DCS may collect undisputed amounts of principal while the final conference board decision is pending.

(6) A claim that the interest calculation was not properly done must be supported by an interest calculation which is certified by a IV-D agency or a certified public accountant. The conference board then determines which calculation is best supported by the evidence.

(7) The division of child support does not perform certified interest calculations for use in a conference board under this section.

(8) The conference board issues a decision, based on the evidence, determining the debt amount, including interest, for the period claimed in the notice.

History

Statutory Authority: RCW 26.21.016. WSR 05-07-059, § 388-14A-7117, filed 3/11/05, effective 4/11/05.

Wash. Admin. Code § 388-14A-7120 When does DCS update the interest on an intergovernmental case for enforcement?

(1) When the division of child support (DCS) accepts an intergovernmental case for enforcement of interest under WAC 388-14A-7110(1), DCS may, at any time after service of a notice of support debt and registration or a notice of support debt and demand for payment, update the amount of interest to be enforced on the case.

(2) To notify the parties to the order that DCS has updated the amount of interest, DCS uses a form called the interest enforcement letter.

(a) The interest enforcement letter is based upon the annual notification of accrued interest from the IV-D agency or an updated interest calculation from a certified public accountant (CPA) or a foreign country's equivalent of a CPA.

(b) DCS sends the interest enforcement letter to the noncustodial parent (NCP), by first class mail to the NCP's last known address.

(3) The interest enforcement letter may advise the NCP of:

(a) The new, updated amount of interest owed for the arrears period; and

(b) The updated total amount of support owed, including interest.

(4) An NCP who objects to an interest enforcement letter must contact the IV-D agency or the CPA or equivalent who did the calculation to dispute the amount of interest claimed.

History

Statutory Authority: RCW 26.23.120, 34.05.350 (1)(b), 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310 and 45 C.F.R. Parts 301.1, 302.36, 303.7, 303.11, 305.63, and 308.2. WSR 13-01-075, § 388-14A-7120, filed 12/18/12, effective 1/18/13. Statutory Authority: RCW 26.23.120, 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310, and 45 C.F.R. Parts 301.1, 302.35, 302.36, 303.3, 303.7, 303.11, 303.20, 305.63, 307.13, and 308.2. WSR 11-22-116, § 388-14A-7120, filed 11/2/11, effective 12/3/11. Statutory Authority: RCW 26.21.016. WSR 05-07-059, § 388-14A-7120, filed 3/11/05, effective 4/11/05.

Wash. Admin. Code § 388-14A-7125 What happens at a hearing on a notice of support debt and registration?

A hearing under this section is for the limited purpose of determining if the nonregistering party can prove one or more of the defenses listed in RCW 26.21A.530(1).

(1) If the contesting party presents evidence establishing a full or partial defense under RCW 26.21A.530(1), the presiding officer may:

(a) Stay enforcement of the registered order;

(b) Continue the proceeding to allow the parties to gather additional relevant evidence; or

(2) DCS may enforce an uncontested portion of the registered order by all remedies available under the law of this state.

(3) If the contesting party does not establish a defense under RCW 26.21A.530(1) to the validity or enforcement of the order, the presiding officer must issue an order confirming the registered order.

(4) The custodial parent (CP) or payee of the order may participate as a party to any hearing under this section.

History

Statutory Authority: RCW 34.05.220(2), 43.20A.550, 74.04.055, 74.08.090, 74.20.040, 74.20A.310. WSR 07-08-055, § 388-14A-7125, filed 3/29/07, effective 4/29/07.

Wash. Admin. Code § 388-14A-7135 What is the effect of confirmation of a registered order on the finality of the support debt calculation?

(1) Except as provided below in subsections (2) and (3) of this section, confirmation of a registered order precludes further contest of the order with respect to any matter that could have been asserted at the time of registration. Confirmation may occur:

(a) By operation of law upon failure to contest registration; or

(b) By order of the administrative law judge (ALJ).

(2) Confirmation of a registered order that does not include interest does not relieve the noncustodial parent (NCP) of any interest that may have accrued or may accrue under the confirmed order.

(a) If interest is later assessed, the NCP or the custodial parent (CP) may not dispute the confirmed amount of the support debt.

(b) The NCP or CP may dispute the amount of interest due and owing on that confirmed amount by requesting a conference board under WAC 388-14A-6400.

(3) Confirmation of a registered order that does include interest confirms only the amount of debt, including interest, that is due and owing for the indicated time periods. Such confirmation does not relieve the NCP of any interest that may have accrued or may accrue for any other time period.

History

Statutory Authority: RCW 34.05.220(2), 43.20A.550, 74.04.055, 74.08.090, 74.20.040, 74.20A.310. WSR 07-08-055, § 388-14A-7135, filed 3/29/07, effective 4/29/07.

Wash. Admin. Code § 388-14A-7200 DCS can serve notices in other states under the Uniform Interstate Family Support Act.

(1) Except as specified in WAC 388-14A-3105, where grounds for personal jurisdiction exist under RCW 26.21A.100 or other Washington law, the division of child support (DCS) may serve the following legal actions in another state by certified mail, return receipt requested or by personal service, under chapter 26.21A RCW:

(a) A notice and finding of financial responsibility under WAC 388-14A-3115; and

(b) A notice and finding of parental responsibility under WAC 388-14A-3120;

(d) An affidavit of birth costs under WAC 388-14A-3555.

(2) A notice and finding of financial responsibility, a notice of paternity test costs, or an affidavit of birth costs becomes final and subject to immediate wage withholding and enforcement without further notice under chapters 26.18, 26.23, and 74.20A RCW unless the noncustodial parent (NCP), within sixty days of service in another state:

(a) Contacts DCS and signs an agreed settlement or consent order; or

(b) Files a written request for a hearing under:

(i) WAC 388-14A-3115 for a notice and finding of financial responsibility;

(ii) WAC 388-14A-3555 for an affidavit of birth costs; or

(iii) WAC 388-14A-8300 for a notice of paternity test costs.

(3) The effective date of a hearing request is the date DCS receives the hearing request.

(4) A notice and finding of parental responsibility becomes final and subject to immediate wage withholding and enforcement without further notice under chapters 26.18, 26.23, and 74.20A RCW unless the NCP, within sixty days of service in another state:

(a) Contacts DCS and signs an agreed settlement or consent order;

(b) Files a written request for a hearing under WAC 388-14A-3120 with DCS; or

(c) Files a written request for paternity testing under WAC 388-14A-8300 to determine if he is the natural father of the dependent child named in the notice and cooperates in the testing. A request for a hearing or paternity testing is filed on the date the request is received by DCS.

(5) If the results of paternity tests requested under subsection (4) of this section do not exclude the NCP as the natural father of the dependent child, the notice and finding of parental responsibility becomes final and subject to immediate wage withholding without further notice under chapters 26.18, 26.23, and 74.20A RCW unless the NCP, within sixty days of service of the paternity test costs in another state:

(a) Contacts DCS and signs an agreed settlement or consent order; or

(b) Files a written request for a hearing under WAC 388-14A-3120.

(6) Administrative law judges and parties must conduct administrative hearings on notices served in another state under this section under the special rules of evidence and procedure in chapter 26.21A RCW and according to chapter 34.05 RCW.

History

Statutory Authority: RCW 34.05.220(2), 43.20A.550, 74.04.055, 74.08.090, 74.20.040, 74.20A.310. WSR 07-08-055, § 388-14A-7200, filed 3/29/07, effective 4/29/07. Statutory Authority: RCW 74.08.090, 34.05.220, 74.20A.055, 74.20A.056. WSR 01-03-089, § 388-14A-7200, filed 1/17/01, effective 2/17/01. Formerly WAC 388-11-305 and 388-14-260.

Wash. Admin. Code § 388-14A-7305 How does a party, IV-D agency or jurisdiction ask for a determination of controlling order?

(1) When there are multiple current support orders covering the same obligor and the same children, a party to a support order may request that the division of child support (DCS) make a determination of controlling order under the Uniform Interstate Family Support Act, chapter 26.21A RCW.

(2) When another state's IV-D agency or another jurisdiction has identified that there are multiple support orders in existence and DCS has personal jurisdiction over both of the parties to the orders, the IV-D agency or jurisdiction may request a determination of controlling order from DCS.

(3) A request for a determination of controlling order may be made at any time, unless there has already been a determination of controlling order for the same obligor and children.

(4) DCS can provide a form which contains all the required elements for a request for determination of controlling order. A request for a determination of controlling order:

(a) Must be in writing;

(b) Must contain copies of any child support orders known to the requesting party. DCS waives this requirement if DCS has a true copy of the order on file; and

(5) A request for determination of controlling order does not constitute a petition for modification of a support order.

History

Statutory Authority: RCW 26.23.120, 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310, and 45 C.F.R. Parts 301.1, 302.35, 302.36, 303.3, 303.7, 303.11, 303.20, 305.63, 307.13, and 308.2. WSR 11-22-116, § 388-14A-7305, filed 11/2/11, effective 12/3/11. Statutory Authority: RCW 34.05.220(2), 43.20A.550, 74.04.055, 74.08.090, 74.20.040, 74.20A.310. WSR 07-08-055, § 388-14A-7305, filed 3/29/07, effective 4/29/07.

Wash. Admin. Code § 388-14A-7315 When might DCS deny a request for a determination of controlling order?

(1) The division of child support (DCS) may deny a request for determination of controlling order made by a party to a child support order or another state's IV-D agency for the following reasons:

(a) There is only one support order for the obligor and the children;

(b) There is no current support owing under any existing support order for the obligor and the children; or

(2) The denial of a request for determination of controlling order does not:

(a) Stop the party or other state's IV-D agency from bringing an action in superior court.

(b) Give rise to a right to administrative hearing.

History

Statutory Authority: RCW 34.05.220(2), 43.20A.550, 74.04.055, 74.08.090, 74.20.040, 74.20A.310. WSR 07-08-055, § 388-14A-7315, filed 3/29/07, effective 4/29/07.

Wash. Admin. Code § 388-14A-7325 How does DCS notify the parties that a determination of the controlling order is going to be made?

(1) When the division of child support (DCS) decides that a determination of controlling order is required, or when a party, IV-D agency or jurisdiction asks for a determination of controlling order, DCS reviews the multiple child support orders for the same obligor and children to determine which order should be enforced.

(a) If DCS decides that the order that should be enforced is a Washington order, DCS refers the matter to the superior court for a determination of controlling order proceeding under chapter 26.21A RCW.

(b) If DCS decides that the order that should be enforced is an order which was not entered in the state of Washington, DCS follows the procedures set out in subsections (2) through (4) of this section.

(2) DCS serves a notice of support debt and registration as provided in WAC 388-14A-7100. DCS serves the notice of support debt and registration on the obligor, the obligee, and on all identified interested parties. The notice of support debt and registration includes a determination of controlling order.

(3) DCS serves the notice of support debt and registration on a party who did not request the determination of controlling order by certified mail, return receipt requested, or by personal service.

(4) DCS serves the notice on the party who requested the determination of controlling order and on any other identified interested parties by first class mail to the last known address.

History

Statutory Authority: RCW 26.23.120, 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310, and 45 C.F.R. Parts 301.1, 302.35, 302.36, 303.3, 303.7, 303.11, 303.20, 305.63, 307.13, and 308.2. WSR 11-22-116, § 388-14A-7325, filed 11/2/11, effective 12/3/11. Statutory Authority: RCW 34.05.220(2), 43.20A.550, 74.04.055, 74.08.090, 74.20.040, 74.20A.310. WSR 07-08-055, § 388-14A-7325, filed 3/29/07, effective 4/29/07.

Wash. Admin. Code § 388-14A-7335 What happens if someone objects to a notice of support debt and registration which contains a determination of the presumed controlling order?

(1) If any party, IV-D agency or jurisdiction objects to the determination of presumed controlling order issued under WAC 388-14A-7325, that objection must be in writing and signed under penalty of perjury. The division of child support (DCS) provides an objection form with the notice of support debt and registration.

(2) An objection to the determination of presumed controlling order must contain:

(a) The reason the party, IV-D agency or jurisdiction objects. Examples of reasons to object include, but are not limited to:

(i) There is another order that was not considered in making the determination;

(ii) The alleged controlling order has been vacated, suspended or modified by a later order, which is attached to the objection;

(iii) The issuing tribunal lacked personal jurisdiction over the nonpetitioning party;

(iv) The order was obtained by fraud; or

(v) Any other legal defense available under chapter 26.21A RCW.

(b) A copy of the order which the party, IV-D agency or jurisdiction believes should be the controlling order, if that order was not included with the notice.

(3) When DCS receives an objection to the proposed determination of controlling order, DCS refers the objection to the prosecuting attorney or attorney general to bring an action for determination of controlling order under RCW 26.21A.130 in the superior court.

History

Statutory Authority: RCW 26.23.120, 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310, and 45 C.F.R. Parts 301.1, 302.35, 302.36, 303.3, 303.7, 303.11, 303.20, 305.63, 307.13, and 308.2. WSR 11-22-116, § 388-14A-7335, filed 11/2/11, effective 12/3/11. Statutory Authority: RCW 34.05.220(2), 43.20A.550, 74.04.055, 74.08.090, 74.20.040, 74.20A.310. WSR 07-08-055, § 388-14A-7335, filed 3/29/07, effective 4/29/07.

Wash. Admin. Code § 388-14A-7345 What is the effect of a determination of controlling order on the finality of the debt calculation?

As provided in RCW 26.21A.130, the final order in a proceeding for determination of controlling order operates as a final determination of the total amount of consolidated arrears and accrued interest, if any, under all of the support orders.

History

Statutory Authority: RCW 34.05.220(2), 43.20A.550, 74.04.055, 74.08.090, 74.20.040, 74.20A.310. WSR 07-08-055, § 388-14A-7345, filed 3/29/07, effective 4/29/07.

Wash. Admin. Code § 388-14A-7400 What can I do if I want to contest an intergovernmental order to withhold income served on my employer?

(1) RCW 26.21A.425 provides that a noncustodial parent (NCP) may contest the validity or enforcement of an income-withholding order issued by an Indian tribe or another state or country and received directly by an employer in this state.

(2) Acting as an administrative tribunal under chapter 26.21A RCW, the division of child support (DCS) does not have the authority to quash income-withholding orders.

(3) An NCP who seeks to contest an income-withholding order as described in subsection (1) must seek relief in the superior court under RCW 26.18.140.

History

Statutory Authority: RCW 26.23.120, 34.05.350 (1)(b), 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310 and 45 C.F.R. Parts 301.1, 302.36, 303.7, 303.11, 305.63, and 308.2. WSR 13-01-075, § 388-14A-7400, filed 12/18/12, effective 1/18/13. Statutory Authority: RCW 34.05.220(2), 43.20A.550, 74.04.055, 74.08.090, 74.20.040, 74.20A.310. WSR 07-08-055, § 388-14A-7400, filed 3/29/07, effective 4/29/07.

Wash. Admin. Code § 388-14A-7500 What can I do if I am concerned about the release of my personal information in an intergovernmental referral?

(1) When the division of child support (DCS) refers a case to an Indian tribe or another state or country, DCS must provide personal information regarding the parties to that other jurisdiction. DCS notifies the party residing in Washington that we are preparing to refer your case and that we must release your personal information.

(2) If you believe that it would be dangerous for DCS to release your personal information to the responding jurisdiction (RJ), you may make a request for nondisclosure of your personal information under RCW 26.21A.255.

(3) The way DCS handles your request for nondisclosure depends on what version of the Uniform Interstate Family Support Act (UIFSA) has been adopted by the RJ where DCS is referring your case.

(a) The RJ may have enacted a version of UIFSA which is similar to the version enacted by the state of Washington as chapter 26.21A RCW (known as "UIFSA 2001");

(b) The RJ may have enacted a version of UIFSA which is similar to the version which was formerly enacted by the state of Washington as chapter 26.21 RCW (known as "UIFSA 1996"); or

(4) If DCS is making an intergovernmental referral to an RJ which has enacted UIFSA 2001:

(a) DCS must disclose your personal information to the RJ.

(b) DCS sends to the RJ a declaration for nondisclosure of information which you have signed under penalty of perjury.

(c) The RJ must seal your personal information and may not disclose that information to the other party or to the public unless a tribunal orders disclosure of the information in the interest of justice, after a hearing in which the tribunal considers your (or your child's) health, safety and liberty.

(5) If DCS is making an intergovernmental referral to an RJ which has enacted UIFSA 1996:

(a) DCS holds a conference board under WAC 388-14A-6400.

(b) If the conference board finds that your (or your child's) health, safety or liberty would be unreasonably put at risk by the disclosure of the information, the conference board issues a nondisclosure finding.

(c) DCS does not disclose your personal information to the RJ, and instead provides the RJ with the nondisclosure finding.

(6) If DCS is making an intergovernmental referral to an RJ which has not adopted UIFSA or a similar law, DCS follows the procedure set out in subsection (5) of this section.

History

Statutory Authority: RCW 26.23.120, 34.05.350 (1)(b), 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310 and 45 C.F.R. Parts 301.1, 302.36, 303.7, 303.11, 305.63, and 308.2. WSR 13-01-075, § 388-14A-7500, filed 12/18/12, effective 1/18/13. Statutory Authority: RCW 34.05.220(2), 43.20A.550, 74.04.055, 74.08.090, 74.20.040, 74.20A.310. WSR 07-08-055, § 388-14A-7500, filed 3/29/07, effective 4/29/07.

Wash. Admin. Code § 388-14A-7600 Does DCS provide the same services in an intergovernmental case as it provides in a case where both parties reside in the state of Washington?

(1) When acting as the responding jurisdiction in an intergovernmental child support case, the division of child support (DCS) provides the full range of services available under our state plan pursuant to Title IV-D of the federal Social Security Act to:

(a) Another state;

(b) A Tribal IV-D program or child support agency; and

(2) The DCS central registry provides the same services for all IV-D cases, including intergovernmental cases.

(3) See WAC 388-14A-1030 for a list of the services provided by DCS.

History

Statutory Authority: RCW 26.23.120, 34.05.350 (1)(b), 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310 and 45 C.F.R. Parts 301.1, 302.36, 303.7, 303.11, 305.63, and 308.2. WSR 13-01-075, § 388-14A-7600, filed 12/18/12, effective 1/18/13.

Wash. Admin. Code § 388-14A-7610 The division of child support complies with federal requirements regarding intergovernmental cases.

As required under 45 C.F.R. 303.7 (a)(3), the division of child support (DCS) ensures that its organizational structure and staff are adequate to provide for the administration or supervision of the functions specified in 45 C.F.R. 303.20(c) for its intergovernmental IV-D caseload, including but not limited to:

(1) Intake;

(2) Establishment of parentage;

(3) Location of noncustodial parents;

(4) Establishment of child support orders;

(5) Collection and enforcement;

(6) Monitoring; and

(7) Review and adjustment of orders.

History

Statutory Authority: RCW 26.23.050, 26.23.110, 43.20A.550, 74.04.055, 74.04.057, 74.08.090, 74.20.040, 74.20A.055, 74.20A.056, and 74.20A.310. WSR 25-09-019, s 388-14A-7610, filed 4/7/25, effective 5/8/25. Statutory Authority: RCW 26.23.120, 34.05.350 (1)(b), 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310 and 45 C.F.R. Parts 301.1, 302.36, 303.7, 303.11, 305.63, and 308.2. WSR 13-01-075, § 388-14A-7610, filed 12/18/12, effective 1/18/13.

Wash. Admin. Code § 388-14A-7620 How does DCS provide information to another jurisdiction in an intergovernmental case?

(1) The division of child support (DCS) uses federally approved forms in intergovernmental IV-D cases, unless a country has provided alternative forms as part of its chapter in A Caseworker's Guide to Processing Cases with Foreign Reciprocating Countries.

(2) DCS uses electronic means to transmit these forms unless a paper version is required under the laws of Washington State or the other jurisdiction.

(3) For intergovernmental cases, DCS transmits requests for information and provides requested information electronically to the greatest extent possible.

(4) When using a paper version of a form, DCS provides one complete set of required documents unless the laws of the responding jurisdiction require multiple copies.

(5) When the child support agency of a tribe or another state or country requests any order or payment record information in order to perform a controlling order determination and reconciliation of arrearages, DCS provides that information within thirty working days of a request, or notifies the state IV-D agency when the information will be provided.

(6) DCS notifies the other agency within ten working days of receipt of new information on the case.

History

Statutory Authority: RCW 26.23.120, 34.05.350 (1)(b), 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310 and 45 C.F.R. Parts 301.1, 302.36, 303.7, 303.11, 305.63, and 308.2. WSR 13-01-075, § 388-14A-7620, filed 12/18/12, effective 1/18/13.

Wash. Admin. Code § 388-14A-7630 What limited services does DCS provide?

(1) For intergovernmental cases, the division of child support (DCS) cooperates with requests for the following limited services:

(a) Quick locate;

(b) Service of process;

(d) Assistance with genetic testing;

(e) Teleconferenced hearings;

(f) Administrative reviews;

(g) High-volume automated administrative enforcement in interstate cases under section 466 (a)(14) of the act; and

(h) Copies of court orders and payment records.

(2) DCS may also honor requests for other limited services as appropriate.

History

Statutory Authority: RCW 26.23.120, 34.05.350 (1)(b), 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310 and 45 C.F.R. Parts 301.1, 302.36, 303.7, 303.11, 305.63, and 308.2. WSR 13-01-075, § 388-14A-7630, filed 12/18/12, effective 1/18/13.

Wash. Admin. Code § 388-14A-7640 Payment and recovery of costs in intergovernmental IV-D cases.

(1) When acting as the responding agency in an intergovernmental IV-D case, the division of child support (DCS) pays the costs it incurs in processing the case, including the costs of genetic testing.

(2) See WAC 388-14A-8300 for the rules regarding payment of genetic testing costs in any IV-D case.

(3) DCS may recover its costs of providing services in intergovernmental nonassistance (both never-assistance and former-assistance) cases as provided under 45 C.F.R. 302.33(d), but when the initiating jurisdiction is a foreign reciprocating country (FRC):

(a) DCS may not assess costs against either the FRC or the custodial parent residing in an FRC; and

(b) DCS may assess costs against the noncustodial parent in such a case.

History

Statutory Authority: RCW 26.23.120, 34.05.350 (1)(b), 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310 and 45 C.F.R. Parts 301.1, 302.36, 303.7, 303.11, 305.63, and 308.2. WSR 13-01-075, § 388-14A-7640, filed 12/18/12, effective 1/18/13.

Wash. Admin. Code § 388-14A-7650 What kind of federal audit requirements are there for intergovernmental cases?

(1) When the division of child support (DCS) is acting as either the initiating jurisdiction (IJ) or the responding jurisdiction (RJ) in an intergovernmental case, there are certain audit requirements which must be met in at least seventy-five percent of the cases reviewed.

(2) For all intergovernmental cases requiring services during the review period, DCS must determine the last required action on each case and determine whether the action was taken during the appropriate time frame.

(3) DCS must use the audit criteria set forth in 45 C.F.R. 308.2(g) when reviewing intergovernmental cases.

History

Statutory Authority: RCW 26.23.120, 34.05.350 (1)(b), 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310 and 45 C.F.R. Parts 301.1, 302.36, 303.7, 303.11, 305.63, and 308.2. WSR 13-01-075, § 388-14A-7650, filed 12/18/12, effective 1/18/13.

Wash. Admin. Code § 388-14A-7700 How does the division of child support (DCS) decide that a new case is an intergovernmental case?

When the division of child support (DCS) opens a new IV-D case, DCS must:

(1) Determine whether or not there is already an existing child support order or orders in effect in the case. DCS uses the state and federal case registries, state records, information provided by the recipient of services, and other relevant information;

(2) Determine which jurisdiction may make a determination of the controlling order and reconciliation of arrearages if there are multiple orders; and

(3) Determine whether the noncustodial parent (NCP) is in another jurisdiction and whether it is appropriate to use its one-state remedies to establish paternity and establish, modify, and enforce a support order, including medical support and income withholding.

History

Statutory Authority: RCW 26.23.120, 34.05.350 (1)(b), 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310 and 45 C.F.R. Parts 301.1, 302.36, 303.7, 303.11, 305.63, and 308.2. WSR 13-01-075, § 388-14A-7700, filed 12/18/12, effective 1/18/13.

Wash. Admin. Code § 388-14A-7710 What does the division of child support (DCS) do when it decides that a case is an intergovernmental case?

Within twenty calendar days of completing the determinations required in WAC 388-14A-7700 and, if appropriate, receipt of any necessary information needed to process the case, the division of child support:

(1) Asks the appropriate intrastate tribunal, or refers the case to the appropriate responding state IV-D agency, for a determination of the controlling order and a reconciliation of arrearages if such a determination is necessary; and

(2) Refers any intergovernmental IV-D case to the appropriate state central registry, Tribal IV-D program, or central authority of a country for action, if one-state remedies are not appropriate.

History

Statutory Authority: RCW 26.23.120, 34.05.350 (1)(b), 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310 and 45 C.F.R. Parts 301.1, 302.36, 303.7, 303.11, 305.63, and 308.2. WSR 13-01-075, § 388-14A-7710, filed 12/18/12, effective 1/18/13.

Wash. Admin. Code § 388-14A-7720 What is the division of child support (DCS) required to do when Washington is the initiating jurisdiction in an intergovernmental case?

When acting as the initiating jurisdiction in an intergovernmental case, the division of child support (DCS) must:

(1) Provide the responding jurisdiction (RJ) sufficient, accurate information to act on the case by submitting with each case any necessary documentation and intergovernmental forms required by the RJ;

(2) Provide the RJ with an updated intergovernmental form and any necessary additional documentation within thirty calendar days of receipt of the request for information, or notify the RJ when the information will be provided;

(3) Notify the RJ at least annually, and upon request in an individual case, of interest charges, if any, owed on overdue support under an initiating state order being enforced in the RJ;

(4) Submit all past-due support owed in IV-D cases that meet the certification requirements under §303.72 of this part for federal tax refund offset;

(5) Send a request for review of a child support order to another state within twenty calendar days of determining that a request for review of the order should be sent to the other state and of receipt of information from the requestor necessary to conduct the review in accordance with section 466 (a)(10) of the Act and §303.8 of this part;

(6) Distribute and disburse any support collections received in accordance with this section and §§302.32, 302.51, and 302.52 of this chapter, sections 454(5), 454B, 457, and 1912 of the Act, and instructions issued by the office;

(7) Notify the RJ within ten working days of case closure that DCS has closed its case, and the basis for case closure as provided in WAC 388-14A-2083;

(8) Instruct the RJ to close its intergovernmental case and to stop any withholding order or notice the RJ has sent to an employer before DCS transmits a withholding order or notice, with respect to the same case, to the same or another employer unless the two states reach an alternative agreement on how to proceed; and

(9) If DCS has closed its case pursuant to WAC 388-14A-2083 and has not notified the RJ to close its corresponding case, DCS must make a diligent effort to locate the obligee, including use of the federal parent locator service and the state parent locator service, and accept, distribute and disburse any payment received from the RJ.

History

Statutory Authority: RCW 26.23.120, 34.05.350 (1)(b), 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310 and 45 C.F.R. Parts 301.1, 302.36, 303.7, 303.11, 305.63, and 308.2. WSR 13-01-075, § 388-14A-7720, filed 12/18/12, effective 1/18/13.

Wash. Admin. Code § 388-14A-7800 What is the division of child support (DCS) required to do when Washington receives a request for intergovernmental child support services?

When the division of child support (DCS) receives a request for intergovernmental child support enforcement services from an Indian tribe, another state or another country, DCS is known as the responding jurisdiction (RJ). As the RJ, DCS must:

(1) Accept and process an intergovernmental request for services, regardless of whether the initiating jurisdiction (IJ) elected not to use remedies that may be available under the law of that jurisdiction;

(2) Within seventy-five calendar days of receipt of an intergovernmental form and documentation:

(a) Provide locate services under WAC 388-14A-1035, if the request is for locate services or if the form or documentation does not include adequate locate information on the noncustodial parent (NCP);

(b) If unable to proceed with the case because of inadequate documentation, notify the IJ of the necessary additions or corrections to the form or documentation; and

(c) If the documentation received with a case is incomplete and cannot be remedied without the assistance of the IJ, process the case to the extent possible pending necessary action by the IJ.

(3) If DCS locates the NCP in another state, DCS returns the intergovernmental referral to the IJ within ten days.

(a) DCS provides the NCP’s locate information to the IJ.

(b) Upon request of the IJ, DCS may forward or transmit the intergovernmental referral to the central registry in the state where the NCP has been located.

History

Statutory Authority: RCW 26.23.120, 34.05.350 (1)(b), 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310 and 45 C.F.R. Parts 301.1, 302.36, 303.7, 303.11, 305.63, and 308.2. WSR 13-01-075, § 388-14A-7800, filed 12/18/12, effective 1/18/13.

Wash. Admin. Code § 388-14A-7810 What is the division of child support (DCS) required to do when DCS receives a request for a determination of controlling order?

When the division of child support (DCS) receives an intergovernmental request for a determination of controlling order, DCS must:

(1) File the controlling order determination request with the appropriate tribunal in its state within thirty calendar days of receipt of the request or location of the noncustodial parent, whichever occurs later; and

(2) Notify the initiating state agency, the controlling order state and any state where a support order in the case was issued or registered, of the controlling order determination and any reconciled arrearages within thirty calendar days of receipt of the determination from the tribunal.

History

Statutory Authority: RCW 26.23.120, 34.05.350 (1)(b), 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310 and 45 C.F.R. Parts 301.1, 302.36, 303.7, 303.11, 305.63, and 308.2. WSR 13-01-075, § 388-14A-7810, filed 12/18/12, effective 1/18/13.

Wash. Admin. Code § 388-14A-7820 What is the division of child support (DCS) required to do when DCS acts as the responding jurisdiction in an intergovernmental case?

(1) When the division of child support (DCS) opens a IV-D case upon receipt of a request for intergovernmental child support enforcement services from an Indian tribe, another state, or another country and acts as the responding jurisdiction (RJ), DCS provides any necessary services as it would in any other IV-D case including:

(a) Establishing parentage and, if appropriate, attempting to obtain a judgment for costs of establishment of parentage;

(b) Establishing a child support order;

(d) Processing and enforcing orders referred by the initiating jurisdiction (IJ), whether pursuant to the Uniform Interstate Family Support Act (UIFSA) or other legal processes, using all appropriate remedies available;

(e) Submitting the case for such federal enforcement techniques as DCS determines to be appropriate;

(f) Collecting and monitoring any support payments from the noncustodial parent and forwarding payments to the location specified by the IJ. In doing so, DCS:

(i) Includes sufficient information to identify the case;

(ii) Indicates the date of collection as defined in WAC 388-14A-5001(3); and

(iii) Includes the RJ's case identifier and locator code, in accordance with federal regulations.

(g) Reviewing and adjusting child support orders upon request, as provided in WAC 388-14A-3900 through 388-14A-3907.

(2) DCS provides timely notice to the IJ in advance of any hearing that may result in the establishment, modification or adjustment of an order.

(3) DCS identifies any fees or costs deducted from support payments when forwarding payments to the IJ in accordance with RCW 74.20.040 and WAC 388-14A-2200.

(4) DCS stops its income withholding order or notice and closes the intergovernmental IV-D case within 10 working days of receipt of instructions for case closure from the IJ, unless DCS and the IJ reach an alternative agreement on how to proceed; and

(5) DCS notifies the IJ when a case is closed pursuant to WAC 388-14A-2083 and 388-14A-2090.

History

Statutory Authority: RCW 26.23.050, 26.23.110, 43.20A.550, 74.04.055, 74.04.057, 74.08.090, 74.20.040, 74.20A.055, 74.20A.056, and 74.20A.310. WSR 25-09-019, s 388-14A-7820, filed 4/7/25, effective 5/8/25. Statutory Authority: RCW 26.23.120, 34.05.350 (1)(b), 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310 and 45 C.F.R. Parts 301.1, 302.36, 303.7, 303.11, 305.63, and 308.2. WSR 13-01-075, § 388-14A-7820, filed 12/18/12, effective 1/18/13.

Wash. Admin. Code § 388-14A-8100 Are there special rules for setting child support for children in foster care?

(1) Child support obligations for children in foster care are set according to the Washington state child support schedule (the WSCSS), found in chapter 26.19 RCW.

(2) When a child or children are placed in foster care, DCS may use the administrative process to set a support obligation:

(a) As a separate obligation for each parent; or

(b) For just one parent, if:

(i) There is already a court or administrative order setting the support obligation of the other parent;

(ii) The other parent is dead; or

(iii) The other parent is unknown.

(3) When setting a support obligation for only one parent, DCS follows the procedure set out in WAC 388-14A-8125.

(4) Prior to May 1, 2022, DCS used the administrative process to set a joint support obligation for parents who are married or in a registered domestic partnership and residing together. When setting a joint obligation, DCS followed the procedures set out in WAC 388-14A-8130.

History

Statutory Authority: RCW 26.09.105, 26.18.170, 26.23.050, 26.23.110, 34.05.220, 74.08.090, and 74.20A.055. WSR 22-08-067, § 388-14A-8100, filed 4/4/22, effective 5/5/22. Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.055, 74.20A.056. WSR 06-16-073, § 388-14A-8100, filed 7/28/06, effective 8/28/06. Statutory Authority: RCW 13.34.160(3), 13.34.270(7), 74.08.090, 74.13.031(11), 74.13.350, 74.20A.030(4), and 74.20A.310. WSR 05-12-135, § 388-14A-8100, filed 6/1/05, effective 7/2/05. Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-8100, filed 1/17/01, effective 2/17/01.

Wash. Admin. Code § 388-14A-8105 Does the cost of care affect how much child support I pay when my child is in foster care?

(1) Child support obligations for children in foster care are set according to chapter 26.19 RCW, without regard to how much the department is expending in foster care funds.

(2) The administrative law judge or review judge may not limit the noncustodial parent's support obligation to the amount the department expends each month for foster care.

History

Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-8105, filed 1/17/01, effective 2/17/01.

Wash. Admin. Code § 388-14A-8110 What happens to the money if current support is higher than the cost of care?

(1) When the division of child support (DCS) collects child support on a foster care case, DCS sends the amounts collected to the department of children, youth, and families (DCYF), which administers foster care funds.

(2) DCYF applies child support payments collected by DCS and deposits in a trust account for the child any child support payments which it doesn't use to reimburse foster care expenses.

History

Statutory Authority: RCW 26.09.105, 26.18.170, 26.23.050, 26.23.110, 26.23.120, 34.05.020, 34.05.060, 74.08.090, 74.20.040, 74.20A.055, and 74.20A.056. WSR 24-15-143, § 388-14A-8110, filed 7/23/24, effective 8/23/24. Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-8110, filed 1/17/01, effective 2/17/01.

Wash. Admin. Code § 388-14A-8120 Are there special rules for collection in foster care cases?

(1) The noncustodial parent (NCP) or parents (NCPs) satisfy their obligation to support the child or children by paying to the division of child support (DCS) the amount specified in a court order or administrative order, if a support order exists, when:

(a) The department of children, youth, and families (DCYF) provides residential care (foster care) for a dependent child; and

(b) DCYF refers the NCP or NCPs to DCS for DCS to take action.

(2) DCS takes action under the provisions of chapters 74.20 and 74.20A RCW and this chapter to enforce and collect support obligations owed for children receiving foster care services.

(3) If, during a month when a child is in foster care, the NCP is the "head of household" with other dependent children in the home, DCS does not collect and retain a support payment if:

(a) The household's income is below the need standard for temporary assistance for needy families (TANF) WAC 388-478-0015; or

(b) Collection of support would reduce the household's income below the need standard.

(4) The NCP's support obligation for the child or children in foster care continues to accrue during any month DCS is prevented from collecting and retaining support payments under this section.

(5) If DCS has collected support payments from the head of household during the months which qualify under subsection (3) of this section, the NCP may request a conference board in accordance with WAC 388-14A-6400.

(6) The NCP must prove at the conference board that the income of the household was below or was reduced below the need standard during the months DCS collected payments.

(7) If the conference board determines that DCS has collected support payments from the head of household that the department or DCYF is not entitled to retain according to this section, DCS must promptly refund, without interest, any support payments, or the portion of a payment which reduced the income of the household below the need standard.

(8) This section does not apply to payments collected prior to August 23, 1983.

History

Statutory Authority: RCW 26.09.105, 26.18.170, 26.23.050, 26.23.110, 26.23.120, 34.05.020, 34.05.060, 74.08.090, 74.20.040, 74.20A.055, and 74.20A.056. WSR 24-15-143, § 388-14A-8120, filed 7/23/24, effective 8/23/24. Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-8120, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-395.

Wash. Admin. Code § 388-14A-8125 How does DCS complete the WSCSS worksheets when setting the child support obligation for one parent of a child in foster care?

(1) When the division of child support (DCS) is setting a support obligation for only one parent, DCS follows the steps set out in this section.

(2) The noncustodial parent (NCP) for whom DCS is setting support is called the party NCP, because that parent is a party to the administrative action.

(3) The parent for whom DCS is not setting support is called the nonparty NCP, because that parent is not a party to the administrative action.

(4) DCS completes a Washington state child support schedule (WSCSS) worksheet using income information for both the party NCP and for the nonparty NCP, instead of setting support based solely on the income of the party NCP.

(5) DCS uses the best available information regarding the income of both the party NCP and the nonparty NCP, as provided in WAC 388-14A-3205.

(6) DCS does not include the income of a nonparty NCP in the worksheets if:

(a) Paternity has not been established for the child;

(b) The nonparty NCP's parental rights have been terminated; or

(7) DCS determines the support obligation of the party NCP without regard to:

(a) The amount of the nonparty NCP's support obligation for the same child or children; or

(b) The cost of foster care placement, as provided in WAC 388-14A-8105.

History

Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.055, 74.20A.056. WSR 06-16-073, § 388-14A-8125, filed 7/28/06, effective 8/28/06.

Wash. Admin. Code § 388-14A-8130 How did DCS complete the WSCSS worksheets when setting a joint child support obligation for a child in foster care prior to May 1, 2022?

(1) Prior to May 1, 2022, the division of child support (DCS) prepared an administrative support notice to establish a joint support obligation for the parents of a child in foster care, DCS followed the steps set out in this section for completing the worksheets under the Washington state child support schedule (WSCSS).

(2) DCS established a joint support obligation when, at the time of order establishment, the parents resided together and were either married or in a registered domestic partnership, unless a child support order covering current support for that child had already been established for one of the parents.

(3) DCS calculated each parent's income under the rules set out in WAC 388-14A-3205, and then calculated the income of the marital or domestic partnership community by combining both parents' income in one column of the worksheet and did not put any income or other information in the other column.

(4) DCS calculated the joint support obligation using the limitations contained in RCW 26.19.065:

(a) The joint child support obligation could not exceed 45% of the net income of the community except for good cause.

(b) DCS followed WAC 388-14A-3410 when calculating and applying the self-support reserve limitation.

(c) Even though there were two parents involved, and despite the application of any limitations, the presumptive minimum obligation of $50 per month per child applied when DCS set a joint child support obligation.

(d) If DCS or the administrative law judge (ALJ) found reasons for deviation, the reasons were supported with appropriate findings of fact in the support order.

(5) As described in subsection (3) of this section, the support obligation in the column of the WSCSS worksheet which contains information regarding both parents is the joint support obligation of the parents.

(6) DCS determined the joint support obligation of the parents without regard to the cost of foster care placement, as provided in WAC 388-14A-8105.

(7) The rules in this section still apply if parties request modification of joint noncustodial parent (NCP) obligations established by administrative orders prior to May 1, 2022.

History

Statutory Authority: RCW 26.09.105, 26.18.170, 26.23.050, 26.23.110, 34.05.220, 74.08.090, and 74.20A.055. WSR 22-08-067, § 388-14A-8130, filed 4/4/22, effective 5/5/22. Statutory Authority: RCW 26.09.105(17), 26.18.170(19), 26.23.050(8), 26.23.110(14), 34.05.020, 34.05.060, 34.05.220, 74.08.090, 74.20.040, 74.20A.055(9), and 74.20A.056(11). WSR 11-12-006, § 388-14A-8130, filed 5/19/11, effective 6/19/11. Statutory Authority: RCW 34.05.220(1), 74.08.090, 74.20A.055, 74.20A.056. WSR 06-16-073, § 388-14A-8130, filed 7/28/06, effective 8/28/06.

Wash. Admin. Code § 388-14A-8200 All Washington employers must report new hires to the Washington state support registry.

(1) RCW 26.23.040 requires all employers doing business in the state of Washington to comply with the employer reporting requirements regarding new hires.

(2) For the purposes of this section, a "new hire" is defined as any person who resides or works in the state of Washington to whom the employer anticipates paying earnings and who:

(a) Has not previously been employed by the employer; or

(b) Was previously employed by the employer but has been separated from such employment for at least sixty consecutive days.

(3) The minimum information that an employer must report is the employee's name, date of birth, Social Security number, and date of hire.

(a) For purposes of this section, the "date of hire" is defined as the date on which the employee first performed services for pay for the employer.

(b) The "date of hire" of an employee described in subsection (2)(b) of this section, is the date on which the employee returned to perform services for pay after a layoff, furlough, separation, or leave without pay.

(4) Employers must report the required information to the Washington State Support Registry (WSSR). An employer may report using the employee's W-4 form or any equivalent form, and may submit the information by:

(a) First class mail;

(b) Fax;

(d) Any other means authorized by the WSSR which will result in timely reporting.

(5) An employer who submits a copy of the employee's completed W-4 form complies with the reporting requirements of RCW 26.23.040(3).

(6) If an employer reports by submitting a W-4 form, the employer may choose to report the additional statutory elements by writing or typing the employee's date of birth and date of hire on the form.

History

Statutory Authority: 2012 c 109, RCW 26.23.040(1), 34.05.350 (1)(b), 43.20A.550, 74.04.055, 74.08.090, and 74.20A.310. WSR 12-18-026, § 388-14A-8200, filed 8/27/12, effective 9/27/12. Statutory Authority: RCW 74.08.090, 26.23.040. WSR 01-03-089, § 388-14A-8200, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-490.

Wash. Admin. Code § 388-14A-8300 Who pays for genetic testing when paternity is an issue?

(1) As provided in WAC 388-14A-3120(14), the noncustodial parent (NCP) and/or the mother of the child may request genetic testing, also called paternity tests, after the service of a notice and finding of parental responsibility.

(2) After receiving a request for paternity tests, the division of child support (DCS) must:

(a) Arrange and pay for the genetic testing, except as provided in subsection (6) of this section, with a laboratory under contract with the department; and

(b) Notify the NCP and the mother of the time and place to appear to give blood samples.

(3) After DCS receives the test results, DCS must mail a notice of the test results to the:

(a) NCP's last known address by certified mail, return receipt requested; and

(b) Mother's and/or custodial parent's last known address by first class mail.

(4) When the genetic tests do not exclude the NCP from being the father, DCS may require the NCP to reimburse the department for the costs of the tests. If DCS seeks reimbursement from the NCP, DCS must notify the NCP:

(a) Of the costs of the tests;

(b) That an administrative order entered as a result of the notice and finding of parental responsibility will include the cost of the tests; and

(c) That DCS may take collection action to collect the genetic testing costs twenty days after the date the NCP receives notice in Washington, or within the time specified in WAC 388-14A-7200, of the test results if the NCP fails to:

(i) Request either a hearing on the issue of reimbursement to DCS for genetic testing costs under WAC 388-14A-3120 or the initiation of a parentage action in superior court; or

(ii) Negotiate an agreed settlement; and

(d) That if the notice and finding of parental responsibility was served in another state, DCS may take collection action according to WAC 388-14A-7200.

(5) When the paternity tests exclude the NCP from being the father, DCS must:

(a) File a copy of the results with the state center for health statistics;

(b) Withdraw the notice and finding of parental responsibility; and

(6) RCW 74.20A.056 does not require DCS to arrange or pay for genetic testing when:

(a) Such tests were previously conducted; or

(b) A court order establishing paternity has been entered.

(7) In an intergovernmental case where DCS is the responding jurisdiction, DCS pays the costs of genetic testing for the initiating jurisdiction and may seek reimbursement from the NCP as provided in this section.

History

Statutory Authority: RCW 26.23.120, 34.05.350 (1)(b), 43.20A.550, 74.04.055, 74.08.090, 74.20.040(9), 74.20A.310 and 45 C.F.R. Parts 301.1, 302.36, 303.7, 303.11, 305.63, and 308.2. WSR 13-01-075, § 388-14A-8300, filed 12/18/12, effective 1/18/13. Statutory Authority: RCW 74.08.090, 74.20A.055, 74.20A.056. WSR 01-03-089, § 388-14A-8300, filed 1/17/01, effective 2/17/01. Formerly WAC 388-11-048 and 388-11-220.

Wash. Admin. Code § 388-14A-8400 Does the division of child support have the right to approve my child support order before the court enters it?

(1) If the department is providing or has provided cash assistance to the family, parties to a court order must give the division of child support (DCS) twenty calendar days prior notice of the entry of any final order and five days prior notice of the entry of any temporary order in any proceeding involving child support or maintenance, because the department has a financial interest based on an assignment of support rights under RCW 74.20.330 or the state has a subrogated interest under RCW 74.20A.030.

(2) Either party may serve notice on DCS, by personal service on, or mailing by any form of mail requiring a return receipt to, the office of the attorney general.

(3) If you don't give sufficient notice before entering the support order, DCS may ask the prosecuting attorney or attorney general to vacate the terms of the support order.

(4) DCS or the department are not entitled to terms for a party's failure to serve the department within the time requirements for this section, unless the department proves that the party knew that the department had an assignment of support rights or a subrogated interest and that the failure to serve the department was intentional.

History

Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-8400, filed 1/17/01, effective 2/17/01.

Wash. Admin. Code § 388-14A-8500 Can the division of child support issue subpoenas?

(1) The division of child support (DCS) issues subpoenas requiring the production of documents or records, or appearance of witnesses, under RCW 34.05.588 and 74.04.290.

(2) Compliance with DCS subpoenas is enforced under RCW 34.05.588 and 74.20A.350.

History

Statutory Authority: RCW 74.08.090. WSR 01-03-089, § 388-14A-8500, filed 1/17/01, effective 2/17/01. Formerly WAC 388-14-220.

Wash. Admin. Code § 388-14A-8600 Does the division of child support enforce interest on unpaid support arrears?

(1) Under RCW 26.23.030(2), the division of child support (DCS) has the authority to assess and collect interest on unpaid child support that has accrued under any support order entered into the Washington state support registry (WSSR).

(2) DCS does not assess or collect interest on administrative or court orders for support entered in the state of Washington unless the amount of interest has been reduced to a judgment.

(3) DCS may assess and collect interest on support orders entered outside of Washington state as provided in WAC 388-14A-7110.

(4) DCS may update the interest assessed on a case as provided in WAC 388-14A-7120.

History

Statutory Authority: RCW 26.21.016. WSR 05-07-059, § 388-14A-8600, filed 3/11/05, effective 4/11/05.

Chapter 388-60B Domestic violence intervention treatment program standards.

Wash. Admin. Code § 388-60B-0015 What definitions apply to this chapter?

The following definitions apply to this chapter:

"Administrative hearing" means a hearing held before an administrative law judge and conducted according to chapter 34.05 RCW and chapter 388-02 WAC.

"Assessment" means the process of obtaining pertinent bio-psychosocial information, as identified by the participant, family, and collateral sources to determine a level of care and to plan individualized domestic violence intervention services and possible referrals for ancillary treatment, assessments, and services.

"Certified" means the status given to domestic violence intervention treatment programs by the department under its authority to certify domestic violence perpetrator programs under RCW 43.20A.735.

"Corrective action" means the steps required of the domestic violence intervention treatment program by the department in order to maintain or regain certification.

"Critical incident" means any one of the following events:

(1) Any death, serious injury, or sexual assault that occurs at a program that is certified by the department;

(2) Alleged abuse or a gross violation of rights of an individual receiving services, that is of a serious or emergency nature caused by an employee, volunteer, contractor, or another individual receiving services;

(3) Alleged abuse, harassment, or a gross violation of rights of a direct treatment service staff member by an employee, volunteer, contractor, or another individual receiving services;

(4) A natural disaster, such as an earthquake, volcanic eruption, tsunami, urban fire, flood, or outbreak of communicable disease that presents substantial threat to program operation or client safety;

(5) A bomb threat or death threat;

(6) Theft or loss of data in any form regarding an individual receiving services, including but not limited to, a missing or stolen computer, or a missing or stolen computer disc or flash drive, or any other type of memory device;

(7) Any physical violence that occurs at the program;

(8) Any violence that is perpetrated by a participant of a certified program that results in death, serious injury, or sexual assault;

(9) Any negative media event regarding a participant receiving services, or regarding a direct treatment staff member or owner(s) of the program; or

(10) Any response to the premises of a program by law enforcement or emergency personnel.

"Department" or "DSHS" means the Washington state department of social and health services.

"Direct service staff" means a person who works or volunteers at a certified domestic violence intervention treatment program and has been designated by the department as a trainee, staff, or supervisor.

"Domestic violence intervention treatment program" or "program" means a program that provides domestic violence assessments or intervention treatment to perpetrators of intimate partner violence and is certified by DSHS under chapter 388-60B WAC.

"Evidence-based" means strategies, activities, or approaches which have been shown through scientific research and evaluation to be effective in preventing or delaying a negative outcome.

"Face-to-face" means either physically in person or by way of live HIPAA compliant video conferencing.

"Forensic counseling" means the provision of group or individual counseling sessions with a participant who has also been engaged with the criminal justice system. Forensic counseling involves skills in assessment, interviewing, report writing, strong verbal communication skills, and case presentation when needed. The practice of forensic counseling involves investigations, research, assessments, consultations, and the design and implementation of treatment programs. In this chapter it specifically relates to assessing, making recommendations, and providing treatment to those who have committed acts of domestic violence regardless of whether the abuse was illegal or resulted in a criminal conviction or not.

"Intimate partner" means a person who is or was married, in a state registered partnership, or in an intimate or dating relationship with another person presently or at some time in the past. Any person who has one or more children in common with another person, regardless of whether they have been married, in a domestic partnership with each other, or lived together at any time, shall be considered an intimate partner.

"Intimate partner abuse" or "intimate partner violence" means a pattern of abusive behavior that is used by one intimate partner against the other and may include, but is not limited to, assaultive and coercive behaviors, physical, sexual, emotional, verbal, psychological, and economic abuse or coercion, or the improper use of children to control the victim. It may also include the infliction or threat of harm against an intimate partner and is directed at achieving compliance from or control over that intimate partner. It may include, but is not limited to, a categorization of domestic violence offenses as defined in RCW 10.99.020 committed by one intimate partner against another.

"Level of treatment" or "level of care" means the level of treatment a participant is required, recommended, or currently receiving as determined by a certified program through a behavioral assessment, standardized testing, the "risk, needs, and responsivity" form, and a current treatment plan.

"Off-site" means the provision of services by a provider from a certified domestic violence intervention treatment program at a location where the domestic violence assessment or treatment is not the primary purpose of the site, such as in correctional facilities.

"Participant" means an individual being assessed, enrolled, discharged, or treated in a certified domestic violence intervention treatment program. This individual may be court-ordered to participate in treatment or someone who chooses to voluntarily participate in treatment. The terms "client," "perpetrator," and "participant" are used interchangeably in this chapter.

"Promising practices" means programs and strategies that have some scientific research or data showing positive outcomes in delaying a negative outcome, but do not have enough evidence to support generalized conclusions.

"Service area" means each geographic location, by county, where a program has more than one active participant attending group or individual sessions.

"Victim services program" means a nonprofit program or organization that provides, as its primary purpose, assistance and advocacy for domestic violence victims. Domestic violence assistance and advocacy must include crisis intervention, individual and group support, information, referrals, safety assessments, and planning. Domestic violence victim assistance and advocacy may also include, but is not limited to: provision of shelter; emergency transportation; self-help services; culturally specific services; legal advocacy; economic advocacy; and accompaniment and advocacy through medical, legal, immigration, human services, and financial assistance systems. Domestic violence programs that are under the auspices of, or the direct supervision of a court, law enforcement, a prosecution agency, or the child protective services section of the department as defined in RCW 26.44.020 are not considered victim services programs.

"Victim" or "survivor" means a person who has been subjected to domestic violence. The terms "victim" and "survivor" are used interchangeably in this chapter.

History

Statutory Authority: RCW 43.20A.735. WSR 25-03-090, s 388-60B-0015, filed 1/16/25, effective 2/16/25. WSR 19-15-044, recodified as § 388-60B-0015, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0015, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0015, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0025 What is the purpose of this chapter?

(1) The overall purpose of this chapter is to increase accountability and competency for programs that provide domestic violence intervention treatment as well as provide minimum standards and a pathway to achieve the following:

(a) To responsibly and as accurately as possible with the information relied upon, assess the risks, needs, and responsivity for perpetrators of intimate partner violence who are seeking assessment and treatment;

(b) To increase the safety of the victim, current partner, children, and other children in the care or residence of perpetrators of intimate partner violence who are enrolled in intervention treatment; and

(c) To hold perpetrators of intimate partner violence accountable in meeting their program requirements and achieving core competencies, including documentation of their cognitive and behavioral changes and personal accountability as outlined in WAC 388-60B-0430, through intervention treatment using evidence-based and promising practices.

(2) The rules in chapter 388-60B WAC establish the following standards for programs that provide domestic violence assessments or any level of intervention treatment to perpetrators of intimate partner violence and include:

(a) Minimum certification requirements for programs that provide services to participants of domestic violence intervention treatment;

(b) Program administrative requirements;

(d) Quality management requirements;

(e) Facility requirements;

(f) Program policies and procedures;

(g) Program treatment record requirements;

(h) Program assessment and treatment requirements; and

(i) A grievance system that includes a grievance process, an appeal process, and access to administrative hearings.

(3) Unless otherwise provided by law, these standards apply to any program that:

(a) Provides or advertises that it provides domestic violence perpetrator assessments or evaluations for intimate partners;

(b) Provides or advertises that it provides domestic violence intervention or perpetrator treatment for intimate partners; or

(c) Defines its services as meeting court orders that require assessment, evaluation, or enrollment in, or completion of, domestic violence perpetrator treatment or domestic violence intervention treatment for intimate partners.

(4) These programs provide assessments, recommendations, or treatment to perpetrators of intimate partner violence, including participants who are self-referred or those who are court-ordered to be assessed or attend treatment.

(5) A program may administer other service programs in addition to domestic violence intervention treatment services; however, the domestic violence intervention treatment program for intimate partners must be considered a separate and distinct program from all other services the agency provides.

(6) Participants of the domestic violence intervention treatment program for intimate partners must not attend the same groups or sessions as participants of other programs or services as part of their domestic violence intervention treatment.

(7) The department requires new applicants who are in the process of applying to DSHS to provide domestic violence intervention assessments or any level of treatment to comply with the requirements in this chapter as of the day it is adopted.

History

Statutory Authority: RCW 43.20A.735. WSR 25-03-090, s 388-60B-0025, filed 1/16/25, effective 2/16/25. WSR 19-15-044, recodified as § 388-60B-0025, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0025, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0025, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0035 The department's advisory committee—Who is on the advisory committee and what is its role?

The department will establish and appoint a volunteer group to serve as the Washington state domestic violence intervention treatment program standards advisory committee.

(1) The role of the advisory committee is to:

(a) Advise the department regarding recommended changes to the program standards; and

(b) Provide technical assistance on program standards, implementation, training, certification, and recertification criteria.

(2) The advisory committee may include the following members:

(a) Up to four persons representing the perspective of survivors of domestic violence who must be chosen with input from the Washington State Coalition Against Domestic Violence (WSCADV);

(b) One person who identifies as a victim or survivor of domestic violence;

(c) Up to four persons representing the perspective of state-certified domestic violence intervention treatment programs who may be chosen with input from the Northwest Association of Domestic Violence Treatment Professionals (NWADVTP) or another currently active organization for domestic violence intervention treatment providers in Washington state;

(d) Up to four persons representing the perspective of adult misdemeanant probation and Washington state courts of limited jurisdiction who may be chosen with input from the Misdemeanant Corrections Association and the Washington State District and Municipal Court Judges Association;

(e) One person representing the department of corrections;

(f) One person representing the office of the administrator for the courts; and

(g) One person representing an academic and research perspective.

(3) Advisory committee members are appointed for up to two-year terms.

(4) The department may replace committee members at any time or if the member has two unexcused absences from two consecutive committee meetings.

(5) If funds are available, the department may reimburse advisory committee members for travel and meal expenses related to service on the committee.

(6) Advisory committee members must not receive any other compensation for service on the committee.

(7) The frequency of meetings for the advisory committee is at discretion of the department, as needed.

History

WSR 19-15-044, recodified as § 388-60B-0035, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0035, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0035, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0045 Program records requirements—What records must programs keep?

(1) The program must keep all records associated with the provision of services for domestic violence assessment or intervention treatment for a minimum of seven years.

(2) In the event of a program or agency closure:

(a) The program must ensure all participants' records are kept and managed for at least seven years after the closure and destroy records in a manner that preserves confidentiality;

(b) The program must provide each participant currently being served with:

(i) Notice of the program closure or program cancellation at least thirty days before the date of closure or program cancellation;

(ii) Assistance with relocation for domestic violence intervention treatment; and

(iii) Information on how to access domestic violence intervention treatment records to which the participant is entitled;

(i) Continue to retain and manage all participant records; or

(ii) Arrange for the continued storage and management of all participant records;

(d) The closing program must notify the department in writing and include the name of the certified program storing and managing the records, provide the method of contact such as a telephone number or electronic address, and provide the mailing and street address where the records will be stored;

(e) Programs run by sole practitioners must name an emergency contact person who will be responsible for the program's records should the sole practitioner be unable to do so due to illness or death; and

(f) When any program or agency storing and maintaining participant records receives an authorized request for a record, the record must be provided to the requester within a reasonable period of time.

History

WSR 19-15-044, recodified as § 388-60B-0045, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0045, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0045, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0055 Department record retention—What records must the department keep?

The department must maintain the following information regarding certified domestic violence intervention treatment programs under its records retention schedule:

(1) A current record of all certified domestic violence intervention treatment programs; and

(2) A current record of programs that:

(a) Are in the process of applying for certification;

(b) Have been denied certification over the last twelve months;

(d) Have had their certification revoked in the last twelve months; and

(e) Are being investigated.

History

WSR 19-15-044, recodified as § 388-60B-0055, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0055, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0055, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0100 Certification requirements—Must a program be certified to provide domestic violence assessments or treatment?

(1) All programs providing domestic violence assessments or domestic violence intervention treatment services must submit an application and be certified by the department.

(2) A program must not provide any domestic violence assessments or services prior to certification.

(3) If there is a gap of time between program certification expiration and recertification approval, the program may request up to a thirty-day extension of their certification in order to continue providing services while their recertification application is processed by the department.

(a) It is at the discretion of the department if an extension will be granted for up to thirty days while waiting for recertification approval or denial; and

(b) The department's decision to deny an extension for up to thirty days is not subject to administrative review under chapter 388-02 WAC.

(4) To receive initial certification or to maintain certification the program must comply with all the requirements of chapter 388-60A WAC.

(5) Programs may request to be certified to offer one or any combination of the following domestic violence services:

(a) Domestic violence behavioral assessments;

(b) Levels one, two, and three domestic violence intervention treatment services; or

(c) Level four domestic violence intervention treatment services, which requires the program to meet additional education and documentation requirements as outlined in WAC 388-60A-0110(3).

History

WSR 19-15-044, recodified as § 388-60B-0100, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0100, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0100, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0105 Application process—How must a program apply for certification or recertification to provide domestic violence assessments or intervention treatment services?

(1) Initial and recertification applications can be downloaded at https://www.dshs.wa.gov/esa/community-services-offices/certification-process. Completed applications, the required fee, and documentation must be mailed together to:

Department of social

and health services

Domestic violence intervention

treatment program manager

P.O. Box 45470

Olympia, WA 98504-5470

(2) A program cannot provide assessments or any level of direct treatment services to domestic violence participants without being certified by the department.

(3) Certification and recertification applications must include the application fee, be filled out completely, and contain all documentation required as indicated on the application in order to be processed by the department.

(4) The department will review the application within 30 days after an application is received to determine if the program meets the standards and certification requirements in this chapter.

(a) Programs may supplement their application as needed during the 30 days after the application is received and the department is reviewing it; and

(b) If a program does not meet the application requirements within the 30 days following submission, the program must reapply for certification.

(5) After initial certification programs certified under this chapter must reapply for certification every two years.

(6) The department must notify the applicant whether the program meets the standards set forth in this chapter.

(a) If a program meets the standards set forth in this chapter, the department will issue the program an approval letter and a certificate; or

(b) If a program does not meet the standards set forth in this chapter, the department will provide the program with:

(i) A written notice containing the reasons the department determined the program did not meet these standards; and

(ii) A list of the specific provisions of this chapter that the program failed to meet.

(7) Treatment programs have the right to an administrative hearing to contest the department's denial of their certification applications. Such hearings shall be governed by this chapter and chapter 388-02 WAC. Where provisions of this chapter and chapter 388-02 WAC conflict, the provisions of this chapter will control.

(8) Certified programs must report to the department any and all changes that occur following the initial or renewal certification process.

(9) The department may request a copy of additional disclosure statements or background inquiries if there is reason to believe that offenses specified under RCW 43.43.830 have occurred since the original application was submitted.

(10) The department may grant an exception or waiver from compliance with specific program certification requirements if the exception or waiver does not violate existing local, state, federal, or tribal law.

(a) To request an exception or waiver to a rule in this chapter, the program must:

(i) Submit the request in writing to the department;

(ii) Assure that any exception or waiver would not jeopardize the safety, health, or treatment of an individual; and

(iii) Assure that any exception or waiver would not impede fair competition of another service program;

(b) The department approves or denies an exception or waiver request in writing and requires the program to keep a copy of the decision; and

(c) The department's decision to deny an exception or waiver request is not subject to administrative review under chapter 388-02 WAC.

(11) The department considers each geographical location of a program an individual program and must certify each location separately.

(a) A program certified to provide assessments or any level of treatment may do so at an off-site location as defined in this chapter, without an additional certification for the off-site location;

(b) If the program provides assessments only, then the program is only required to have one certification and does not need a separate certification for each geographical location it serves; and

(c) If a program that has provided only assessments wants to add certification to provide any level of care, the program must certify each geographical location where any level of care will be offered unless it meets the 'off-site' definition in this chapter.

(12) The application fee for initial certification and recertification of a domestic violence intervention treatment program is $125.00.

(a) The department publishes the application fee for certification of domestic violence intervention treatment programs in the application packet; and

(b) If there is any change in the fee, the update will be done and made effective in July of each year.

History

Statutory Authority: RCW 43.20A.735. WSR 25-03-090, s 388-60B-0105, filed 1/16/25, effective 2/16/25. WSR 19-15-044, recodified as § 388-60B-0105, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0105, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0105, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0110 Required documentation for certification and recertification—What must be included in an application to provide domestic violence assessments or treatment?

(1) For programs applying for initial certification or recertification the program's director must submit the following documentation with the program's application:

(a) A written statement signed by the program's director that the program complies with the standards contained in this chapter;

(b) A copy of the current business license that authorizes the program, or its governing agency, to do business in Washington state at the physical address indicated on the application;

(d) A list of all direct treatment staff at the program;

(e) Results of current criminal history background checks conducted by the Washington state patrol for all current direct treatment program staff;

(i) If the program staff has lived outside of the state of Washington in the last 10 years, then a background check that covers each state they lived in prior to Washington for the last 10 years must be included with the application; and

(ii) The results of an FBI or other national criminal background check can be used in place of the Washington state patrol check if it documents the state of Washington, and any other state they lived in for the past 10 years was part of the background check search;

(f) An attestation for each current paid or volunteer staff person, documented in the application, whether the staff person has ever been a party to any civil proceedings involving domestic violence or crimes of moral turpitude;

(g) If the staff person has been party to any civil proceedings involving domestic violence or crimes of moral turpitude, the application must also include the legal findings of each incident along with the staff person's written explanation (see WAC 388-60B-0210 (2)(b));

(h) Proof that each direct treatment staff is currently registered or licensed as a counselor with the Washington state department of health; and

(i) Written documentation that the program maintains cooperative and collaborative relationships with agencies providing services related to domestic violence which must include, at a minimum, all of the following:

(i) One item of documentation showing that the program has established and continues to maintain a cooperative relationship with another local program or agency involved in the provision of direct or ancillary services related to domestic violence including, but not limited to, probation services, legal services, a domestic violence intervention treatment program, or a victim services program;

(ii) One item of documentation showing that the program regularly attends and participates in a local domestic violence task force, intervention committee, coordinated community response group, or workgroup in each service area where they have more than one active participant. This requirement does not apply if the above mentioned groups do not exist in the service area, or if the program needs to attend virtually, and the group does not offer the option to attend virtually;

(iii) One item of documentation showing that the program has a collaborative relationship, either electronic or in person, with another Washington state certified domestic violence intervention treatment program which includes:

(A) Written documentation of regularly scheduled opportunities for confidential case staffing; and

(B) Written documentation of regularly scheduled opportunities for collaboration in the delivery of domestic violence intervention treatment services and procedures for victim safety (the program can find a current list of certified domestic violence intervention treatment programs in the state of Washington online at https://www.dshs.wa.gov/esa/community-services-offices/domestic-violence-intervention-treatment); and

(iv) With the initial certification application only, a current list of all the local domestic violence victim services programs in the program's area as reasonably available.

(2) If applying to provide any level of domestic violence intervention treatment services the program must include the following on their application, which must be approved by the department prior to certification:

(a) An explanation of the program's evidence-based or promising practice treatment modalities (see WAC 388-60B-0310(3)); and

(b) The program's methods of treatment.

(3) In order to apply for level four domestic violence intervention treatment, the program must also submit documentation of the supervisor level direct treatment staff who will be responsible for facilitating group and individual sessions for participants in level four treatment.

(a) The supervisor must document an initial six hours of training, approved by DSHS in providing level four treatment; and

(b) For recertification, the supervisor must document four hours every 24 months of continuing education, approved by DSHS in providing level four treatment, focused on criminogenic factors, risk issues, psychopathy, and related topics.

(4) All programs must submit the applicable required policies and procedures as outlined in WAC 388-60B-0115, which must be approved by the department prior to initial certification.

(5) If the program was certified prior to the adoption of chapter 388-60B WAC, the program must submit the applicable policies and procedures with their first recertification application after the adoption of these rules.

(6) For programs applying for recertification, the program must also submit:

(a) A statement of qualifications for any staff added since the last certification period (form #10-210) which can be found online at https://www.dshs.wa.gov/esa/community-services-offices/domestic-violence-intervention-treatment or requested by mail from the address listed in WAC 388-60B-0105(1);

(b) An update of continuing education hours for each direct treatment staff (form #14-544) which can be found online athttps://www.dshs.wa.gov/esa/community-services-offices/domestic-violence-intervention-treatment or requested by mail from the address listed in WAC 388-60B-0105(1); and

(c) If the program is applying to provide a new domestic violence intervention service on their recertification application, then the program must also submit the following with their application:

(i) The applicable policies and procedures which have not already been approved, but are necessary to provide the new service(s) (see WAC 388-60B-0115); and

(ii) If the program is applying to provide a new level of treatment the following must be submitted and approved by the department prior to providing the service:

(A) A description of the program's evidence-based or promising practice treatment modalities; and

(B) The program's methods of treatment.

History

Statutory Authority: RCW 43.20A.735. WSR 25-03-090, s 388-60B-0110, filed 1/16/25, effective 2/16/25. WSR 19-15-044, recodified as § 388-60B-0110, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0110, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0110, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0115 Policies and procedures—Which policies and procedures must be approved by the department before I may provide domestic violence assessments or treatment services?

(1) A domestic violence intervention treatment program must keep updated policies and procedures that have been approved by the department prior to initial certification. The policies and procedures must be readily available at all times to all staff and volunteers either in electronic or paper form.

(2) Programs that were certified prior to the implementation of chapter 388-60A WAC must submit policies and procedures to DSHS with their program's first re-certification application after the adoption of these rules.

(3) For programs applying to provide assessments, the policies and procedures must be individualized to the program and include:

(a) Program records under WAC 388-60A-0045;

(b) Facility requirements under WAC 388-60A-0120;

(d) Personnel records under WAC 388-60A-0200;

(e) Supervision and supervisor requirements under WAC 388-60A-0250 and 388-60A-0260;

(f) Referral screening under WAC 388-60A-0300;

(g) Victim safety under WAC 388-60A-0325;

(h) Victim confidentiality under WAC 388-60A-0330;

(i) Participant confidentiality under WAC 388-60A-0360;

(j) Releases of information under WAC 388-60A-0365;

(k) Behavioral assessment and interview criteria under WAC 388-60A-0400;

(4) For programs certified or applying to provide any level of domestic violence intervention treatment, the policies and procedures must be individualized to the program and at a minimum cover the following:

(a) Program records under WAC 388-60A-0045;

(b) Facility requirements under WAC 388-60A-0125;

(d) Personnel records under WAC 388-60A-0200;

(e) Supervision and supervisor requirements under WAC 388-60A-0250 and 388-60A-0260;

(f) Referral screening under WAC 388-60A-0300;

(g) Treatment focus under WAC 388-60A-0310;

(h) Group treatment under WAC 388-60A-0315;

(i) Treatment practices under WAC 388-60A-0320;

(j) Victim safety under WAC 388-60A-0325;

(k) Victim confidentiality under WAC 388-60A-0330;

(l) Participant requirements under WAC 388-60A-0345;

(m) Co-occurring treatment under WAC 388-60A-0350;

(n) Participant confidentiality under WAC 388-60A-0360;

(o) Releases of information under WAC 388-60A-0365;

(p) Participant contracts under WAC 388-60A-0370;

(q) Treatment planning under WAC 388-60A-0405;

(r) Minimum treatment periods and requirements under WAC 388-60A-0420;

(s) Reoffenses and noncompliance during treatment under WAC 388-60A-0425; and

(t) Discharging participants under WAC 388-60A-0435;

(5) For programs certified or applying to provide levels one, two, and three treatment, the policies and procedures must be individualized to the program and also cover the following:

(a) Levels one, two and three placement criteria under WAC 388-60A-0410(1) through 388-60A-0410(3);

(b) Levels one, two, and three required cognitive and behavioral changes participants must make in treatment under WAC 388-60A-0415(1);

(6) For programs certified or applying to provide level four treatment the policies and procedures must be individualized to the program and also cover the following:

(a) Level four placement criteria under WAC 388-60A-0410(4);

(b) Level four required skills and behavioral changes under WAC 388-60A-0415(2); and

History

WSR 19-15-044, recodified as § 388-60B-0115, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0115, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0115, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0120 Facility requirements—What facility requirements must a program meet for the space where domestic violence intervention assessments or treatment services are provided?

Each program certified to provide assessments or any level of care must ensure that its physical and virtual treatment space is suitable for the purposes intended.

(1) For programs that offer behavioral assessments or any level of treatment at a physical location:

(a) The group room must easily accommodate 14 people, not counting space taken by staff desks, file cabinets, or similar items; or

(b) If the program regularly and consistently holds groups smaller than 12 participants, the group room must be able to comfortably accommodate the size of the group and facilitator based on attendance records.

(2) The program must ensure that the facility space:

(a) Is not a personal residence;

(b) Is accessible to an individual with a disability, and if a program operates in a historic building or a building that was constructed before current ADA standards, the program must inform potential participants of barriers to accessibility and offer the participant a referral to programs that are ADA accessible when applicable;

(d) Ensures confidentiality and anonymity for participants including:

(i) Having window coverings for reception, group, and assessment spaces; and

(ii) Having signage outside the building that does not indicate domestic violence treatment;

(e) Has adequate private space for personal consultation with an individual, staff charting, and therapeutic activities, as appropriate;

(f) Has secure and locked storage of active and closed confidential participant and victim records which are not accessible to participants or the public;

(g) Has separate, secure storage of poisonous external chemicals and caustic materials;

(h) Has evacuation routes with highlighted emergency exits posted in each room used by participants or staff;

(i) Has a restroom available to participants and staff during business hours; and

(j) Has sufficient ventilation and temperature control to facilitate assessments or groups comfortably.

(3) If the program operates in the same building or in very close proximity to a victim services program, the domestic violence intervention treatment program must conduct assessments and groups sessions at least three hours apart from any victim services.

(4) A different agreement in regard to proximity and day or time allowances or restrictions may supersede the requirements of the standard in WAC 388-60B-0120(3) when it is outlined by a signed memorandum of understanding between the treatment program and the victim services program.

Exception: Domestic violence intervention treatment services being delivered off-site, such as in jails or prisons are not subject to the facility standards in this section.

(5) For programs that offer behavioral assessments or any level of treatment through live HIPAA compliant video conferencing:

(a) The assessor or group facilitator must ensure they are in a confidential setting, unable to be heard by others who are not part of the session.

(b) Permanent walls must separate the assessor or group facilitator from others. A temporary screen or cubicle or other barrier of the like is not permitted to create a confidential space.

History

Statutory Authority: RCW 43.20A.735. WSR 25-03-090, s 388-60B-0120, filed 1/16/25, effective 2/16/25. WSR 19-15-044, recodified as § 388-60B-0120, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0120, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0120, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0125 Quality management—What are the minimum treatment outcomes for participants and how must a program measure staff and treatment effectiveness?

Each treatment program certified to provide assessments or any level of domestic violence intervention treatment must document program specific quality management procedures to increase staff and program treatment effectiveness.

(1) Programs providing assessments or any level of domestic violence intervention treatment must document their quality management in writing and at a minimum include:

(a) How the program monitors compliance with the rules in this chapter, at a minimum every six months, including the supervisor's direct observance of groups when applicable and a review of assessments and participants' records for compliance with this chapter and the program's policies and procedures;

(b) How the program reviews and improves its cultural competency, at a minimum on an annual basis;

(d) How the program regularly attends and participates in a local domestic violence task force, intervention committee, or workgroup in each of their service areas, as defined in WAC 388-60B-0015, when they have more than one active participant in that area.

(2) Programs providing any level of domestic violence intervention treatment must also document in writing:

(a) The use of evidence-based or promising practices;

(b) A copy of the program's treatment outline along with any handouts, exercises, or instructions, as a guide for the facilitators of groups;

(d) How the program collaborates with at least one other certified domestic violence intervention treatment program, either electronically or in person, including written documentation of regularly scheduled opportunities for:

(i) Confidential case staffing;

(ii) Collaboration in the delivery of domestic violence intervention treatment services; and

(iii) Procedures for victim safety;

(e) The policies and procedures the program has in place regarding complaints and grievances; and

(f) How the program collects a confidential evaluation of treatment outcomes for treatment participants which must outline how:

(i) Each participant is given a treatment outcomes evaluation at discharge and asked to complete it at that time. The treatment outcomes form is found online at https://www.dshs.wa.gov/esa/community-services-offices/domestic-violence-intervention-treatment or may be requested by mail from:

Domestic violence intervention

treatment program manager

Department of social and

health services (DSHS)

P.O. Box 45470

Olympia, Washington 98504-5470

(ii) If completed physically, in person the confidential results of the treatment outcomes evaluation is sealed by the participant after it is completed and submitted by the program to DSHS by United States mail within 30 days of completion;

(iii) If completed electronically, the confidential results are submitted by the participant to DSHS via electronic mail at DVProgram@dshs.wa.gov, as soon as it is completed.

(g) If the survivor chooses to provide feedback, the program will provide them with a treatment outcomes evaluation for survivors regarding their experience of the participant's behaviors before, during treatment, and at discharge;

(i) The treatment outcomes form for survivors is found at https://www.dshs.wa.gov/esa/community-services-offices/domestic-violence-intervention-treatment or may be requested by mail from the address listed in this subsection; and

(ii) The survivor may give the outcomes evaluation to the program to be kept confidential and sent to DSHS, or they may send it directly to DSHS if they choose by United States mail to the address listed in this subsection, or electronically to DVProgram@dshs.wa.gov.

History

Statutory Authority: RCW 43.20A.735. WSR 25-03-090, s 388-60B-0125, filed 1/16/25, effective 2/16/25. WSR 19-15-044, recodified as § 388-60B-0125, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0125, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0125, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0130 Adding to existing certification—How must a program add assessments or a level of treatment to an existing certification?

(1) To add certification to provide any service(s) to an existing certified domestic violence intervention program, the program must submit an abbreviated application that is signed by the program's director.

(2) The abbreviated application to add services can be downloaded at https://www.dshs.wa.gov/esa/community-services-offices/domestic-violence-intervention-treatment or requested by mail from:

Domestic violence intervention

treatment program manager

Department of social and

health services (DSHS)

P.O. Box 45470

Olympia, Washington 98504-5470

(3) Completed applications and required documentation can be emailed to DVProgram@dshs.wa.gov or mailed to the address in this section.

(4) The application must be signed, dated, completed entirely, and must include the following:

(a) The name of the supervisor providing management and supervision of services;

(b) The physical address of the program where the new requested service(s) will be provided;

(d) A copy of the program's treatment topics and evidence-based or promising practice treatment modality related to the new service(s), if applicable; and

(e) Updated quality management procedures to include the new service(s).

(5) The department must approve the application for the provision of the new requested service(s) before the program can provide the service(s).

(6) The department may conduct an on-site review prior to approving the new requested service(s) or issuing a new certificate that includes the added service(s).

History

Statutory Authority: RCW 43.20A.735. WSR 25-03-090, s 388-60B-0130, filed 1/16/25, effective 2/16/25. WSR 19-15-044, recodified as § 388-60B-0130, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0130, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0130, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0135 Change in ownership—What must be sent to the department when a program is sold or changes ownership?

(1) When a certified domestic violence intervention treatment program changes ownership, the department requires:

(a) A new certification application (see WAC 388-60A-0105 through 388-60A-0115) including all required documentation;

(b) Payment of the certification application fee (see WAC 388-60A-0120(6)); and

(c) A statement regarding the disposition and management of all participant and victim records in accordance with applicable state and federal laws.

(2) The program must receive a new certification under the new ownership before providing any domestic violence assessments or any level of domestic violence intervention treatment services.

History

WSR 19-15-044, recodified as § 388-60B-0135, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0135, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0135, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0140 Change of address—What must be sent to the department when a program changes the physical location of where they provide assessments or groups?

(1) When a certified domestic violence intervention treatment program relocates to another address, the department requires the program to submit a completed change of address form found online at https://www.dshs.wa.gov/esa/community-services-offices/domestic-violence-intervention-treatment or requested by mail from:

Domestic violence intervention

treatment program manager

Department of social and

health services (DSHS)

P.O. Box 45470

Olympia, Washington 98504-5470

(2) The program must provide the department with:

(a) The effective date and physical address of the program's new location;

(b) Notification of any changes to direct service staff members or supervisor(s), who must receive department approval before providing any direct client services;

(c) A statement regarding the management of all participant and victim records in accordance with applicable state and federal laws; and

(d) An attestation that the new location complies with facility requirements under WAC 388-60B-0125.

(3) The program must receive a certification for the new location's address before providing any assessments or any level of domestic violence intervention treatment service at that address.

(a) An exception may be granted at the discretion of the department if the program had to move suddenly due to an emergency or danger in the previous facility; and

(b) The department may conduct an on-site review prior to approving or issuing a new certificate for the new location.

History

Statutory Authority: RCW 43.20A.735. WSR 25-03-090, s 388-60B-0140, filed 1/16/25, effective 2/16/25. WSR 19-15-044, recodified as § 388-60B-0140, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0140, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0140, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0200 Personnel records—What personnel records must a program keep for direct service staff?

(1) The program must keep records concerning all personnel, including paid and volunteer staff.

(2) Personnel records must contain the following information:

(a) Their most recent Washington state, FBI or other national background check results, which must have been conducted within the last twenty-four months;

(b) A copy of their current registration or license as a counselor with the Washington state department of health;

(d) A copy of the continuing education and training certificates earned over the last twenty-four months.

(3) For programs with more than one direct service staff, the personnel record must also contain documentation of a staff orientation to the program and include:

(a) An overview of the program's philosophy regarding domestic violence intervention treatment;

(b) A review of the program's treatment outline;

(d) A review of the state's domestic violence laws (see WAC 388-60A-0340);

(e) A job description, which is signed by the employee or volunteer; and

(f) The date of hire and the date of termination if applicable.

History

WSR 19-15-044, recodified as § 388-60B-0200, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0200, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0200, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0210 Minimum staff qualifications—What staff qualifications must a program document for direct service staff?

(1) Each treatment program certified for assessments or any level of domestic violence intervention treatment must ensure that all staff with direct treatment contact with participants be:

(a) Currently licensed or registered as counselors as required under chapter 18.19 RCW;

(b) Free of criminal convictions involving domestic violence or moral turpitude;

(i) Direct service staff who have convictions involving crimes of domestic violence or moral turpitude may submit a written explanation of their convictions and a request for an exception to this requirement;

(ii) The department will review the explanation and request for an exception on a case-by-case basis, and the decision to grant or deny such a request will be at the department's discretion;

(iii) This discretionary decision is not subject to an administrative hearing appeal as outlined under chapter 388-02 WAC; and

(i) A direct treatment staff person whose actions have been the subject of a DSHS investigation and have resulted in the denial, suspension, or revocation of a program's certification status is subject to a review by DSHS to determine if the direct treatment staff person is considered to be in good standing;

(ii) The department will review the status of a direct service staff on a case-by-case basis and decisions for designation and recognition of the direct service staff person as a trainee, staff, or supervisor will be at the discretion of the department; and

(iii) This discretionary decision is not subject to an administrative hearing appeal as outlined under chapter 388-02 WAC.

(2) Each direct treatment staff person must have a bachelor's degree from an accredited university in counseling, psychology, social work, or similar social services field.

(a) The department may grant an exception or waiver from compliance with this requirement if the exception would not violate an existing local, state, federal, or tribal law;

(b) In order to qualify for an exception, the employee must possess year-for-year professional level experience equivalent to a related bachelor's degree in counseling, psychology, social work, or similar social service field and the department determines this equivalency at the discretion of the DSHS program manager responsible for monitoring domestic violence intervention treatment programs;

(i) Submit the request in writing to the department;

(ii) Assure that the exception would not jeopardize the safety, health, or treatment of an individual; and

(iii) Assure that the exception would not impede fair competition of another service agency;

(d) The department approves or denies an exception request in writing and requires the program to keep a copy of the decision; and

(e) The department's decision to deny an exception request is not subject to administrative review under chapter 388-02 WAC.

(3) Prior to providing any direct treatment services to program participants, each direct treatment staff person must have completed:

(a) A minimum of 30 hours of domestic violence training from an established domestic violence victim or survivor services program, as defined in this chapter;

(b) A portion, but not all of the victim training hours may be accrued through training from the Washington State Coalition Against Domestic Violence and those trainings may be attended in person or online;

(c) A minimum of 30 hours of training on the provision of domestic violence intervention assessment and services, provided by an established and certified domestic violence intervention treatment services program or other organization that has been approved by the department to provide the training and must include:

(i) An orientation to the treatment program if the training is through a certified program;

(ii) An overview of all applicable policies and procedures;

(iii) Instructions on how to conduct behavioral assessments;

(iv) Instructions on how to facilitate groups; and

(v) Instructions regarding the implementation, administration, interpretation, and utilization of domestic violence offender risk assessment tools;

(A) If located within Washington state, the domestic violence intervention treatment program must be certified and meet the standards as outlined in this chapter; and

(B) If located out-of-state, the domestic violence intervention treatment program must meet the standards outlined in this chapter and in chapter 43.20A RCW; and

(d) Direct service staff must complete all 60 hours of required training before the employee may apply for trainee status and begin to provide any direct services to participants and any work experience accrued prior to completion of the 60 hours of training will not count toward any requirement for work experience.

History

Statutory Authority: RCW 43.20A.735. WSR 25-03-090, s 388-60B-0210, filed 1/16/25, effective 2/16/25. WSR 19-15-044, recodified as § 388-60B-0210, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0210, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0210, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0220 Staff disclosures—What disclosures must direct service staff provide to participants seeking assessments or who are in the program?

(1) Prior to conducting an assessment or providing any level of treatment, each direct service treatment staff must document in the participant's record that the participant was provided with the direct treatment staff's counselor disclosure which must include:

(a) The name of the direct service treatment staff;

(b) The name of the domestic violence intervention treatment program and the program's business address and telephone number;

(d) The direct service staff member's education, training, and experience;

(e) The direct service staff member's designation by the department as a trainee, staff, or supervisor;

(f) The name and description of the types of counseling or interventions provided by the direct service staff, including the treatment approach, methods, and techniques employed in their domestic violence intervention treatment program;

(g) Fee information, including:

(i) The cost for each assessment, group or individual counseling session;

(ii) Billing practices including any advance payments and refunds; and

(iii) A statement that participants are not liable for any fees or charges for services rendered prior to receipt of the disclosure statement;

(h) The limits of confidentiality under RCW 18.19.180;

(i) Disclosure of the direct service staff's supervisory or consultation agreement, including the supervisor's contact information, if they are not the program's supervisor or if they are receiving supervision from another practitioner;

(j) Disclosure that the direct service staff person is not credentialed to diagnose mental disorders or to conduct psychotherapy as defined in WAC 246-810-010(14) if it is outside their scope of practice;

(k) The following information regarding credentialed counselors:

(i) Counselors practicing counseling for a fee must be credentialed with the department of health for the protection of the public health and safety;

(ii) Credentialing of an individual with the department of health does not include a recognition of any practice standards, nor necessarily imply the effectiveness of any treatment;

(iii) The purpose of the Counselor Credentialing Act, chapter 18.19 RCW, which is to:

(A) Provide protection for public health and safety; and

(B) Empower the citizens of the state of Washington by providing a complaint process against those counselors who would commit acts of unprofessional conduct; and

(iv) A reference of the acts of unprofessional conduct in RCW 18.130.180 and the name, address, and contact telephone number within the department of health for complaints; and

(l) Signature and date blocks for the direct service staff and participant, including an attestation that the participant has read, understands, and was provided with the required disclosure statement.

History

WSR 19-15-044, recodified as § 388-60B-0220, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0220, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0220, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0230 Trainee requirements—What qualifications must the program document for direct treatment staff designated as a "trainee" by the department?

(1) A trainee is a direct treatment staff person who has completed the sixty hours of domestic violence victim and perpetrator trainings as outlined in WAC 388-60A-0210 but has not yet accrued the minimum hours of experience required at the staff level.

(2) A trainee may serve as a cofacilitator of groups, but must not have sole responsibility for the group at any time.

(3) A trainee must not have sole responsibility for conducting an interview and assessment, for terminating a participant from treatment, or for writing the participant's discharge summary.

History

WSR 19-15-044, recodified as § 388-60B-0230, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0230, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0230, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0240 Staff requirements—What qualifications must the program document for direct treatment staff designated as "staff" by the department?

(1) To qualify at the staff level the employee must meet all the qualifications at the trainee level and also have accrued and documented:

(a) A minimum of fifty hours of supervised, direct treatment services to domestic violence participants in a certified domestic violence intervention treatment program or out of state equivalent, which includes documentation of the staff person's observation of at least six certified domestic violence intervention treatment groups including debriefings with the facilitator; and

(b) A minimum of fifty hours of experience working with victims of domestic violence.

History

WSR 19-15-044, recodified as § 388-60B-0240, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0240, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0240, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0250 Supervisor requirements—What qualifications must the program document for direct treatment staff designated as a "supervisor" by the department?

(1) To qualify at the supervisor level, the employee must meet all the qualifications required for the staff level and also have accrued and documented:

(a) A minimum of two years of experience in facilitating domestic violence intervention treatment groups at a certified program;

(b) At least two hundred and fifty hours of direct treatment contact with participants in a certified domestic violence intervention treatment program; and

(2) A supervisor must have a master's degree from an accredited university in counseling, psychology, social work, or similar social services field.

(3) The department's program manager will review requests for an exception to this requirement on a case-by-case basis.

(a) An exception for the master's degree requirement must not be given to a direct treatment staff member who has already been given an exception for the bachelor's degree;

(b) In order to qualify for an exception, the employee must possess year-for-year professional level experience equivalent to a related master's degree in counseling, psychology, social work, or similar social services field and the department determines this equivalency at the discretion of the DSHS program manager responsible for monitoring domestic violence intervention treatment programs;

(i) Submit the request in writing to the department;

(ii) Assure that the exception would not jeopardize the safety, health, or treatment of an individual; and

(iii) Assure that the exception would not impede fair competition of another service agency;

(d) The department approves or denies an exception request in writing and requires the program to keep a copy of the decision; and

(e) The department's decision to deny an exception request is not subject to administrative review under chapter 388-02 WAC.

History

WSR 19-15-044, recodified as § 388-60B-0250, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0250, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0250, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0260 Supervisor responsibilities—What responsibilities must the supervisor document for the program?

(1) Each program certified for assessments or any level of domestic violence intervention treatment must have at least one person providing supervision to direct treatment staff.

(2) Supervision must be documented in the direct service staff's personnel file and follow the program's policies and procedures regarding supervision. At a minimum this must include:

(a) At least once every six months, the supervisor must observe all treatment staff who are at the trainee or staff level and who provide direct treatment services such as assessments or any level of treatment;

(b) At least once every six months, the supervisor must review a sample of each direct treatment staff's assessments and participant's records as applicable for compliance with program policies and the WAC standards found in this chapter;

(c) A program's supervisor must document their observations and feedback for the program trainee or staff member and include it in the employee or volunteer's personnel file; and

(d) Programs that consist of one employee, who is the supervisor, are not required to document group observations or file reviews.

(3) A supervisor may be located either on or off-site.

(4) The supervisor is responsible for reporting critical incidents, as defined in this chapter to the department within one business day.

(5) The supervisor must provide the department with documentation of the incident and the actions the program has taken as a result of the incident.

(6) If a program has more than one supervisor, the program must either:

(a) Designate a lead supervisor to fulfill the responsibilities of this section; or

(b) Document in writing how the responsibilities in this section will be shared among the supervisors.

History

Statutory Authority: RCW 43.20A.735. WSR 25-03-090, s 388-60B-0260, filed 1/16/25, effective 2/16/25. WSR 19-15-044, recodified as § 388-60B-0260, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0260, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0260, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0270 Continuing education—What continuing education requirements must the program document for direct service staff?

(1) Each treatment program certified for assessments or any level of domestic violence intervention treatment must ensure that all staff having direct treatment contact with participants documents their continuing education hours.

(2) Each direct treatment staff must complete a minimum of twenty hours of continuing professional education each year after the program is certified, or each year after the staff person is added to the staff list.

(3) No more than five of those hours may be obtained by attending "in-house" training.

(4) Of the twenty annual hours of continuing education, each direct treatment staff must complete a minimum of nine hours in victim training which includes, but is not limited to, any combination of the following topics:

(a) Domestic violence victim advocacy;

(b) Safety planning with domestic violence survivors;

(d) Information on no contact orders or protective orders;

(e) Housing options for domestic violence survivors; or

(f) Other trainings that directly relate to domestic violence survivors or victim advocacy.

(5) Of the twenty annual hours of continuing education, each direct treatment staff must complete a minimum of one hour related to suicide prevention.

(6) Of the twenty annual hours of continuing education, each direct treatment staff must complete a minimum of ten hours in domestic violence intervention, perpetrator, or batterer's treatment. Any combination of the following topics may also be included with the remaining hours if they are submitted with an explanation of how the training relates to domestic violence intervention treatment:

(a) Mental health;

(b) Substance use, gambling or other addictions;

(d) Racism;

(e) LGBTQ culture or homophobia;

(f) Trauma informed treatment;

(g) Complex trauma;

(h) Deescalation in a treatment setting;

(i) Group facilitation;

(j) Domestic violence offender behaviors;

(k) Experiential treatment;

(l) Behavioral assessments;

(m) Cognitive behavioral treatment;

(n) Motivational interviewing;

(o) Forensic counseling;

(p) Dialectical behavioral treatment;

(q) Child abuse;

(r) Sexual assault; or

(s) Other trainings that directly relate to providing domestic violence intervention treatment.

(7) The recommended format for all trainings is live and in-person, however direct treatment staff may obtain continuing professional education online when approved in writing by the program's supervisor.

(8) Supervisors who provide level four treatment must also complete and submit four hours of department approved continuing education every two years following the initial six-hour training in level four treatment.

(a) The four hours of training for level four treatment may be included in the forty hours of continuing education training hours.

(b) The continuing education hours for level four treatment must include training on criminogenic factors, risk issues, psychopathy, and related topics.

(9) The direct treatment staff must document all continuing education training hours on department approved forms.

(a) The form must be accompanied by completion certificates, course or workshop outlines, and the supervisor's signature; and

(b) The program must submit the form and accompanying documentation to the department at the time the program applies for recertification (see WAC 388-60A-0110).

History

WSR 19-15-044, recodified as § 388-60B-0270, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0270, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0270, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0280 Adding direct treatment staff—What documentation must a program submit to the department to add a new direct service staff person, or request designation as a staff or supervisor for existing direct service staff, during a certification period?

(1) A new direct service staff person or an existing person requesting a change in staff level must be approved by the department as a trainee, staff, or supervisor before providing any direct services such as assessments or any level of treatment.

(2) The certified program must submit an application to add or change direct service staff which can be obtained online at https://www.dshs.wa.gov/esa/community-services-offices/domestic-violence-intervention-treatment or requested by mail from:

Domestic violence intervention

treatment program manager

Department of social and

health services (DSHS)

P.O. Box 45470

Olympia, Washington 98504-5470

(3) With the application, the program must submit documentation to the department which proves that the staff meets the minimum qualifications for all treatment staff stated in WAC 388-60B-0210 in addition to the staff level being requested as stated in WAC 388-60B-0230 through 388-60B-0250.

History

Statutory Authority: RCW 43.20A.735. WSR 25-03-090, s 388-60B-0280, filed 1/16/25, effective 2/16/25. WSR 19-15-044, recodified as § 388-60B-0280, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0280, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0280, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0300 Referral screening—May a program screen referrals in order to accept or deny services to potential participants?

(1) A treatment program has the authority to accept or reject any referral for assessment or enrollment in its program.

(2) The program must base acceptance and rejection of a participant on written criteria the program has developed to screen potential participants.

(3) A treatment program may impose any relevant and appropriate conditions on participants that the program deems appropriate for the success of treatment.

History

WSR 19-15-044, recodified as § 388-60B-0300, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0300, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0300, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0305 Nondiscrimination—What are the nondiscrimination criteria with which a program must comply?

(1) A domestic violence intervention treatment program may not discriminate against any participant based on:

(a) Race;

(b) Ethnicity;

(d) Age;

(e) Gender or gender identity;

(f) Disability;

(g) Religion;

(h) Marital status or living arrangements;

(i) Educational attainment;

(j) Language spoken or limited language proficiency;

(k) Socio-economic status; or

(l) Sexual orientation.

(2) Program materials, publications, and audio-visual materials must be culturally aware, sensitive, and nondiscriminatory.

History

WSR 19-15-044, recodified as § 388-60B-0305, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0305, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0305, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0310 Treatment focus—What requirements must a program focus on during treatment and what methods of treatment may they use?

(1) A domestic violence intervention treatment program certified for any level of treatment must document in each participant's record that the program's treatment focus is primarily on increasing victim safety by ending the participant's violence and holding the participant accountable for their abusive behaviors.

(2) The program must document in the participant's record:

(a) The dates, times, and topics covered for each session; and

(b) The behavioral progress of the participant in reaching the objectives or goals as outlined in their treatment plan.

(3) The program must use forensic counseling skills in facilitating evidence-based or promising practices that may include, but are not limited to:

(a) Cognitive-behavioral approaches;

(b) Motivational interviewing or similar client-centered approaches;

(d) Strength-based strategies; or

(e) Positive behavioral reinforcement strategies.

(4) The program must base all treatment on strategies and philosophies that do not blame the victim or imply that the victim shares any responsibility for the abuse which occurred.

(5) The primary goal of a domestic violence intervention treatment program must be to increase the victim's safety by:

(a) Individualizing treatment for each participant with unique goals, the modality of treatment, and adequate and appropriate intervention to address the participant's high risk factors and needs as outlined in their treatment plan; and

(b) Holding the participant accountable for changing the participant's patterns of abusive thinking and behaving.

History

WSR 19-15-044, recodified as § 388-60B-0310, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0310, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0310, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0315 Group treatment—What standards must programs follow regarding the provision of group treatment?

(1) Each treatment program certified for any level of treatment must meet face-to-face with the participant and adhere to the following standards regarding group treatment:

(a) Participants must attend group sessions on a weekly basis;

(b) The group sessions must be single gender;

(c) Participants must be given the choice to attend the group they feel most comfortable in when gender identity is a factor;

(d) The group size is limited to a maximum of 12 participants, and a minimum of two participants;

(e) On a short-term basis the program may accept a participant into their domestic violence intervention treatment program even if the program lacks sufficient participants to constitute a group;

(f) Group sessions with four to 12 participants in attendance must be at least 90 minutes in length;

(g) Group sessions with three or fewer participants in attendance must be at least 60 minutes in length;

(h) Group sessions must be closed to all persons other than participants, group facilitators, and others specifically invited by the group facilitators including, but are not limited to:

(i) Professionals in related fields;

(ii) A research scholar or state of Washington evaluator;

(iii) Advocates from victim service agencies;

(iv) Persons offering interpretation services for the deaf or hearing impaired or language translation or interpretation;

(v) Interns, trainees, or others who bring specific information applicable to the group; and

(i) Any person attending the group as specified under this section must sign a confidentiality agreement of which the program must keep a record.

(2) Groups facilitated by way of live HIPAA compliant video conferencing must comply with the following standards:

(a) The group facilitator must remind all participants of confidentiality standards before each group begins and when any new group member joins thereafter.

(i) Confidentiality standards must include the group participant's physical location, which must not allow for any other person to hear or see the group, and the prohibition of the use of any recording devices.

(ii) The participant must be visible from the torso up while attending group.

(iii) The participant must not use a virtual background or screen, which distorts their background, and makes it more difficult for the facilitator to check for confidentiality requirements.

(b) The group facilitator must disconnect any group participant who violates the confidentiality standards immediately upon discovery and meet one-on-one with that group participant regarding confidentiality standards before they are permitted to attend group again.

(i) The domestic violence intervention treatment program must have a policy regarding online confidentiality, and the consequences for violating that confidentiality, when the program uses live video conferencing for group or individual sessions.

(ii) If a group participant violates confidentiality standards then it is up to the policy and discretion of the domestic violence intervention treatment program whether the group member can resume treatment via video conferencing or not.

History

Statutory Authority: RCW 43.20A.735. WSR 25-03-090, s 388-60B-0315, filed 1/16/25, effective 2/16/25. WSR 19-15-044, recodified as § 388-60B-0315, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0315, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0315, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0320 Treatment practices—How must a program approach treatment and what must happen if it is determined that a participant should move into a different level of treatment?

Each treatment program certified for any level of domestic violence intervention treatment must:

(1) Provide forensic counseling, using evidence-based or promising practices in all levels of treatment;

(2) Require participants to attend face-to-face weekly group or individual sessions, depending on their level of treatment and individual treatment plan;

(3) Use a trauma-informed approach in treatment;

(4) Provide treatment that meets the individual needs of participants based on their ongoing assessment information, motivations for abuse, and motivations for creating healthy relationships;

(5) Document the required cognitive and behavioral changes required by participants in treatment as cited in WAC 388-60B-0415;

(6) Submit compliance reports and relevant information to the courts or appropriate probation office when requested by the referral source or court when applicable;

(7) When increasing or decreasing the level of treatment of a participant the program must document:

(a) Updated assessment information;

(b) A change in treatment needs;

(d) Written approval from the program's supervisor;

(e) An updated treatment plan; and

(8) When a program changes the level of treatment for a participant the program must notify the participant and the referring agency, when applicable.

(a) The program must document if the referring agency has opted out of receiving treatment change notifications and if so, it must be documented in the participant's file; and

(b) If the program cannot reach the recipient the program must document their reasonable efforts to reach them.

History

Statutory Authority: RCW 43.20A.735. WSR 25-03-090, s 388-60B-0320, filed 1/16/25, effective 2/16/25. WSR 19-15-044, recodified as § 388-60B-0320, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0320, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0320, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0325 Victim safety—What steps must programs take in order to help increase victim safety?

(1) Each treatment program certified for assessments or any level of treatment must adequately consider the safety of the victims, current partners, and children of the participants receiving assessments or who are enrolled in the treatment program.

(2) All victim contact initiated by the program must be done by a staff or supervisor level employee as defined in WAC 388-60B-0240 and 388-60B-0250, unless the program contracts with a victim services agency to contact victims.

(3) Programs that are certified for assessments or any level of treatment must take the following steps, as applicable to help increase victim safety:

(a) Notify the victim of each program participant before completing the assessment that the participant is being seen by the certified program for an assessment to determine:

(i) If domestic violence intervention treatment is appropriate for the participant, and if so, what level of treatment the participant will start in at the program; and

(ii) If applicable, what other treatments may be required or recommended as part of the participant's treatment plan;

(b) Inform victims if the program offers live HIPAA compliant video conferencing for assessments or treatment, and the safety concerns this poses for victims, their children, and anyone else who may be in close proximity to the participant during and immediately after assessment or treatment;

(c) Inform victims about emergency and safety planning, outreach, advocacy, and other applicable services offered by a domestic violence victim services program in their community;

(d) Notify the victim of each program participant within 14 days of the participant being accepted or denied entrance to the program that the participant has enrolled in or has been rejected for treatment services; and

(e) When the participant has been accepted into treatment, give victims a brief description of the domestic violence intervention treatment program including all of the following:

(i) The primary objective of the domestic violence intervention treatment program to help increase the safety of the victim and children as well as holding the participant accountable;

(ii) The core competencies and minimum completion criteria for the participant in treatment;

(iii) The fact that the victim is not expected to do anything to help the participant complete any treatment program requirements;

(iv) The limitations of domestic violence intervention treatment; and

(v) The program's direct treatment staff's responsibility regarding mandated reporting and duty to warn.

(4) The program must document in writing the program's efforts to notify the victim by phone of the requirements in this section.

(a) The program may mail the required information in this section if they cannot reach the victim by phone after three documented attempts;

(b) The program must document in writing the program's efforts to obtain the victim's contact information;

(c) When communicating with the victim at the time of assessment, enrollment, or denial into treatment the program must not assess the victim in any way, but the program may ask if the victim has any information they would like to share; and

(d) If on their own accord the victim provides the program with information regarding the participant or aspects of their relationship, then the program must keep the victim's information in a separate file from the participant's file.

(5) The program must not invite or require the victim to attend domestic violence intervention treatment sessions or education groups which the program requires participants to attend as a condition of their contracts.

(6) Programs may meet the requirements of this section through an agreement or contract with a victim services program, but it is the responsibility of the certified program to ensure and document in writing that all requirements are met.

History

Statutory Authority: RCW 43.20A.735. WSR 25-03-090, s 388-60B-0325, filed 1/16/25, effective 2/16/25. WSR 19-15-044, recodified as § 388-60B-0325, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0325, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0325, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0330 Victim confidentiality—What must programs do in order to safeguard victim confidentiality?

Each treatment program certified to provide assessments or any level of domestic violence intervention treatment must follow standards regarding victim confidentiality.

(1) A certified program must treat all information the victim provides to the program as confidential unless the victim gives written permission for the program to release the information or the program is required by law to release the information.

(2) If the program is required by law to release the information shared by the victim, such as in cases of abuse of children, the program must explain the process to the victim and the direct treatment staff's obligations as a mandated reporter under RCW 74.34.020(14).

(3) Any information provided by or to the victim must be kept separate from any files for participants unless the victim has waived their confidentiality for the specific information that will be kept in the participant's file.

(4) If a victim informs the program that the participant has engaged in new abusive behavior, the treatment program must:

(a) Provide the victim with contact information for the local domestic violence victim services programs;

(b) Review with the victim the domestic violence intervention treatment program's victim confidentiality rules including how the victim can waive or release their confidentiality; and

(i) Discuss the victim's safety and document the program's efforts to increase the victim's safety; and

(ii) Document the victim's confidentiality release or waiver in writing, which specifies the information the victim is releasing and for what purpose the information is being released.

(5) If the victim informs the program about a participant's new or recent abusive behavior, and either the victim or the program has reason to believe that disclosing this information to the participant will place the victim at significant risk, the program must keep this information confidential and must not directly address the behavior with the participant until, to the best of the program's knowledge, doing so no longer poses a significant risk to the victim.

(6) The program may explore other sources, such as probation or court records, by which the program has uncovered new or recent abusive behavior and may address the behavior with the participant in treatment if it can be disclosed that the program received this information from a source other than the victim, so as to not place the victim at additional risk.

History

WSR 19-15-044, recodified as § 388-60B-0330, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0330, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0330, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0335 Cooperation with victim services—How must a program cooperate with local domestic violence victim services agencies?

Each treatment program certified to provide assessments or any level of domestic violence intervention treatment must ensure:

(1) The treatment program has established and maintains cooperative relationships with domestic violence victim services programs located in their community;

(2) The treatment program has a current list of local domestic violence victim programs in their area and the services each program provides;

(3) The list of domestic violence victim programs must be available on-site, in print or electronic form, to all direct service staff at all times; and

(4) The program regularly attends and participates in the local domestic violence task force, intervention committee, or workgroup if one exists in their community.

History

WSR 19-15-044, recodified as § 388-60B-0335, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0335, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0335, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0340 Domestic violence laws—What must a program know about domestic violence laws and justice system practices?

Each treatment program certified to provide assessments or any level of domestic violence intervention treatment must ensure that the program has an understanding of the laws pertaining to domestic violence and the operation of the justice system.

(1) At a minimum, a program must be familiar with and have written documentation of:

(a) State laws regulating the response to domestic violence by the criminal justice system;

(b) Relief available to victims of domestic violence offered by:

(i) Washington domestic violence law and civil protection orders;

(ii) Criminal no-contact orders; and

(iii) Civil restraining orders; and

(c) Information about local law enforcement, prosecution, and court and probation programs that work with domestic violence cases.

(2) The written documentation required in this section must be available at all times in print or electronic form to all direct service staff.

History

WSR 19-15-044, recodified as § 388-60B-0340, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0340, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0340, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0345 Participant requirements—What must the program require of participants accepted into a domestic violence intervention treatment program?

(1) All participants enrolled in domestic violence intervention treatment must attend consecutive, same gendered, weekly group treatment sessions that are face-to-face.

(2) Another type of intervention may be approved for participants in any level of treatment for certain documented clinical reasons, such as psychosis, disability, or other conditions that make the individual not amenable to treatment in a group setting.

(3) A program may develop policies which allow level three and four participants to attend individual sessions as part of the participant's treatment plan in order to address their risk factors and meet their unique needs.

(4) Participants who experience hardship attending a certified program, which provides assessments or treatments in person, may ask the program to accommodate them in attending face-to-face by way of live HIPAA compliant video conferencing.

(a) The domestic violence intervention treatment program is not required to accommodate any participant with the option of live HIPAA compliant video conferencing;

(b) If the program does not choose to accommodate the participant with live HIPAA compliant video conferencing for assessment or treatment, the program must refer the participant to another certified domestic violence intervention treatment program who can accommodate the participant with video conferencing.

(5) The program must assign participants to a home group and the participant must be required to attend the same scheduled group each week.

(6) The program's supervisor must authorize any exceptions to this requirement and document the reason for the exception in the participant's file.

(7) A program may develop policies which allow a brief lapse in treatment of no more than 30 days when a participant transfers from another program or experiences extraordinary circumstances that impede their attendance.

(8) Any lapse in treatment must be approved by the program's supervisor and must not exceed 30 days unless approved in writing by the program's supervisor.

(9) Before the participant begins any level of domestic violence intervention treatment, the program must document in the participant's record:

(a) The participant has signed all applicable releases of information required by the treatment program, including those specified in WAC 388-60B-0365;

(b) The participant has signed a contract for services with the treatment program; and

(c) The participant has an assessment and treatment plan completed by a Washington state certified domestic violence intervention treatment program.

History

Statutory Authority: RCW 43.20A.735. WSR 25-03-090, s 388-60B-0345, filed 1/16/25, effective 2/16/25. WSR 19-15-044, recodified as § 388-60B-0345, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0345, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0345, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0350 Co-occurring treatment—May participants engage in other types of treatments while they are in domestic violence intervention treatment?

Each treatment program certified for any level of treatment must adhere to the following standards regarding co-occurring treatment:

(1) A program may recommend or require a participant to participate in other types of treatment or classes during the same period the client is participating in the required weekly domestic violence intervention treatment sessions;

(2) Any other type of treatment or therapy must support the goal of victim safety by facilitating change in the participant's abusive behavior without blaming the victim for the participant's abuse;

(3) Participants must sign a release of information for all cooccurring treatment providers;

(4) In order to increase victim safety, participants must not engage in marital or couples counseling unless they meet all of the following requirements:

(a) The participant has been regularly attending domestic violence intervention treatment services for a minimum of six months;

(b) The program has documented that the participant has taken full accountability for their abusive behaviors; and

(c) The program has communicated with the victim or current partner and documented that the participant has made cognitive and behavioral changes that reduce the risk of intimate partner violence towards the victim; and

(5) Co-occurring therapies must not be substituted for the required domestic violence intervention treatment sessions, including but not limited to:

(a) Individual therapy;

(b) Family therapy;

(d) Parenting classes;

(e) Substance use evaluations, treatment, drug testing; or

(f) Anger management.

History

WSR 19-15-044, recodified as § 388-60B-0350, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0350, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0350, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0355 Participant rights—What are the participant rights that a program must follow and provide to the participant?

(1) Each certified program must provide assessment and treatment participants with rights.

(2) The participant's record must include a copy of the rights, which are signed by the participant and include the following:

(a) A treatment program must provide each participant with the highest quality of service;

(b) Treatment program staff must establish a climate where all relationships with colleagues and participants are respectful;

(c) Each participant must have the assurance that the program staff will conduct themselves professionally, and avoid unprofessional conduct as specified in RCW 18.130.180;

(d) Staff working for a treatment program must not engage in or tolerate verbal abuse, physical abuse, sexual harassment, or exploitation towards a program participant;

(e) Each participant enrolled in domestic violence intervention treatment must have a written contract signed by the participant and the treatment program staff that meets therequirements of WAC 388-60A-0370; and

(f) The participant has the right to request reports and other related materials from their individual file which must be sent directly to the participant or their attorney in a timely manner when it is requested by the participant and they have signed an applicable release of information.

History

WSR 19-15-044, recodified as § 388-60B-0355, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0355, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0355, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0360 Participant confidentiality—What must programs do in order to safeguard participant confidentiality?

Each program certified to provide assessments or any level of domestic violence intervention treatment must:

(1) Follow the confidentiality requirements contained in chapter 18.19 RCW for registered counselors and certified professionals;

(2) Require all program participants and guests to agree in writing not to disclose the identity of group participants or personal information about the participants;

(3) Keep all communications between the participant and direct treatment staff confidential unless:

(a) The participant has signed a release of information; or

(b) The program is legally required to release the information; and

(4) Receive written consent, that gives details about the specific uses for the tape, when a program audio or video tapes a group session.

(a) The program must obtain an additional consent statement from each participant to permit use of the tape for any purpose other than the purposes specified in the original consent;

(b) Audio or video recordings must be stored in a locked, secure and confidential location that is not accessible to participants or the public; and

(c) Audio or video recordings must be destroyed when confidential storage is no longer available, before the program closes or before ownership of the program is transferred.

History

WSR 19-15-044, recodified as § 388-60B-0360, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0360, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0360, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0365 Releases of information—What releases of information must the program require from participants before they are accepted into a program?

In order to obtain information for the assessment or treatment of the participant, to facilitate the communication necessary for periodic safety checks and case monitoring, and to increase the safety of the victim and any children involved, the treatment program must require all participants to sign the following releases, which must remain in effect until at least ninety days after the participant is discharged from treatment:

(1) A release for the victim when applicable;

(a) The release must allow the certified program to communicate with the victim during the assessment and treatment process;

(b) The release must allow the certified program to notify the victim that the participant has been accepted or rejected for treatment;

(c) The release must allow the certified program to notify the victim of any significant changes in the participant's treatment plan or noncompliance with treatment; and

(d) The release must allow the program to notify the victim if their safety appears to be at risk due to the participant's potential for violence or lethality;

(2) A release to receive and provide information regarding the participant with child protective services, child welfare services, other child services, or DSHS programs;

(3) A release allowing the program to receive and provide relevant information regarding the participant, including safety concerns, with each of the following entities as applicable:

(a) Significant others or current partners;

(b) Any adult children who are biological to or have lived with the participant;

(d) Police;

(e) Lawyers, including prosecutors;

(f) Courts;

(g) Probation officers;

(h) Parole officers;

(i) Court-appointed guardian ad litem; and

(j) Any concurrent or former treatment or assessment agencies, including but not limited to:

(i) Domestic violence intervention treatment programs;

(ii) Sexual offender programs;

(iii) Mental health agencies;

(iv) Individual therapists; and

(v) Substance use treatment programs; and

(4) A release allowing the information and data from the participant's individual file to be used for research and evaluation must be offered but not required to be signed by the participant and the release must indicate that any information disclosed for research and evaluation purposes will remain confidential.

History

WSR 19-15-044, recodified as § 388-60B-0365, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0365, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0365, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0370 Participant contracts—What elements must be included in a contract between a program and participant?

(1) Each treatment program certified for any level of domestic violence intervention treatment must require participants to sign and date a formal contract for services before treatment begins.

(2) The program must document that a copy of the contract was offered to the participant.

(3) The contract between each participant and the treatment program must include the following elements:

(a) A statement regarding the treatment program's philosophy that the victim may not be blamed for the participant's abuse, the participant must stop all forms of abuse, the abuser is to be held accountable for their actions, and the program's primary concern is for the safety of victims;

(b) A requirement that the participant must:

(i) Cooperate with all program rules;

(ii) Stop violent and threatening behaviors;

(iii) Develop and adhere to an accountability plan;

(iv) Comply with and when requested, bring documentation of, compliance with all court orders including but not limited to spousal support, child support, parenting plans, and orders of protection or no contact;

(v) Cooperate with the rules for group participation; and

(vi) Sign all required releases of information;

(d) A requirement that the participant must actively participate in treatment, including sharing personal experiences, values, and attitudes, as well as completing all group activities and assignments;

(e) Treatment completion criteria and core competencies;

(f) The program's policy regarding concurrent treatment requirements;

(g) The program's policy regarding the possession of weapons as described under chapter 9.41 RCW;

(h) An agreement that group members must honor the confidentiality of all participants;

(i) A statement that the treatment program has the duty to warn and protect victims, law enforcement, and third parties of any reasonably foreseeable risk of serious harm the program determines the participant poses to them;

(j) A requirement that the participant must either:

(i) Provide the program with the participant's arrest records, criminal history, civil or family law actions, protection orders, no contact orders, incident or police reports, and any information regarding treatment services previously received; or

(ii) Identify the existence of and location of all service records, and authorize release of all such records to the domestic violence treatment program;

(k) The program's policy regarding the use of drugs and alcohol, including a provision that the participant must attend treatment sessions free of drugs and alcohol; and

(l) Fees and methods of payment for treatment.

History

WSR 19-15-044, recodified as § 388-60B-0370, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0370, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0370, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0400 Behavioral assessment and interview criteria—Who may conduct the interview and assessment and what must it include?

(1) A participant must complete an individual interview and behavioral assessment with a certified program prior to starting any level of treatment.

(2) The purpose of the assessment is to determine:

(a) The level of risk, needs, and responsivity for the participant;

(b) The level of treatment the program will require for the participant; and

(3) Only treatment staff who meet the minimum qualifications for direct treatment staff as defined in this chapter may complete the interview and assessment process and all related paperwork.

(a) An assessment must be completed by a staff person who has been designated by the department at the staff or supervisor level as outlined in WAC 388-60B-0240 and 388-60B-0250;

(b) A trainee must not have sole responsibility for conducting an interview or assessment;

(c) A trainee may sit in on an interview and assessment process, but the staff or supervisor level person must conduct the interview and write the assessment.

(4) The assessment process must include:

(a) Verification of the participant's identity by photo identification, shared in person or electronically, unless photo identification is a barrier to treatment and the provider documents this in the participant's record;

(b) A behavioral assessment and screening interview with the participant;

(d) The participant's legal history; and

(e) A summary of the results from all applicable evidence-based, empirical, and objective standardized tests.

(5) The assessment process is ongoing throughout treatment and changes to the participant's program based on updated assessment information must be documented in the participant's record.

(6) Each program certified for assessments must comply with the following:

(a) The program staff must meet face-to-face with the participant to conduct the assessment, and the assessment must be kept in the participant's file;

(b) Information gathered by or provided to the program from the current victim, past victims, significant others, children, or other family members must not be included in the assessment unless:

(i) The program has written consent from that person to include such information in the written assessment; or

(ii) The program is quoting public information gathered from a public record such as a police report, protective order, no contact order, or a similar document;

(c) The assessment must be written, completed, signed, and dated by the staff or supervisor who completed the interview and assessment; and

(d) The program must document their reasonable efforts to share a completed assessment in a timely manner when it is requested by another certified program and an applicable release of information has been signed by the participant.

(7) General assessment information: During the assessment interview a program staff or supervisor must write the assessment and document information that includes the following:

(a) The participant's referral source and contact information for the source when applicable;

(b) Basic demographic and contact information;

(d) The participant's access to the victim and their children, family, and coworkers;

(e) An assessment of the participant's individual culture which includes:

(i) Gender identity;

(ii) Preferred pronouns;

(iii) Sexual orientation;

(iv) Religion or spiritual beliefs;

(v) Race;

(vi) Ethnicity; and

(vii) Groups with which the participant identifies;

(f) The possible cultural context for the participant's views about using violence in family relationships;

(g) An assessment of the participant's history of victimization that includes:

(i) Domestic violence victimization;

(ii) Sexual assault victimization; and

(iii) Other trauma history including complex trauma;

(h) Current or past protective orders, no contact orders, parenting assessments, parenting plans, and orders for supervised visitation with children;

(i) A summary of information from police or incident reports for current and past incidents involving coercive or abusive behaviors;

(i) The program must document the participant's specific abusive behaviors; and

(ii) The program must document whether there were children present during any incidents or in the immediate aftermath of an incident and what the children's exposure was to the abuse, the victim's injuries, and damage to property;

(j) The participant's comments or views about specific abusive behaviors in current and past incidents;

(k) Additional collateral information that is necessary to assess the participant's risks and needs, including, but not limited to information from:

(i) Probation or parole officers;

(ii) The victim, previous partners, or a current partner if they choose to provide information;

(iii) Victim advocates;

(iv) 911 tapes;

(v) Guardians ad litem, CASAs, or parenting evaluators;

(vi) Child protective service workers; and

(l) An assessment of whether children have been effected in any way by the participant's domestic violence and if a parenting class specific to perpetrators of domestic violence will be required by the program.

(8) Domain 1: An assessment of the participant's current and past high risk factors that include, but are not limited to:

(a) Victim initiated separation from the participant in the last six months or other indication the victim may initiate separation;

(b) The infliction or threat of physical harm against an intimate partner including strangulation, physical, sexual, and psychological abuse, or a pattern of assaultive, coercive, and controlling behaviors directed at achieving compliance from or control over that partner;

(c) Access to a firearm, previous use or threats to use a weapon as it is defined in chapter 9.41 RCW, or prior training with weapons;

(d) Signs of jealousy, possessiveness, isolation, monitoring, stalking, or holding a victim captive;

(e) Abuse of children, pets, or an elderly person;

(f) Instability in the participant's life including, but not limited to employment, new or increased substance use, friendships, or intimate relationships;

(g) Children of the victim that are not the participant's biological children;

(h) History of violence in or outside of the home and any police contacts for the violence;

(i) Previous domestic violence or anger management assessments or treatments;

(j) Ideation, attempts, or threats of homicide and suicide; and

(k) Repeated violations of probation, no contact orders, protection orders, or similar orders.

(9) Domain 2: A screening for traumatic brain injury, making appropriate referrals for further assessment or treatment when needed. Screening information gathered must include:

(a) Traumatic brain injury or report of injury to the frontal lobe from an accident, sports, military, or similar activities;

(b) Any history of concussions or brain disease or injuries from strokes or dementia; and

(10) Domain 3: A screening for indicators associated with the participant's mental health, making appropriate referrals for further assessment or treatment when needed. The screening must include:

(a) A complete diagnostic evaluation when it is completed by an appropriately credentialed mental health professional practicing within their scope of practice; and

(b) Whether the participant reveals any of the following:

(i) Indicators associated with post-traumatic stress disorder;

(ii) Indicators associated with bipolar disorder;

(iii) Indicators associated with anxiety and depression;

(iv) Indicators associated with personality anomalies;

(v) Anti-social traits;

(vi) Sociopathic traits;

(vii) Psychopathic traits;

(viii) Previous or current mental health treatment; and

(ix) Other mental health or emotional indicators the participant or staff consider relevant to planning successful participation in domestic violence intervention treatment, such as psychosis.

(11) Domain 4: An assessment of the participant's belief system as it relates to:

(a) Hierarchical relationships;

(b) Spiritual, cultural, or religious beliefs about gender and family roles that condone partner violence;

(d) Level of accountability.

(12) Domain 5: A screening for substance use, making appropriate referrals for further assessment or treatment by a chemical dependency professional when needed. The screening must include:

(a) Past and current substance use;

(b) Information about charges, assessments, or treatments related to substance use; and

(c) Other substance use information the participant or staff consider relevant to successful participation in domestic violence intervention treatment.

(13) Domain 6: An assessment of the participant's environmental factors which must include:

(a) Criminal history from the participant's:

(i) Self-report;

(ii) A background check that covers each state they have lived in over the last 10 years; and

(iii) Collateral sources;

(b) Friends and family with criminogenic behaviors;

(d) A brief employment history and current status including:

(i) Length of employment; and

(ii) Level of job satisfaction;

(e) Highest level of education completed and any barriers to education or learning, including literacy, learning disabilities, or language needs;

(f) The people who make up the participant's support system and how their beliefs do or do not support the participant's abusive behaviors;

(g) The participant's motivations for healthy family relationships;

(h) The participant's strengths, social activities, hobbies, and recreational activities; and

(i) Whether or not the participant is socially isolated.

(14) Domain 7: Documentation of the results from an evidence-based, empirical, and objective standardized test that assesses risk, lethality, or needs for domestic violence perpetrators and documentation of the participant's level of psychopathy when needed.

(a) Examples of acceptable assessments for risk, lethality, or needs for domestic violence perpetrators include, but are not limited to:

(i) The Domestic Violence Inventory;

(ii) The Domestic Violence Screening Instrument – Revised;

(iii) The Ontario Domestic Assault Risk Assessment; and

(iv) The Spousal Assault Risk Assessment;

(b) If a program staff or supervisor has reason to believe it is needed or the participant has indicated any combination of three or more anti-social, sociopathic, or psychopathic traits, then the staff or supervisor must gather information related to the participant's level of psychopathy; and

(i) Self-Report Psychopathy Scale (SRP4);

(ii) Hare P-scan; or

(iii) Psychopathy checklist (PCL-R or PCL-SV);

(A) The administration of the PCL requires appropriate credentials and training; and

(B) The Interpersonal measure of psychopathy (IM-P) may be used with the PCL-R.

(15) Acute or critical factors: The following assessment factors are considered critical or acute and indicate the participant is at a higher risk for lethality or recidivism and must be required to attend level three or four treatment unless the program's supervisor documents extraordinary reasons for an exception in the participant's record.

(16) Other assessment factors may indicate a participant is at a high risk even if they do not meet any of these factors. The critical or acute factors include, but are not limited to:

(a) Previous incidents of physical assaults causing injury, sexual assaults, strangulation, or previous reported incidents toward more than one partner;

(b) Previous use or threats with weapons against an intimate partner or family member;

(d) Physical, sexual, or assaultive violence against children, pets, or an elderly person;

(e) Attempts or threats of homicide or suicide in the last 12 months;

(f) Repeated violations of probation, no contact orders, protective orders, or similar orders; or

(g) A medium or high level of psychopathy.

(17) If the program cannot obtain one or more of the items required in the assessment, then the program must document within the assessment their reasonable efforts to obtain the information.

(18) During an assessment process, the program staff or supervisor who conducted the interview must document a completed DSHS domestic violence 'risks, needs and responsivity form,' which can be downloaded from https://www.dshs.wa.gov/esa/community-services-offices/domestic-violence-intervention-treatment.

(19) Summary: The assessment must contain a written summary which at a minimum includes findings from the behavioral assessment and interview with the participant, collateral information, and input from third party sources, and includes:

(a) A summary of the participant's social and legal history;

(b) An assessment of the degree of abusive cognitive and behavioral patterns;

(d) An assessment of the participant's level of accountability and their motivations and readiness to change;

(e) A summary and assessment of the results of all evidence-based, empirical, and objective standardized tests given through the assessment process; and

(f) The program's recommendation and rationale for no domestic violence intervention treatment or a condition for treatment that indicates level one, two, three, or four treatment that corresponds to the participant's risks and needs as determined through the interview and assessment process;

(i) The recommended level of treatment must not be diminished by factors such as the absence of legal charges, the type of legal charge the participant may have received, plea deals, or any other influences from outside entities; and

(ii) The program must recommend a level of domestic violence intervention treatment when intimate partner violence has occurred, unless the program has documented a reasonable and valid rationale for a recommendation of an alternative service or no treatment at all in the assessment; and

(g) All required and recommended referrals to other types of treatment such as substance use, parenting, or mental health treatment in order for the participant to be successful in domestic violence intervention treatment.

History

Statutory Authority: RCW 43.20A.735. WSR 25-03-090, s 388-60B-0400, filed 1/16/25, effective 2/16/25. WSR 19-15-044, recodified as § 388-60B-0400, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0400, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0400, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0405 Treatment planning—What must the treatment plan include and when must it be updated?

Each program certified for any level of domestic violence intervention treatment must adhere to the following treatment planning standards:

(1) The program must develop an individualized written treatment plan for each participant who is accepted into the domestic violence intervention treatment program;

(2) The initial treatment plan must be completed before the participant begins treatment;

(3) The initial treatment plan and all updates to the plan must be signed and dated by the participant and direct service staff member who updated the plan;

(a) The program must document that a copy of the original and any updated treatment plans have been given to the participant and the referral source unless the recipient has opted out of receiving it; and

(b) If the referral source or participant has opted out of receiving a copy, documentation of them opting out must be documented in the participant's file;

(4) The program must base the participant's treatment on:

(a) The interview and assessment completed by a Washington state certified domestic violence intervention treatment program;

(b) The risks, needs, and responsivity form (available for download at https://www.dshs.wa.gov/ca/domestic-violence/certification-process) which the program completed for the participant; and

(c) Ongoing risk and assessment information obtained throughout treatment from the participant, collateral, and third party sources;

(5) The treatment plan must:

(a) Adequately and appropriately address any criminogenic needs, as well as high risk, critical, and acute factors of the individual participant;

(b) Identify the program's general responsivity by documenting the evidence-based or promising treatment modality the program will use to address the participant's risks and needs in order to assist them in meeting their goals or objectives;

(c) Identify the program's specific responsivity, taking into account the participant's characteristics such as their strengths, learning style, personality, motivation, bio-social factors, and culture;

(d) Include individualized goals or objectives which are behaviorally specific and measurable;

(e) Document required referrals to other treatments or classes such as mental health, substance use, or parenting, which are necessary in order for the participant to be successful in domestic violence intervention treatment;

(f) Document recommended referrals to other treatment programs and resources; and

(g) Document which treatment gets priority and the sequence of treatment for the participant if more than one treatment service is indicated on the plan; and

(6) The treatment plan must be updated when indicated by:

(a) Significant changes in the participant's behavior or circumstances;

(b) Factors associated with victim safety;

(d) If the participant is moving to a higher or lower level of treatment.

History

WSR 19-15-044, recodified as § 388-60B-0405, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0405, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0405, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0410 Placement criteria—How must a program determine a participant's level of treatment?

(1) For level one treatment the program must ensure:

(a) A program must place participants in level one treatment if the program has documented through the assessment, collateral contacts, the participant's legal history and the "risks, needs and responsivity" form all of the following:

(i) The participant has no previous domestic violence charges regardless of an arrest or legal outcomes;

(ii) The participant is at an overall low risk for lethality or recidivism; and

(iii) The participant has engaged in abusive and controlling behavior with an intimate partner;

(b) If the program cannot obtain information from all of the sources in this section then the program must document their reasonable efforts to obtain the information and must place the participant in level two, three, or four treatment; and

(c) A participant who has already been placed in a higher level of treatment must not be transferred to level one treatment at any time.

(2) For level two treatment the program must ensure:

(a) A program must place participants in level two treatment if the program has determined through the assessment, collateral contacts, the participant's legal history, the assessment process and the "risks, needs and responsivity" form the following:

(i) The participant is at an overall medium risk for lethality or recidivism;

(ii) The participant has an established pattern of abuse and control; and

(iii) The participant has little or no criminogenic needs; and

(b) If the program cannot obtain information from any of the sources in this section, then the program must document their reasonable efforts to obtain the information.

(3) For level three treatment, the program must ensure the program places participants in level three treatment if the program has documented through the assessment, collateral contacts, the participant's legal history and the 'risks, needs and responsivity' form the following:

(a) The participant is at an overall high risk for lethality or recidivism;

(b) The participant has indicated an acute or critical assessment factor as specified in WAC 388-60A-0400(15) and 388-60A-0400(16); or

(d) The participant has criminogenic needs which can be addressed in group or through ancillary individual sessions, depending on their unique risks and needs as identified in the participant's assessment and outlined in their treatment plan.

(4) For level four treatment, the program must ensure:

(a) The participant's risks and needs indicate a medium or high level of psychopathy as identified through a combination of information from:

(i) The assessment;

(ii) Collateral sources;

(iii) The participant's legal history; and

(iv) A relevant assessment tool which may include but is not limited to:

(A) The Self-Report Psychopathy Scale (SRP4);

(B) The PCL-SV or PCL-R which may include the IM-P;

(D) Other evidence-based measures of psychopathy; and

(b) Level four treatment may be facilitated through group or individual sessions or a combination of group and individual sessions in order to meet the participant's unique treatment needs as outlined in their treatment plan.

(5) Levels one and two treatment may be combined in the same group.

(6) Level three treatment participants may be combined with levels one and two or in a separate group, depending on the individual treatment needs and goals of each participant.

(7) Participants in level four treatment must be in a separate group from all other participants in lower levels of treatment and must not be combined with any other groups at any time.

History

WSR 19-15-044, recodified as § 388-60B-0410, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0410, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0410, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0415 Required cognitive and behavioral changes—Depending on their level of treatment, what changes must the program document that the participant has made?

(1) For levels one, two and three treatment, the program must ensure:

(a) The groups are facilitated by a program staff member who is designated by the department at the staff or supervisor level;

(b) A trainee may cofacilitate with a staff or supervisor, but must not facilitate the group alone at any time;

(c) The program uses evidence-based or promising practices (see WAC 388-60A-0310) to facilitate the areas of treatment focus listed in this section;

(d) The cognitive and behavioral changes in this section are the minimum standard for certified domestic violence intervention treatment and the program must add topics, discussions, lessons, exercises, or assignments that meet the individual treatment needs of the participant;

(e) The areas of treatment in this section include cognitive and behavioral changes, which must be shared in treatment by the participant and documented by the program in the participant's individual record as those changes are identified;

(f) Each treatment program certified for levels one, two, and three domestic violence intervention treatment must document in each participant's file that the following cognitive and behavioral changes are documented for each participant and at a minimum include:

(i) Types of abuse: Individual and specific examples of how the participant has acknowledged that they have engaged in any abusive behaviors including but not limited to the following types of abuse:

(A) Physical;

(B) Emotional and psychological including terrorizing someone or threatening them;

(D) Spiritual;

(E) Cultural;

(F) Sexual;

(G) Economic;

(H) Physical force against property or pets;

(I) Stalking;

(J) Acts that put the safety of partners, children, pets, other family members, or friends at risk; and

(K) Electronic, online, and social media;

(ii) Belief systems: Exploration of the participant's individual and cultural belief system, including acknowledgement of how those beliefs have allowed and supported violence against an intimate partner including privilege or oppression;

(A) Specific examples of how the participant's individual belief system has allowed or supported the use or threat of violence to establish power and control over an intimate partner; and

(B) Examples of how the participant has experienced societal approval and support for control through violence and the designation of an intimate partner or children as safe targets for this violence;

(iii) Respectful relationships: Documentation of new skills the participant has gained through exercises in learning and practicing respectful relationship skills including techniques to be nonabusive and noncontrolling that include but are not limited to:

(A) Requesting and obtaining affirmative consent as an essential aspect of interpersonal relationships; and

(B) Respecting boundaries about others' bodies, possessions, and actions;

(iv) Children: Documentation of the participant's understanding of how children have been impacted by the participant's abuse and the incompatibility of domestic violence and abuse with responsible parenting including but not limited to:

(A) An understanding of the emotional impacts of domestic violence on children;

(B) An understanding of the long-term consequences that exposure to incidents of domestic violence may have on children; and

(v) Accountability: Documentation of the participant's understanding of accountability for their abusive behaviors and their resulting behavioral changes including but not limited to:

(A) Documentation of the participant's understanding of how they are solely responsible for their abusive and controlling behavior and how they acknowledge this fact;

(B) An understanding of the need to avoid blaming the victim and the ability to consistently take responsibility for the participant's abusive behavior, including holding themselves and others in group accountable for their behavior;

(C) Documentation of a minimum of three separate individual examples of how the participant has taken accountability since beginning domestic violence intervention treatment which must be kept in the participant's file;

(D) Documented examples of how the participant has demonstrated spontaneous accountability in treatment, taking accountability in the moment;

(E) Documentation of the participant's accountability plan:

(I) The treatment program may assist the participant in developing the plan;

(II) In the plan the participant must make a commitment to giving up power and control, including abusive and controlling behaviors towards the victim and others;

(III) In the plan the participant must take accountability for specific abusive behaviors they have committed and have a plan for stopping all abusive behaviors;

(IV) In the plan the participant must identify examples of individualized and specific behavioral changes they have made which demonstrate an understanding of accountability; and

(V) In the plan the participant must identify their personal motivations, ethics, and values as they relate to maintaining healthy relationships; and

(F) Documentation that the participant has demonstrated an understanding of accountability in their past and current relationships, and their progress in taking accountability including the resulting cognitive and behavioral changes during treatment;

(vi) Financial and legal obligations: Documentation of the participant's understanding of why it is necessary for them to meet their financial and legal obligations to family members and the actions they are taking to meet those obligations;

(vii) Empathy: Documentation of the exercises or assignments on empathy building that demonstrate the participant's cognitive and behavioral changes as a result of increasing their empathy;

(viii) Defense mechanisms: Documentation of what the participant has identified as their individual defense mechanisms such as projection, denial, and detachment as well as healthy coping strategies the participant has learned, and the cognitive and behavioral changes they have made in dealing with unpleasant feelings;

(ix) Self-care: Documentation of individualized self-care practices the participant has learned and incorporated into their lives, and documentation of their understanding of why self-care is crucial for healthy relationships;

(x) Support system: Documentation of the participant's healthy support system, including who they have identified as part of that system and how they provide healthy support;

(xi) Indicators: Documentation of the indicators or red flags the participant has identified that they have engaged in, their understanding of how those behaviors are abusive, and the cognitive and behavioral changes they have made as a result;

(xii) Cognitive distortions: Documentation of the cognitive distortions or thinking errors the participant has identified, that they have used to justify their abusive behaviors, and how they have learned to reframe and change their thinking when those cognitive distortions are present;

(xiii) Personal motivations: Documentation of the participant's personal motivations for abusive behaviors and the cognitive and behavioral changes they have made to replace those beliefs and subsequent behaviors which include but are not limited to:

(A) A sense of entitlement;

(B) A belief that the participant should have power and control over their partner;

(D) The need to be right or win at all costs; and

(E) Insecurity and fear;

(xiv) Relationship history: Documentation of the participant's relationship history which documents common characteristics, motivations for abuse, applicable cognitive distortions, and indicators of domestic violence throughout the participant's history of intimate relationships;

(A) The treatment program and group may assist the participant in developing the relationship history; and

(B) The relationship history must focus on the participant's behaviors in an accountable manner without blaming others; and

(xv) Criminogenic needs: Documentation of treatment in group or individual sessions with level three participants that addresses their individual criminogenic needs as indicated through assessment and treatment planning.

(2) For level four treatment the program must ensure:

(a) The participant's individual risks, needs, and goals as indicated on the participant's treatment plan are addressed in level four treatment either in groups, individual sessions, or a combination of group and individual sessions;

(b) Level four treatment must only be facilitated by direct treatment staff designated as a supervisor who has attended the initial six hours of education approved by the department for providing level four treatment as well as four hours of continuing education every twenty-four months following the initial training;

(i) The program uses cognitive behavioral and trauma informed techniques in treatment;

(ii) The program uses techniques that:

(A) Enhance intrinsic motivation;

(B) Use targeted interventions that are directly tied to the participant's needs, goals, or objectives identified in the participant's individualized treatment plan;

(D) Increase positive reinforcement with participants; and

(E) Engage in ongoing support in communicating with the participant;

(d) The skills and behavioral changes for participants in level four treatment are the minimum standard and the program must add behavior changes, skills, lessons, exercises, or assignments that meet the individual treatment needs of the participant;

(e) The program must ensure that the following is documented in each participant's file in level four treatment and at a minimum include:

(i) The individualized meaning or motivations behind the participant's abusive behaviors and documentation of their belief about why it is in their best interest to meet their needs in alternative, legal, and healthy ways;

(ii) Documentation of how the negative legal and social consequences for someone who commits domestic violence has an affect on them personally and how that serves as motivation for changing their behaviors;

(iii) Documentation of their individual motivation for developing and improving a healthy support system, including who is already part of that support system and the identification of potential members of their healthy support system; and

(iv) Documentation of how the participant is working with the program to meet their individual dynamic criminogenic needs by:

(A) Reducing antisocial and procriminal attitudes, values, beliefs, and cognitive-emotional states;

(B) Reducing procriminal associates and increasing involvement with others who are pro-social;

(D) Reducing antisocial behaviors;

(E) Identifying family factors that include criminality and a variety of psychological problems in the family of origin;

(F) Encouraging behaviors that lead to higher levels of personal, educational, vocational, or financial achievement;

(G) Encouragement of involvement in pro-social leisure activities;

(H) Understanding how abusing alcohol and drugs effects the participant's choices, decisions, and outcomes; and

(I) Understanding how employment status and their level of satisfaction effects the participant's choices, decisions, and outcomes.

(3) The program must make reasonable accommodations for participants with different educational levels, learning disabilities and learning styles throughout all levels of treatment.

History

WSR 19-15-044, recodified as § 388-60B-0415, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0415, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0415, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0420 Minimum treatment periods and requirements—How must a program determine the treatment period for each participant?

(1) The minimum treatment period is the time required for the participant to fulfill all conditions of treatment set by the treatment program as indicated in the participant's contract and their treatment plan.

(2) Satisfactory completion of treatment must not be based solely on the client participating in the treatment program for a certain period of time or attending a certain number of sessions.

(3) In addition to meeting the participant's goals and objectives as outlined in their treatment plan, the program must require each participant to satisfy all treatment program requirements for:

(a) A minimum of six months of consecutive weekly same gender group sessions for level one treatment;

(b) A minimum of nine months of consecutive weekly same gender group sessions for level two treatment;

(c) A minimum of twelve months of consecutive weekly same gender group, individual, or a combination of group and individual sessions for level three treatment; or

(d) A minimum of eighteen months of consecutive weekly same gender group, individual, or a combination of group and individual sessions for level four treatment.

(4) Any breaks in treatment must be reasonable, justified, and follow the program's policies.

(a) A break in treatment cannot exceed thirty days, unless it is approved by the program's supervisor, and the reason for the decision is documented in the participant's file;

(b) A break in treatment may include conditions the participant must meet during the break in order to maintain a compliant status, such as assignments or check-ins which must be documented in the participant's file, and the participant must receive a copy of the conditions; and

(c) A break in treatment must be reported to the referral source unless they have opted out of receiving notification of breaks in treatment which must be documented in the participant's file.

History

WSR 19-15-044, recodified as § 388-60B-0420, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0420, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0420, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0425 Reoffenses and noncompliance during treatment—What must happen if a participant reoffends or is not compliant while they are in treatment?

Each treatment program certified for any level of domestic violence intervention treatment must ensure:

(1) The treatment program has defined what it means to reoffend, including abusive or controlling behaviors that may or may not be illegal.

(2) The treatment program has established and written consequences if a participant reoffends during treatment or does not comply with program requirements.

(3) The program has documented that the participant was made aware of the consequences of reoffending prior to starting treatment.

(4) If the participant reoffends during treatment the program must document in the participant's record:

(a) The details of the reoffense;

(b) Any changes to the ongoing assessment, treatment plan, level of treatment, or minimum treatment period and requirements for the participant as a result of the reoffense or if the program has discharged the participant because the program feels the participant is unlikely to benefit from additional time at the program; and

(5) The program must document reoffenses or noncompliance in:

(a) The participant's record;

(b) Reports to the court, if applicable; and

(6) When a participant is noncompliant with their contract, program rules, or attendance, within seven days of the noncompliance the program must:

(a) Notify the court or other referral source, if applicable; and

(b) Document in the participant's file:

(i) The details of the noncompliance;

(ii) The consequences imposed by the program and referral source, if applicable; and

(iii) Any changes to the participant's ongoing assessment and treatment plan as a result of the noncompliance.

History

WSR 19-15-044, recodified as § 388-60B-0425, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0425, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0425, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0430 Completion criteria and core competencies—What must the program document for a participant to be eligible to successfully complete treatment?

(1) The program must ensure:

(a) The participant has met the program's written criteria for satisfactory completion of treatment including:

(i) Cooperation with all program rules and requirements;

(ii) The goals or objectives of the participant's treatment plan, which include measurable behavioral changes; and

(iii) The minimum treatment period and requirements;

(b) The participant has attended and complied with all other treatment sessions required by the program, which may include ancillary treatments or classes such as mental health, substance use, or parenting;

(d) When a participant who is court ordered to pay spousal or child support is behind on payments, they must show a payment plan agreement and documentation that they have been in compliance with the plan for a minimum of six months, in order to be in compliance; and

(e) Documentation of all cognitive and behavioral changes as required through coverage of the treatment topics, the completion of all assignments, and the requirements as outlined in the level of treatment in which they participated.

(2) In order to complete levels one, two, or three treatment the program must also document the participant has successfully demonstrated core competencies:

(a) Accountability and adherence to the participant's accountability plan;

(b) Increased victim safety as evidenced by written documentation of the participant's demonstration of a change in their beliefs which have resulted in the participant's cessation of all violent acts or threats of violence for a minimum of the last six months; and

(c) Knowledge of their personal primary motivations for abusive or controlling behaviors and alternative ways to meet their needs in a nonabusive manner.

(3) In order to complete level four treatment, the program must document the following in the participant's file:

(a) The participant's plan for how they will meet their needs in nonabusive, legal, and healthy ways;

(b) The problem solving and self-control skills the participant has learned and demonstrated in treatment to deal with unpleasant feelings; and

(c) The program's assessment of satisfactory changes to the participant's environmental factors such as peer groups, employment, or substance use.

History

WSR 19-15-044, recodified as § 388-60B-0430, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0430, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0430, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0435 Discharging participants—What must a program do when a participant is discharged from treatment?

(1) Discharge criteria must be uniform and predictable.

(2) Discrimination may not occur against any participant.

(3) The program may discharge or transfer a participant if the treatment program cannot provide adequate treatment services to the participant because of the treatment program's current development or certified levels of treatment.

(4) When a participant is discharged for satisfactory completion of treatment the program must ensure:

(a) The treatment program documents a written discharge summary in the participant's file within seven days of completion which includes:

(i) A summary of the cognitive and behavioral changes the participant demonstrated in treatment;

(ii) The goals or objectives the participant met in treatment as outlined in their treatment plan(s);

(iii) The program's assessment of the participant's current risk factors;

(iv) Any recommendations for the participant's treatment after discharge; and

(v) The participant's eligibility criteria to return to the treatment program in the future; and

(b) The treatment program must notify the following parties within seven days when a participant satisfactorily completes treatment:

(i) The court having jurisdiction, if the participant has been court-mandated to attend treatment; and

(ii) The victim, if feasible, which must be documented in writing.

(5) When a participant is discharged for incomplete or unsatisfactory treatment the program must ensure:

(a) The treatment program documents a written discharge summary in the participant's file within three days of discharging participants who do not complete treatment which must include:

(i) The reason the participant was discharged from treatment;

(ii) A summary of what the participant demonstrated in treatment including any cognitive or behavioral changes;

(iii) The program's assessment of the participant's current risk factors;

(iv) Recommendations for the participant's treatment after discharge; and

(v) The participant's eligibility criteria to return to the treatment program in the future;

(b) The program must document that the participant has not complied with:

(i) The participant's contract with the treatment program;

(ii) The participant's treatment plan with the treatment program;

(iii) A court order;

(iv) A probation agreement; or

(v) Group rules;

(c) The treatment program must notify the following parties in writing when the program discharges a participant from the program because of failure to complete treatment:

(i) The court having jurisdiction, if the participant has been court-mandated to attend treatment;

(ii) The participant's probation or parole officer, if applicable; and

(iii) The victim of the participant, if feasible; and

(d) The program must notify the above parties within three days of terminating the participant's enrollment in the program.

History

WSR 19-15-044, recodified as § 388-60B-0435, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0435, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0435, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0500 On-site reviews and plans of correction—How does the department review certified programs for compliance with the regulations of this chapter?

To obtain and maintain certification to provide domestic violence intervention treatment services, including certification to provide assessments or any level of care, each program is subject to an on-site or remote review to determine if the program is in compliance with the minimum certification standards of this chapter.

(1) The determination of whether the review will be conducted on-site or remotely will be made by the department and is not subject to administrative review under chapter 388-02 WAC.

(2) The determination to conduct an on-site or remote review will take into consideration the program's location, self-reported health conditions or complications of the program's personnel, and any other factors which the department considers valid in its determination process.

(3) For a standard review, a department representative(s) conducts an entrance meeting with the program that may include a review of:

(a) Program policies and procedures;

(b) Direct service staff personnel records;

(d) Written documentation of the program's treatment program;

(e) Attendance sheets and other forms related to the provision of domestic violence intervention treatment services;

(f) The facility where services are delivered and where physical or electronic records are kept;

(g) The program's quality management plan; and

(h) Any other information that the department determines to be necessary to confirm compliance with the minimum standards of this chapter, including, but not limited to interviews with:

(i) Individuals served by the program; and

(ii) The program's direct treatment staff members.

(4) The department representative(s) concludes a review with an exit meeting that includes, if available and applicable:

(a) A discussion of findings;

(b) A statement of deficiencies requiring corrective action; and

(5) The department requires the program to correct the deficiencies listed on the plan of correction:

(a) By the negotiated time frame agreed upon by the program and the department representative; or

(b) Immediately if the department determines participant or victim health and safety concerns require immediate corrective action.

(6) If the program fails to make satisfactory corrective actions by the negotiated deadline in the compliance report, the department may:

(a) Begin to take progressive action against the program's certification; or

(b) Initiate an investigation of the program.

(7) The department may schedule a follow-up review after a standard review or investigation to ensure all corrective actions have been successfully implemented.

History

Statutory Authority: RCW 43.20A.735. WSR 25-03-090, s 388-60B-0500, filed 1/16/25, effective 2/16/25. WSR 19-15-044, recodified as § 388-60B-0500, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0500, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0500, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0510 Complaint investigations—How must an investigation get initiated and what is the process of the investigation?

DSHS investigates complaints regarding domestic violence intervention treatment programs that provide assessments or any level of intervention services.

(1) Any person may submit a written complaint to DSHS if the person has the following concerns about a certified program:

(a) The program has acted in a way that places the identified victim, current partner, or children at risk; or

(b) The program has failed to follow standards in this chapter.

(2) Once it receives a complaint about a certified program, the department will:

(a) Determine that the complaint includes sufficient information to be deemed valid;

(b) Notify the program within 14 days of the complaint being determined valid that the department has received a complaint about the program; and

(3) The department may begin an investigation of a domestic violence intervention treatment program without a written complaint if the department believes that the program:

(a) Has placed the identified victim, current partner, or children at risk; or

(b) Failed to follow the standards of this chapter.

(4) The investigation of a complaint against a domestic violence intervention treatment program may include:

(a) Contact with:

(i) The person making the complaint;

(ii) Other persons involved in the complaint; and

(iii) The treatment program;

(b) A request for written documentation of evidence; and

(5) The department must complete its investigation within 60 days of beginning the investigation, unless circumstances warrant a longer period of time.

(6) The department will prepare written results of the complaint investigation.

(7) If the department decides that the treatment program behaved in a way that placed victims at risk or failed to meet the standards outlined in this chapter, the written results must include a decision regarding the status of the program's certification.

(8) If the department determines that a complaint against a domestic violence intervention treatment program is founded, the department may:

(a) Send a written warning to the treatment program;

(b) Suspend the treatment program's certification;

(d) Temporarily or indefinitely remove a program staff's designation as a trainee, staff, or supervisor.

(9) The department must send the written results of its investigation to the program.

(a) If any allegations were founded, the written results must be sent by certified mail, return receipt requested, or electronic mail, with read receipt, within 20 days after completing the investigation; and

(b) If all allegations were unfounded, the written results may be sent to the program by electronic mail.

(10) The department will send a copy of the written results of the investigation to the person who made the complaint against the domestic violence intervention treatment program either by United States mail or electronic mail when feasible.

History

Statutory Authority: RCW 43.20A.735. WSR 25-03-090, s 388-60B-0510, filed 1/16/25, effective 2/16/25. WSR 19-15-044, recodified as § 388-60B-0510, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0510, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0510, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0520 Program or staff status changes—What must happen if a program's certification or a staff member's designation is changed by the department?

(1) If the department issues a written warning to a program, the department must send notice by certified mail and provide the treatment program with:

(a) The specific reasons for the written warning;

(b) The chapter 388-60A WAC standards that the written warning is based on;

(d) The deadline for completion of any corrective actions or remedial steps; and

(e) If the treatment program refuses or fails to remedy the problems outlined in the written warning, the department may revoke or suspend the certification of the program.

(2) If the department suspends a treatment program's certification, the department must send notice by certified mail and provide the treatment program with:

(a) The specific reasons for the suspension;

(b) The chapter 388-60A WAC standards that the suspension is based on;

(d) Any remedial steps or corrective actions which the program must complete to the satisfaction of the department before the department will reinstate the program's certification and lift the suspension; and

(e) The deadline for completion of any corrective actions or remedial steps.

(3) If the department revokes a program's certification, the department must send notice by certified mail and provide the program with:

(a) The specific reasons for the revocation;

(b) The chapter 388-60A WAC standards the revocation is based on; and

(4) If the department temporarily or indefinitely removes a program staff's designation as trainee, staff, or supervisor, the department must send notice by certified mail and provide the treatment program with:

(a) The specific reasons for the removal of the program staff's designation;

(b) The chapter 388-60A WAC standards that the decision to remove the program staff's designation was based on; and

(c) If applicable, any remedial steps or corrective actions the program staff must take in order to have their designation as a trainee, staff, or supervisor reinstated.

(5) When the department revokes or suspends a program's certification, issues a written warning, or removes a program staff's designation as trainee, staff, or supervisor, then the department will notify the program director through certified mail of the program's right to request an administrative hearing.

(6) The program director may request an administrative hearing from the office of administrative hearings under chapter 388-02 WAC within thirty calendar days of the date on which the program received notice of the department's decision via certified mail, and if the program fails to submit its request for a hearing within this timeframe, the program shall have no right to administrative review of the department's decision.

History

WSR 19-15-044, recodified as § 388-60B-0520, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60A-0520, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60A-0520, filed 5/29/18, effective 6/29/18.

Wash. Admin. Code § 388-60B-0530 Program responsibilities after an action—What actions must the program take after notification that its certification has been suspended, revoked, or if no direct service staff are qualified to provide services?

(1) If the department revokes, suspends a program's certification, or if no qualified direct service staff are available to provide services, the program must:

(a) Take immediate steps to notify and refer current participants to other certified domestic violence intervention treatment programs prior to the effective date of revocation or suspension;

(b) Cease accepting participants of domestic violence into its treatment program;

(d) Notify, in writing, the presiding judge and chief probation officer of each judicial district from which the treatment program receives court referrals.

(2) If a program also holds a license or certification from the state of Washington for other treatment modalities, the department may notify the appropriate licensing or certifying authority that the program's domestic violence intervention treatment certification has been suspended or revoked, as applicable.

History

WSR 19-15-044, recodified as § 388-60A-0530, filed 7/11/19, effective 7/28/19. WSR 18-14-078, recodified as § 110-60B-0530, filed 6/29/18, effective 7/1/18. Statutory Authority: RCW 26.50.150. WSR 18-12-034, § 388-60B-0530, filed 5/29/18, effective 6/29/18.

Chapter 388-61 Family violence.

Wash. Admin. Code § 388-61-001 How does the Family Violence Amendment affect me if I am getting TANF/SFA?

The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), also known as the Welfare Reform Act, allowed every state to create a program addressing family violence for temporary assistance for needy families (TANF) recipients.

(1) For TANF/state funded assistance (SFA), family violence is when a recipient, or family member or household member has been subjected by another family member or household member as defined in RCW 7.105.010 to any of the following:

(a) Physical acts that resulted in, or threatened to result in, physical injury;

(b) Sexual abuse;

(d) Being forced as the caretaker relative of a dependent child to engage in nonconsensual sexual acts or activities;

(e) Threats of or attempts at, physical sexual abuse;

(f) Mental abuse;

(g) Neglect or deprivation of medical care; or

(h) Stalking.

(2) DSHS must:

(a) Screen and identify adults, minor teen parents, or emancipated teens getting TANF/SFA for a history of family violence;

(b) Notify in writing and verbally adults, minor teen parents, or emancipated teens getting TANF/SFA about the Family Violence Amendment;

(d) Refer individuals needing counseling to supportive services;

(e) Waive WorkFirst requirements in cases where the requirements would make it more difficult to escape family violence, unfairly penalize victims of family violence, or place victims at further risk of family violence. This may include:

(i) Time limits for TANF/SFA recipients, for as long as necessary (after 52 months of receiving TANF/SFA);

(ii) Cooperation with the division of child support.

(f) Develop specialized work activities for family violence clients, as defined in subsection (1) of this section if participation in work activities would place the recipients at further risk of family violence.

History

Statutory Authority: RCW 74.04.050, 74.04.055, 74.04.057, 74.08.090, and 74.08A.250. WSR 23-08-082, § 388-61-001, filed 4/5/23, effective 5/6/23. Statutory Authority: RCW 74.04.050, 74.08.090, and 74.08A.010. WSR 04-21-028, § 388-61-001, filed 10/13/04, effective 12/1/04. Statutory Authority: Public Law 104-193, Section 103, Subsection 408 (a)(7)(c)(iii), HB 3901, section 103(4), RCW 74.08A.010, 74.04.050 and 74.08.090. WSR 98-07-040, § 388-61-001, filed 3/12/98, effective 4/12/98. Statutory Authority: RCW 74.04.050, 74.08.090 and 74.04.057. WSR 97-20-124, § 388-61-001, filed 10/1/97, effective 11/1/97.

Chapter 388-61A Domestic violence victim services and prevention efforts.

Wash. Admin. Code § 388-61A-1000 What definitions apply to this chapter?

The following definitions apply to this chapter:

(1) "Advocacy" means that the client is involved with an advocate in individual or group sessions with a primary focus of safety planning, empowerment, and education of the client through reinforcement of the client's autonomy and self-determination. Advocacy also means speaking and acting for change or justice with, or on behalf of, another person or cause. Advocacy is survivor-centered and uses nonvictim blaming methods that include:

(a) Identifying barriers and strategies to enhance safety, including safety planning;

(b) Clarifying and increasing awareness of the power and control associated with domestic violence and the options one may have to obtain resources while staying safe; and

(2) "Advocate" means a trained staff person who works in a domestic violence program and provides advocacy to clients.

(3) "Child care" means the temporary care of a client's child or children by domestic violence program staff at the program's location or another location where the client is receiving confidential or individual services from the domestic violence program or is participating in activities sponsored by the domestic violence program, other than employment, and so long as the client remains on the premises.

(4) "Children/youth activities" means age appropriate activities other than children/youth advocacy, such as recreational and educational activities.

(5) "Children/youth advocacy" means age appropriate supportive services that strive to assist children/youth to express feelings about their exposure to domestic violence. It is an educational, rather than a therapeutic service and is focused on providing education about domestic violence, safety planning, and developing or enhancing problem solving skills. Advocacy can be provided on an individual basis and in group settings.

(6) "Client" means a victim of domestic violence who is accessing services at a domestic violence program. A client may also be referred to as a survivor, service recipient, or resident.

(7) "Community advocate" means a person employed or supervised by a domestic violence program who is trained to provide ongoing assistance and advocacy for victims of domestic violence in assessing and planning for safety needs, making appropriate social service, legal, and housing referrals, providing community education, maintaining contacts necessary for prevention efforts, and developing protocols for local systems coordination.

(8) "Community-based domestic violence program" or "CBDVP" means a nonprofit program or organization that provides, as its primary purpose, assistance and advocacy for domestic violence victims. Domestic violence assistance and advocacy includes crisis intervention, individual and group support, information and referrals, and safety assessment and planning. Domestic violence assistance and advocacy may also include, but is not limited to: Provision of shelter, emergency transportation, self-help services, culturally specific services, legal advocacy, economic advocacy, and accompaniment and advocacy through medical, legal, immigration, human services, and financial assistance systems. CBDVPs also provide community education and prevention efforts. Domestic violence programs that are under the auspices of, or the direct supervision of, a court, law enforcement or prosecution agency, or the child protective services section of the department as defined in RCW 26.44.020, are not considered CBDVPs.

(9) "Community education" refers to information that is provided in community settings about domestic violence and services related to victims of domestic violence. Community education activities include: training, presentations, outreach to specific communities or geographic areas, community events, and media events.

(10) "Confidential communication" means all information, oral, written, or nonverbal, that is transmitted between a victim of domestic violence and an employee or volunteer of a domestic violence program in the course of their relationship and in confidence, which means that the employee or volunteer will not disclose the information to a third person unless authorized in writing by the victim.

(11) "Confidential information" includes, but is not limited to, any information, advice, notes, reports, statistical data, memoranda, working papers, records, or the like, made or given during the relationship between a victim of domestic violence and a domestic violence program, however maintained. Confidential information includes personally identifying information as defined in this chapter, and any other information that would personally identify a victim of domestic violence who seeks or has received services from a domestic violence program.

(12) "Crisis hotline or helpline" means a designated telephone line of the domestic violence program that operates twenty-four hours a day, three hundred sixty-five days a year. A hotline/helpline provides crisis intervention, safety planning, information, and referral services.

(13) "Crisis intervention" means services provided to an individual in crisis to stabilize the individual's emotions, clarify issues, and provide support and assistance to help explore options for resolution of the individual's immediate crisis and needs.

(14) "Culturally specific supportive services and prevention efforts" means services and prevention efforts created by and for specific cultural populations that have been historically underserved or unserved. Services and prevention efforts are typically designed by and with individuals from the specific culture who are cognizant of the specific community generated risks and protective characteristics and often utilize the language and settings familiar to the population served.

(15) "Department" means the department of social and health services (DSHS).

(16) "Domestic violence" means the infliction or threat of physical harm against an intimate partner, and includes physical, sexual, and psychological abuse against the partner, and is a part of a pattern of assaultive, coercive, and controlling behaviors directed at achieving compliance from or control over that intimate partner. It may include, but is not limited to, a categorization of offenses as defined in RCW 10.99.020, committed by one intimate partner against another.

(17) "Domestic violence program" means an agency, organization, or program with a primary purpose and history of effective work in providing advocacy, safety assessment and planning, and self-help services for domestic violence victims in a supportive environment, and includes, but is not limited to, a CBDVP, emergency shelter, or domestic violence transitional housing program.

(18) "Emergency shelter" means a place of supportive services and safe, temporary lodging offered on a twenty-four hour, seven days per week basis to victims of domestic violence and their children. Domestic violence programs may use hotels and motels for victims who need safe shelter, but the domestic violence program must also have an emergency shelter that meets the requirements of this chapter. The mere act of making a referral to emergency shelter is not itself considered provision of emergency shelter.

(19) "Intimate partner" means a person who is or was married, in a state registered domestic partnership, or in an intimate or dating relationship with another person at the present or at some time in the past. An intimate partner is also any person who has one or more children in common with another person, regardless of whether they have been married, in a domestic partnership with each other, or lived together at any time.

(20) "Job shadowing" means a work experience where an individual observes and learns about a job, activity, or activities by walking through the work day as a shadow to a skilled and competent employee. The experience is planned for and structured with the goal of observing behavior and situations, engaging in interactive questions and answers, and experiencing the link between learning and practice. Job shadowing may be anywhere from a few hours, to a day, week, or more, depending on the job or activity.

(21) "Legal advocacy" means personal support and assistance with victims of domestic violence to ensure their interests are represented and their rights upheld within the civil and criminal legal systems and administrative hearings. It includes:

(a) Educating and assisting victims in navigating legal systems;

(b) Assisting victims in evaluating advantages and disadvantages of participating in legal processes;

(d) Promoting victims' choices and rights to individuals within legal systems.

(22) "Legal advocate" means a person employed by a domestic violence program or court system to advocate for victims of domestic violence, within the civil and criminal legal systems and administrative hearings, by attending court proceedings, assisting in document and case preparation, and ensuring linkage with the community advocate.

(23) "Live training" means events that are held at a specific time and not prerecorded, where participants have the opportunity to ask questions and hear the questions of others in real time. Examples of live training include events that are in person, teleconferences, and interactive.

(24) "Lodging unit" means one or more rooms used for a victim of domestic violence including rooms used for sleeping or sitting.

(25) "Personally identifying information" is individually identifying information for or about an individual including information likely to disclose the location of a victim of domestic violence, regardless of whether the information is encoded, encrypted, hashed, or otherwise protected, including, but not limited to:

(a) First and last name;

(b) Home or other physical address;

(d) Social Security number;

(e) Driver's license number, passport number, or student identification number;

(f) Religious affiliation;

(g) Date of birth;

(h) Nine digit postal (ZIP) code;

(i) Physical appearance of;

(j) Case file or history; and

(k) Other information that would personally identify a victim of domestic violence who seeks or has received services from a domestic violence program, or such other information which, taken individually or together with other identifying information, could identify a particular individual.

(26) "Prevention" means efforts that are designed to ultimately eradicate domestic violence through the promotion of healthy, respectful, and nonviolent relationships. Successful domestic violence prevention efforts address change at both the individual and community levels, and tailor messages to diverse populations. Characteristics of promising prevention practices include working to decrease risk factors for perpetration of abuse as well as victimization while at the same time promoting positive factors that protect individuals from perpetrating or experiencing abuse. Domestic violence prevention includes strategies, policies, and programs that focus on at least one of the following:

(a) Increasing community dialogue about the root causes of intimate partner violence;

(b) Shifting cultural norms;

(d) Promoting respectful and healthy relationships.

(27) "Resident" means a client of the domestic violence program who is residing in an emergency shelter as defined in this chapter.

(28) "Restroom facility" means a bathroom with at least a common-use indoor flush-type toilet, one nearby sink for hand washing, and a bathtub or shower facility.

(29) "Safety planning" is a process of thinking through with the victim how to increase safety for both the victim of domestic violence and any children of the victim. Safety planning addresses both immediate and long-term risks, barriers, or concerns regarding the victim and any children in the context of their communities and in relationship with the domestic violence perpetrator. It is based on knowledge about the specific pattern of the domestic violence perpetrator's tactics and the protective factors of the victim and any children. Safety planning may be done formally, informally, in writing or orally, or in any other conversational process between the victim and advocate.

(30) "Secretary" means the department secretary or the secretary's designee.

(31) "Self-study" is a form of study in which one is, to a large extent, responsible for one's own instruction. Examples of self-study include reading articles, books, academic journals, training materials, engaging in online learning opportunities, and prerecorded webinars. Self-study content must be current or have historical relevance to the domestic violence advocacy field.

(32) "Shelter" means temporary lodging and supportive services offered by a CBDVP to victims of domestic violence and their children.

(33) "Staff" means trained persons who are part of a domestic violence program and are paid or volunteer to provide services to clients.

(34) "Support group" means an interactive group session of two or more victims of domestic violence that is facilitated by trained staff on a regular basis. Participants share experiences, offer mutual support, and receive information and education around a specific topic of common interest. Support groups validate the experiences of victims, explore options, build on strengths, and respect participants' rights to make their own decisions. A shelter or house meeting where, for example, chores are discussed, and there is no advocacy provided, is not a support group.

(35) "Supportive services" means assistance and advocacy for victims of domestic violence and their children that are designed to meet the needs of victims and children and provided in accordance with the service model defined in this chapter. Supportive services include, but are not limited to, activities described in the definition of CBDVP.

(36) "Underserved or unserved populations" means populations who face barriers in accessing and using victim services, including populations underserved or unserved because of religion, sexual orientation, gender identity or expression, underserved or unserved racial and ethnic populations, and populations underserved or unserved because of special needs including language barriers, disabilities, immigration status, and age.

(37) "Victim" means an intimate partner who has been subjected to domestic violence.

(38) "We," "us," or "our" refers to the department and its employees.

(39) "You," "I," or "your" refers to the domestic violence program.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1000, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1005 What is the legal basis for establishing minimum standards for domestic violence programs?

Chapter 70.123 RCW authorizes the department to establish minimum standards for programs that receive funding from the department to provide supportive services and prevention efforts.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1005, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1010 What is the purpose of this chapter?

The rules of this chapter are to establish minimum uniform statewide standards for domestic violence supportive services, emergency shelters, and prevention efforts funded by the department.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1010, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1015 What service model must be used to provide the services required by this chapter?

Supportive services and emergency shelters for victims of domestic violence are essential to provide protection to victims from further abuse and physical harm. Research demonstrates that access to supportive services that increase a survivor's knowledge of safety planning and awareness of community resources leads to increased safety and well-being over time. Consequently, the model for providing services must incorporate all the following practices and minimum standards:

(1) Services provided to victims must include access to safety, advocacy, information about options, and referrals to helping resources.

(2) Services must use a survivor-centered and empowerment service model that:

(a) Promotes safety for all victims of intimate partner violence and their children;

(b) Is survivor-centered and treats victims with dignity and respect;

(d) Supports the relationship between victims and their children;

(e) Offers options and support for autonomous decision making that is based on the needs and circumstances of each victim and their family;

(f) Assists individuals and families in accessing protection and services that are respectful and inclusive of cultural and community characteristics;

(g) Ensures program accountability by involving victims in evaluating the services they receive from the domestic violence program; and

(h) Supports engagement and collaboration with other community agencies and systems for the purpose of developing a comprehensive response system for victims and their children.

(3) The program must refrain from engaging in activities that compromise the safety of victims or their children.

(4) The program must not provide services that blame the victim for the abuse or do not hold the abuser accountable for the violence. Such services are ineffective and will likely result in further harm to the victim, up to and including death.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1015, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1020 Is the department required to provide funding to any program that requests funding?

(1) We are not obligated to disburse funds to all domestic violence programs that meet the minimum standards set forth in this chapter. Our goals are to:

(a) Provide for a statewide network of supportive services, including emergency shelter, and advocacy for victims of domestic violence and their children;

(b) Provide for culturally specific and appropriate services for victims of domestic violence and their children from populations that have been historically underserved or unserved; and

(2) Funding for this program is intended to develop and maintain domestic violence programs that are:

(a) Focused on victim advocacy, safety, empowerment, maintaining confidentiality, and safety planning;

(b) Inclusive and responsive to the ethnic, cultural, racial, and socioeconomic diversity of the state; and

(3) If an organization applies for funding, we will consider such things as:

(a) Geographic location;

(b) Population density;

(c) Specific population needs, including urban and rural areas, and the need for culturally and linguistically appropriate services and prevention efforts;

(d) Availability and existence of domestic violence outreach and prevention efforts;

(e) An applicant's demonstrated history and experience in providing domestic violence services and its ability to provide services that comply with the minimum standards of this chapter;

(f) The availability of other domestic violence programs in a community and the level of collaboration between and among existing programs; and

(g) The amount of funding we have available to maintain stability and support for domestic violence programs currently funded by the department under this chapter.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1020, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1025 What services must a department-funded domestic violence program provide?

(1) Supportive services provided by the domestic violence program must align with the survivor-centered and empowerment service model described in this chapter, and must also:

(a) Include a discussion of safety and options with each victim of domestic violence seeking assistance;

(b) Be respectful, respond to each client's life situation, and respect each person's right to self-determination;

(c) Be provided in a safe and supportive environment that offers the client the opportunity to examine the events that led to the need for domestic violence services; and

(d) Be provided in a private setting for the comfort of the client and to protect the client's right to confidentiality.

(2) Domestic violence programs must provide the following:

(a) A location with a private setting to meet and assist victims of domestic violence who have a need for community advocacy or supportive services;

(b) A dedicated telephone line that serves as the contact number for the domestic violence program;

(d) Crisis intervention;

(e) Safety planning;

(f) Individual advocacy, including legal advocacy;

(g) Support groups;

(h) Child care assistance during individual advocacy sessions and support groups for the adult victim;

(i) Emergency transportation assistance or access to transportation;

(j) Information and referral; and

(k) Community education and prevention efforts.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1025, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1030 What are the requirements for providing emergency shelter?

(1) Programs that we contract with for emergency shelter must also provide:

(a) A crisis hotline or helpline;

(b) A place of temporary lodging that complies with the service and facility requirements of this chapter;

(c) A day program or drop in service for victims who have a need for supportive services but do not need emergency shelter;

(d) Resident access to a trained staff person twenty-four hours a day, three hundred sixty-five days a year;

(e) The opportunity for residents to receive and participate in supportive services during their stay in emergency shelter; and

(f) Age appropriate supportive services and resources for children/youth residing in emergency shelter.

(2) Programs must not require that clients participate in supportive services as a condition of residing in emergency shelter.

(3) Your program must have written procedures regarding your emergency shelter intake process. Victims who are at immediate risk of harm or who are in immediate danger due to domestic violence must be given priority for emergency shelter.

(4) You must have a staff person available twenty-four hours a day, three hundred sixty-five days a year, who is able to assess requests for emergency shelter and arrange for immediate intake into your shelter or a hotel or motel.

(5) Where an individual is eligible for emergency shelter:

(a) A staff person must be present to admit a service recipient into the emergency shelter; and

(b) Your program must make reasonable efforts to have a staff person present to admit a service recipient into a hotel or motel.

(6) Hotels or motels may be used as a temporary emergency sheltering option but must not be used in place of an emergency shelter that meets the standards set forth in this chapter. Individuals placed in a hotel or motel or other temporary shelter option must be provided with supportive services during the time they are in emergency shelter.

(7) You must provide an individual with referrals to other services or domestic violence agencies when:

(a) Your emergency shelter is full;

(b) A client residing in emergency shelter must be transferred to another domestic violence program for client safety reasons;

(d) An inappropriate referral was made to your domestic violence program; or

(e) The person seeking emergency shelter has problems that require services of another program or programs before they receive domestic violence services.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1030, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1035 What services and resources must be available to children/youth residing in emergency shelter?

(1) With the parent's or guardian's permission, you must offer children/youth the opportunity to receive and participate in the following age appropriate supportive services during their emergency shelter residency:

(a) Orientation to the emergency shelter;

(b) Information about domestic violence;

(d) Information and referral to other supportive services.

(2) You must provide a safe and secure play area for children/youth residing in the emergency shelter.

(3) You must provide information to the client about resources for indoor and outdoor recreational activities in the community for children/youth residing in emergency shelter, such as outings to parks, playgrounds, movies, libraries, sports activities, youth clubs and other similar activities.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1035, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1040 What are the requirements for a crisis hotline or helpline?

(1) Emergency shelters must provide a crisis hotline/helpline telephone number for accessing the services of the domestic violence program. The telephone number must be widely distributed throughout the service area covered by the domestic violence program and be identified as the crisis hotline/helpline of the program.

(2) The crisis hotline/helpline service must comply with the following minimum requirements:

(a) It must operate twenty-four hours a day, three hundred sixty-five days a year;

(b) It must be a dedicated telephone line that serves as the crisis hotline or helpline;

(c) Staff that answer the hotline/helpline must be trained in, periodically review, and be familiar with, the crisis helpline/hotline written procedures and all referral and intake practices of the domestic violence program;

(d) In most cases, callers to the hotline/helpline must be able to speak, within fifteen minutes, to a trained staff person who can help the caller obtain services, including access to emergency shelter;

(e) Staff must have access to a telecommunications device for the deaf (TDD) or similar technology, and they must be trained in its use; and

(f) Staff must address safety in every call.

(3) You must have crisis hotline/helpline written procedures that address the following:

(a) How crisis hotline staff will meet the needs of non English speaking and hearing impaired callers;

(b) Steps staff must take when a caller requests emergency shelter; and

(c) If you use an answering service or another similar system, how you will provide training to the staff of the answering service and monitor the services they provide to your program.

(4) If you use a call forwarding system for your domestic violence program's hotline/helpline, answering service, or any other similar system, you must guarantee that the caller's first contact is supportive.

(5) You may use an answering machine, voice mail, or similar recording device as a back up means of responding to calls to your program's crisis hotline/helpline. However, these devices must not be used as your program's primary method of answering crisis hotline/helpline calls. Messages left on your program's answering machine, voice mail, or similar recording device must be returned within the timeframe described in this section.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1040, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1045 What prevention efforts must you provide?

Prevention is changing the social norms that allow and perpetuate domestic violence. The core strategy for preventing domestic violence is the promotion of healthy, respectful, nonviolent relationships by shifting attitudes, behaviors, and social norms at the individual, relationship, community, and societal levels. While prevention activities will vary by community and population, programs that we contract with must design and engage in efforts that:

(1) Promote attitudes, behaviors, and social conditions aimed at preventing domestic violence before it happens;

(2) Attempt to decrease risk factors for perpetration of abuse as well as victimization while also promoting positive factors that protect individuals from perpetrating or experiencing abuse;

(3) Include strategies that use varied teaching methods to address multiple learning processes;

(4) Are age and developmentally appropriate;

(5) Are culturally and linguistically applicable to the specific community;

(6) Engage with a subsection of the broader community, reaching beyond the program's community of clients;

(7) Emphasize multi-session, comprehensive activities with small, defined communities; and

(8) Include strategies, policies, and programs that are concentrated, can be sustained and expanded over time, and focus on at least one of the following:

(a) Increasing community dialogue about the root causes of intimate partner violence;

(b) Shifting cultural norms;

(d) Promoting respectful and healthy relationships.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1045, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1050 What activities are not considered prevention?

While valuable, we do not consider certain activities to be prevention. Examples of these activities include, but are not limited to:

(1) Community education as defined in this chapter;

(2) Transformative and restorative justice efforts;

(3) Single session or one-time activities, such as trainings, presentations, or events;

(4) Activities that focus on defining domestic violence, or teaching data, dynamics, and the impacts of domestic violence;

(5) Providing information on how to access domestic violence services or how to help others in accessing services;

(6) Support groups as defined in this chapter (support groups are considered a supportive service); and

(7) Activities that focus on improving responsiveness to domestic violence survivors by community members or system partners.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1050, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1055 What information must be in a client's file?

(1) You must have a written file for each client served by your domestic violence program. Client files must:

(a) Include an intake that clearly documents the client's eligibility for domestic violence services;

(b) Include copies of all required releases and client notices;

(d) Document only sufficient information to identify the service provided, and do not include any of the following:

(i) References to service recipient feelings, emotional or psychological assessments, diagnoses, or similar subjective observations or judgments;

(ii) Direct quotes from the client.

(2) Where supportive services are provided to the child/youth of clients, your domestic violence program must:

(a) Maintain separate documentation for each child/youth who receives supportive services and do not include it in the parent/guardian's file;

(b) Be brief in documenting the supportive services provided to the child/youth;

(i) References to the child/youth's feelings, emotional or psychological assessments, diagnoses, or similar subjective observations or judgments;

(ii) Direct quotes from the child/youth.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1055, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1060 What information must the domestic violence program keep confidential?

(1) Agents, employees, and volunteers of a domestic violence program must maintain the confidentiality of all personally identifying information, confidential communications, and all confidential information as defined in this chapter. Information that individually or together with other information could identify a particular victim of domestic violence must also be kept confidential.

(2) Any reports, records, working papers, or other documentation, including electronic files that are maintained by the domestic violence program and information provided to the domestic violence program on behalf of the client, must be kept confidential. Any information considered privileged by statute, rule, regulation, or policy that is shared with the domestic violence program on behalf of the client must not be divulged without a valid written waiver of the privilege that is based on informed consent, or as otherwise required by law.

(3) You must comply with the provisions of this section regarding confidential communications concerning clients regardless of when the client received the services of the domestic violence program.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1060, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1065 What information may be disclosed?

(1) You may disclose confidential information only when one or more of the following is met:

(a) The client provides informed, written consent to the waiver of confidentiality that relates only to the client or the client's dependent children;

(b) Your failure to disclose is likely to result in a clear, imminent risk of serious physical injury or death of the client or other person;

(d) Release of information is otherwise required by law, court order, or following in camera review pursuant to RCW 70.123.075, with the following additional requirements:

(i) The domestic violence program must make reasonable attempts to provide notice to the person affected by the disclosure of the information; and

(ii) If personally identifying information is or will be disclosed, the domestic violence program must take steps necessary to protect the privacy and safety of the persons affected by the disclosure of information.

(2) Any disclosure of confidential information subject to any of the exceptions set forth in subsection (1) of this section must be limited to the minimum necessary to meet the requirement of the exception, and any disclosure does not void the client's right to confidentiality and privilege on any other confidential communication between the client and the domestic violence program.

(3) In the case of an unemancipated minor, the minor and the parent or guardian must provide the written consent to disclose confidential information. Consent to disclose confidential information must not be given by a parent who has abused the minor or the minor's other parent. In the case of a disabled adult who has been appointed a guardian pursuant to Title 11 RCW, the guardian must consent to disclosure of confidential information if so authorized in the order appointing him or her as guardian, unless the guardian is the abuser of the disabled adult.

(4) To comply with federal, state, tribal, or territorial reporting, evaluation, or data collection requirements, a domestic violence program may disclose aggregated, nonpersonally identifying data about services provided to their clients and nonpersonally identifying demographic information.

(5) You must provide copy of the disclosed information to the client if the client requests it.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1065, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1070 What are the requirements for a written waiver of confidentiality?

(1) To be valid, a written waiver of confidentiality must:

(a) Be voluntary;

(b) Relate only to the client or the client's dependent children;

(d) Include an expiration date for the release; and

(e) Inform the client that consent may be withdrawn at any time whether it is made orally or in writing.

(2) If the written waiver of confidentiality does not include an expiration date, it expires ninety days after the date it was signed.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1070, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1075 What must you provide to clients about their right to confidentiality?

(1) You must provide each client with a written "notice of rights" at the time of the initial intake and any subsequent intake into the domestic violence program. At a minimum, the notice of rights must inform clients of the following:

(a) The client's right to privacy and confidentiality of the information shared with the domestic violence program;

(b) Exceptions to confidentiality as described in this chapter;

(c) That if the client signs a written waiver of confidentiality that allows their information to be shared with others, the client does not give up their right to have that information protected under other statutes, rules, or laws;

(d) That the client has the right to withdraw a written waiver of confidentiality at any time; and

(e) That the domestic violence program will not condition the provision of services to the client based on a requirement that the client sign one or more releases of confidential information.

(2) Information on the "notice of rights" must be explained to the client at the time of intake into the domestic violence program and then again at the time the client is considering whether to sign a written waiver of confidentiality.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1075, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1080 What type of training is required for staff of the domestic violence program?

Initial and continuing education training of domestic violence program staff is critically important. In addition, quality supervision is an integral component for the provision of excellent advocacy and in supporting staff. Advocates and advocate supervisors must be able to demonstrate an understanding of the nature and scope of domestic violence as defined by this chapter, as well as the historical and societal attitudes in which domestic violence is rooted. Training must be current and relevant to the provision of empowerment based advocacy. Domestic violence agencies should also strive to ensure that staff incorporate training on services to underserved populations as part of each advocate's annual continuing education hours. In furtherance of these goals, domestic violence program staff must meet the following minimum training requirements.

Initial training

(1) Staff providing supportive services and prevention efforts, and supervisors of staff must obtain a minimum of twenty hours of initial basic training that covers all the following topics and skills:

(a) Theory and implementation of empowerment based advocacy;

(b) The history of the domestic violence movement;

(d) Legal, medical, social service, and systems advocacy;

(e) Anti-oppression and cultural competency theory and practice;

(f) Confidentiality and ethics;

(g) Safety planning skills and barriers to safety;

(h) Planning, clarifying issues and options, and crisis intervention;

(i) Providing services and advocacy to individuals from culturally specific populations; and

(j) Policies and procedures of the domestic violence program.

(2) Staff who will be engaged in prevention efforts must incorporate training on prevention as part of, or in addition to, the initial training requirements.

(3) Initial training must be completed prior to providing supportive services to clients or their children.

(4) The recommended format for initial trainings is live and in-person group sessions. Structured job shadowing and self-study may be included as part of the overall initial training. All domestic violence program in-house training must be based on a written training plan that covers one or more of the required initial training topics.

Continuing education and supervisor training

(5) Staff who provide either supportive services or are engaged in prevention efforts, or both, and staff supervisors must obtain an annual minimum of twenty hours of continuing education training beginning in the state fiscal year after they completed their initial training, and in every year thereafter. Staff who will be engaged in prevention efforts must incorporate training on prevention as part of, or in addition to, the annual continuing education requirements.

(6) A minimum of ten hours must be live training on topics specifically focused on either serving victims of domestic violence and their children, or prevention efforts, or both.

(7) The remaining ten hours of training may be satisfied through self-study on topics specifically focused on serving victims of domestic violence and their children, or prevention efforts, or both.

(8) Within six months of being hired as an advocate supervisor and for each year thereafter, the supervisor must obtain a minimum of five hours of training on supervision. Supervision training can be counted toward the twenty hours of annual continuing education training hours required by this chapter. Examples of supervision training topics include leadership skills, job coaching and staff evaluation, multicultural supervision, and how to foster professional development of, and self-care with, advocates. While live, in-person training is the preferred method for supervision training, all methods of live and self-study training are acceptable.

Training for staff not providing supportive services or prevention activities

(9) Domestic violence program staff are not required to obtain initial and continuing education training as described in this section if they do not:

(a) Provide supportive services to clients or their children; or

(b) Conduct prevention efforts.

(10) Examples of staff who are included in this category are emergency shelter housekeeping staff, individuals providing child care assistance as defined in this chapter, and bookkeeping and accounting staff. We recommend, however, that staff who may come into contact with clients and their children, but who do not provide supportive services or conduct prevention efforts, receive training on the following:

(a) Confidentiality;

(b) Relevant policies and procedures of the domestic violence program; and

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1080, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1085 How should training be documented?

Initial, continuing education, and supervisor training must be documented as required by the department.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1085, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1090 Must supervisors of domestic violence program staff have specific experience and training?

Supervisors of staff providing supportive services to domestic violence clients must have the following minimum experience and training requirements prior to being hired as a supervisor:

(1) At least two years of experience providing advocacy to victims of domestic violence within a domestic violence program; and

(2) A minimum of fifty hours of training on domestic violence issues and advocacy within three years prior to being hired as a supervisor.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1090, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1095 What written policies or procedures do you need to have?

The domestic violence program must have written policies or procedures on the following:

(1) Programs that provide emergency shelter must have procedures for the intake process, including that victims who are at immediate risk of harm or in immediate danger due to domestic violence must be given priority for emergency shelter;

(2) Confidentiality and protection of client records and communication;

(3) Nondiscrimination relating to staff, clients, and provision of services;

(4) The provision of bilingual and interpreter services to clients;

(5) Responding to calls from non English speaking and hearing impaired callers;

(6) Programs that are required to have a crisis hotline/helpline and use an answering service, or any other similar system to answer calls, must have procedures for providing training to the answering service staff and how you will monitor the services the answering service provides to your program;

(7) Responding to subpoenas and warrants;

(8) Reporting of child abuse as legally mandated;

(9) Client access to their files;

(10) Grievance procedure for clients;

(11) Prohibiting harassment of service recipients based on race, sexual orientation, gender identity (or expression), religion, and national origin, and procedures for addressing violations;

(12) Emergency procedures in the event of fire, disaster, and first aid, medical, or law enforcement intervention;

(13) Responding to disruptive or dangerous contact from abusers and other possible intruders or uninvited individuals requesting or seeking access to the domestic violence program;

(14) Records retention;

(15) Accounting procedures; and

(16) Personnel policies and procedures that include the following:

(a) Recruitment of staff and volunteers, including that programs recruit, to the extent feasible:

(i) Persons who are former victims of domestic violence; and

(ii) Persons from relevant communities to provide culturally and linguistically appropriate services;

(b) Hiring;

(d) Grievance procedure for staff; and

(e) Maintaining personnel and training files, including job descriptions for paid staff and volunteers.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1095, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1100 What safety requirements are emergency shelters required to meet?

You must keep your equipment and the physical structures in the emergency shelter, including furniture and appliances, safe and clean for the clients you serve. You must:

(1) Maintain the emergency shelter, premises, equipment, and supplies in a clean, safe and sanitary condition, free of hazards, and in good repair;

(2) Provide guard or handrails, as necessary, for stairways, porches, and balconies;

(3) Have a method for securing all windows, doors, and other building accesses to prevent the entry of intruders;

(4) Make sure that clients residing in emergency shelter are able to immediately enter the shelter if they do not have the ability to independently access the facility with their own key, key card, door code, or other device;

(5) Provide adequate lighting of exterior areas to ensure the safety of clients residing in emergency shelter and staff during the night;

(6) Provide a way for staff to enter any area occupied by clients should there be an emergency;

(7) Secure all unused refrigerators and freezers accessible to children in such a way that prevents them from climbing in and becoming trapped;

(8) Request an annual fire and life safety inspection from the local fire department or fire marshal and:

(a) Document and maintain the request and any report issued as a result of the inspection; and

(b) Immediately correct any violations noted by the inspector;

(9) Have at least one program staff present or on-call to go to the emergency shelter twenty-four hours a day, seven days per week when clients are residing in shelter;

(10) Provide residents with contact numbers and instructions, in the resident's primary language, on how they can access domestic violence program staff; and

(11) Make sure that emergency shelter residents have, or have access to in the shelter, at least one telephone for incoming and outgoing calls.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1100, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1105 What are the requirements for bedrooms?

The minimum requirements for bedrooms are as follows:

(1) A bed for each resident that is in good condition, with a clean and comfortable mattress;

(2) A minimum ceiling height of seven and one-half feet; and

(3) At least fifty square feet of usable floor area per bed and floor area where the ceiling is less than five feet is not considered usable floor area.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1105, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1110 What are the requirements for cribs or bassinets?

If the emergency shelter provides cribs or bassinets, the shelter must comply with the crib safety standards issued by the United States Consumer Product Safety Commission.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1110, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1115 What kind of diaper changing area must I provide?

You must provide a sanitary diaper changing area. In addition, you must develop and post in view of the changing area hygienic procedures for handling and storing diapers and sanitizing the changing area. These procedures must also be provided in writing to all residents with infants.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1115, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1120 What are the kitchen requirements?

The following are the minimum general requirements for kitchen facilities:

(1) A sink for washing dishes;

(2) A refrigerator or other storage equipment capable of maintaining a consistent temperature of forty five degrees Fahrenheit or lower;

(3) A range or stove;

(4) Covered garbage container;

(5) Eating and cooking utensils that are clean and in good repair; and

(6) Counter surfaces that are clean and resistant to moisture.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1120, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1125 What are the requirements for providing food to clients residing in emergency shelter?

(1) Your domestic violence program must provide food and beverages for the basic sustenance of clients residing in emergency shelter, unless other resources are immediately available.

(2) You must store food and beverages, including infant formula, at the emergency shelter to provide to clients residing in shelter when other resources are not immediately available, and for emergency shelter residents who are unable to safely access other food resources.

(3) Milk and infant formula must be available at all times for children residing in the emergency shelter.

(4) You must purchase and provide only food and beverages that are of safe quality to clients residing in emergency shelter. Storage, preparation, and serving techniques must ensure that nutrients are retained and spoilage is prevented.

(5) Food and beverages prepared for clients residing in emergency shelter must be prepared, served, and stored safely and in a sanitary manner.

(6) Food must be available to prepare school lunches, if lunch is not otherwise available to the children of emergency shelter residents.

(7) Clients residing in emergency shelter must be provided, or have immediate access to, food that is in accordance with their religious or cultural beliefs and personal practices.

(8) When staff prepare and serve food to clients in communal emergency shelters, the food must be prepared in compliance with chapter 246-215 WAC, Food service.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1125, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1130 What are the requirements for providing clothing to clients residing in emergency shelter?

(1) If an adult or child comes into emergency shelter without adequate clothing, you must assist them with access to clean, well fitting clothing appropriate to the season, and the individual's age, gender, and particular needs.

(2) Clothing that you provide must be clean and have been stored in a sanitary manner.

(3) Clothing that is provided to an individual becomes that person's personal property and must not be retrieved from the client when they leave the emergency shelter.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1130, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1135 What personal hygiene items do I need to provide to clients residing in emergency shelter?

All clients residing in emergency shelter must be provided with personal hygiene products during their residency, such as soap, hair care products, toothbrush and paste, and deodorant. Particular attention must be paid to providing items for individuals that have special needs because of their ethnicity, disability, or medical condition.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1135, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1140 What are the requirements for toilets, sinks, and bathing facilities?

You must meet the following requirements for toilets, sinks, and bathing facilities:

(1) You must provide at least one indoor flush-type toilet, one nearby sink for hand washing, and a bathtub or shower facility. These facilities must be located within the emergency shelter building premises.

(2) Communal emergency shelters must provide at a minimum, one restroom facility (as defined under WAC 388-61A-1000(28)) for every fifteen residents who do not have access to private restroom facilities. For example, communal emergency shelters must provide one restroom facility for one to fifteen residents, two for sixteen to thirty residents, and so on.

(3) You must comply with all of the following requirements for toilet and bathing facilities:

(a) Toilet and bathing facilities must allow for privacy of emergency shelter residents;

(b) The floors of all toilet and bathing facilities must be resistant to moisture;

(c) Toilets, urinals, and hand washing sinks must be the appropriate height for the children served, or have a safe and easily cleaned step stool or platform that is water resistant;

(d) Facilities for hand washing and bathing must be provided with hot and cold running water and hot water must not exceed one hundred and twenty degrees Fahrenheit;

(e) Potty chairs and toilet training equipment for toddlers must be regularly maintained, disinfected, and kept in a sanitary condition and when in use, you must put potty chairs on washable, water resistant surfaces; and

(f) You must provide soap and clean washcloths and towels, disposable towels, or other hand drying devices to emergency shelter residents.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1140, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1145 What types of linen do I need to provide to clients?

You must provide bed linen, towels, and washcloths that are clean and in good repair. After use by a client, bed linen, towels, and washcloths must be laundered prior to use by another client.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1145, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1150 What are the requirements for laundry facilities?

The requirements for laundry facilities are as follows:

(1) You must provide adequate laundry and drying equipment or make other arrangements for getting laundry done on a regular basis. Laundry facilities in the emergency shelter must be provided free to shelter residents.

(2) You must handle and store laundry in a sanitary manner.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1150, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1155 What are the requirements for drinking water?

Water supplies that are used for human consumption must be from a water system that has been approved by the local health authority or department as safe for human consumption. This refers to both public water systems and individual systems.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1155, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1160 What are the requirements for sewage and liquid wastes?

You must discharge sewage and liquid wastes into a public sewer system or septic system that has been approved by the local health authority or department.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1160, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1165 What kind of heating is required?

(1) Rooms used by clients in the emergency shelter must be equipped with a safe and adequate source of heat that can keep the room at a healthful temperature during the time the room is occupied.

(2) The use of gas or oil fired space heaters is prohibited.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1165, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1170 How must I ventilate the emergency shelter?

You must ensure that your emergency shelter is ventilated for the health and comfort of the clients residing in shelter by meeting the following requirements:

(1) A mechanical exhaust to the outside must ventilate toilets and bathrooms that do not have windows opening to the outside;

(2) In order to prevent objectionable odors and condensation, all bathrooms, toilet rooms, laundry rooms, and other enclosed space containing wet mops and brushes, must have natural or mechanical ventilation;

(3) Bedrooms and communal living areas must have a window or opening to the outdoors that can be locked or secured from the inside; and

(4) Gas or oil fired water heaters and forced air systems must be safely vented to the outside.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1170, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1175 How much lighting is required in the emergency shelter?

You must locate light fixtures and provide lighting that promotes good visibility and comfort for clients residing in emergency shelter.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1175, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1180 What are the requirements about pets in the emergency shelter?

Pets are prohibited from the kitchen during food preparation.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1180, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1185 What first-aid supplies must I provide?

You must keep first-aid supplies on hand and accessible to clients residing in emergency shelter for immediate use. In instances where an adult or child has ingested a potentially poisonous chemical or substance, you must call the Washington poison center for further instruction. Instructions for contacting the Washington poison center must be included with either the first-aid supplies or visibly posted for residents, or both.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1185, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1190 What are the requirements for storing medications?

(1) Clients residing in emergency shelter must be provided with a means to safely and securely store, and have direct and immediate access to, their medications such as individual lock boxes, lockers with a key or combination lock, or a similar type of secure storage.

(2) All medications, including pet medications and herbal remedies, must be stored in a way that is inaccessible to children.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1190, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1195 What measures must I take for pest control?

You must make reasonable attempts to keep the emergency shelter free from pests, such as rodents, flies, cockroaches, fleas, and other insects.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1195, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1200 What are the requirements for labeling and storing chemicals and toxic materials?

(1) Containers of chemical cleaning agents and other toxic materials must:

(a) Be clearly labeled with the contents; and

(b) Include the manufacturer's instructions and precautions for use.

(2) You must store the following items in a place that is not accessible to children:

(a) Chemical cleaning supplies;

(b) Toxic substances;

(d) Aerosols; and

(e) Items with warning labels.

(3) You must store chemical cleaning supplies, toxic substances, and poisons separately from food items, clothing, and bedding in order to prevent contamination.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1200, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1205 Where do I keep firearms and other dangerous weapons?

(1) If a resident has a firearm or other dangerous weapon, you must secure it in a locked storage container, gun safe, or another storage area made of strong, unbreakable material. Stored firearms must be unloaded.

(2) If a storage container for firearms has a glass or another breakable front, you must secure firearms with a locked cable or chain placed through the trigger guards.

(3) You must store ammunition in a place that is separate from the firearms or locked in a gun safe.

(4) You must allow access to firearms, weapons, and ammunition only to authorized persons.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1205, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1210 Will the department evaluate its contractors?

The department will evaluate its contractors as follows:

(1) To measure compliance with our requirements we will conduct a biennial evaluation of each contractor;

(2) Emergency shelters will be inspected during on-site evaluations of contractors to measure compliance with our facility requirements; and

(3) If a lodging unit of the emergency shelter is occupied at the time of an on-site evaluation, the contractor must give the client an opportunity to leave the unit prior to the arrival of the evaluator.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1210, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1215 What will happen if I am out of compliance with the minimum standards or my contract?

(1) If we find that the contractor is out of compliance with the standards specified in this chapter or the terms of the contract, we will give you written notice of the deficiencies. You must correct the deficiencies according to a plan of correction we approve.

(2) We may suspend, revoke, or terminate the funding of a contractor if it is out of compliance with this chapter or the contract.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1215, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1220 What will happen if there is a complaint to the department about the contractor?

(1) If we receive information, or have reason to believe, that a contractor may be out of compliance with this chapter or the contract, we may initiate an investigation.

(2) If the investigation requires that we be on-site at your emergency shelter, you must give clients residing in lodging units an opportunity to leave the unit during the inspection.

(3) If we find that you are out of compliance with the standards specified in this chapter or the terms of the contract, we will give you written notice of the deficiencies. You must satisfactorily correct the deficiencies according to a plan of correction we approve.

(4) We may suspend, revoke, or terminate the funding of a contractor if it is out of compliance with this chapter or the contract.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1220, filed 4/10/18, effective 5/11/18.

Wash. Admin. Code § 388-61A-1225 May the department waive any of the minimum standards of this chapter?

Under certain conditions we may waive some of the rules contained in this chapter.

(1) To request a waiver you must submit a written request that:

(a) Clearly describes the minimum standards(s) for which the waiver is requested;

(b) Describes the reason(s) why your program is unable to meet the requirements of this chapter without the waiver;

(c) Identifies whether there are other resources or services that can adequately compensate for the minimum standard(s) for which the waiver is requested;

(d) Demonstrates that granting of the waiver will not jeopardize the safety or health of clients; and

(e) Shows that the absence of granting the waiver will have a detrimental effect on the provision of services.

(2) If the written waiver request proposes any substitutions of procedures, materials, service, or equipment from those specified in this chapter, the substitutions must be at least equivalent to those required.

History

Statutory Authority: Chapter 70.123 RCW. WSR 18-09-015, § 388-61A-1225, filed 4/10/18, effective 5/11/18.

Chapter 388-71 Home and community services and programs.

Wash. Admin. Code § 388-71-0503 What definitions apply to this chapter?

"Agency provider" means a long-term care worker (LTC) who works for a home care agency.

"Area agencies on aging (AAA)" means a contracted entity that aging and long-term support administration (ALTSA) grants funds to in order to carry out the functions of the Older Americans Act, general-fund state programs, and to provide case management services and supports to individuals 18 and older who receive medicaid-funded long-term care (LTC) in their own homes.

"Applicant" means a person who is in the process of becoming an in-home LTC worker.

"Background check" means a name and date of birth check, or a fingerprint-based background check, or both.

"Background check result" is defined in WAC 388-113-0010.

"Background check central unit (BCCU)" means the DSHS entity responsible for conducting background checks for the department.

"Character, competence, and suitability determination (CC&S)" is defined in WAC 388-113-0050.

"Client" means an individual receiving in-home long-term care services from DSHS that are funded by medicaid or the long-term services and supports trust program (WA cares).

"Conflict of interest" means under 42 CFR 431 (c)(1)(vi), case management must be separate from service delivery functions. A contracted entity that aging and long-term support administration (ALTSA) grants funds to in order to carry out the functions of the Older Americans Act, general-fund state programs, and to provide case management services and supports to individuals 18 and older who receive medicaid-funded LTC in their own homes must comply with conflict-free case management.

"Department" means the department of social and health services (DSHS) or its designees.

"Family member" includes, but is not limited to a:

(1) Spouse or domestic partner;

(2) Parent, child, sibling, aunt, uncle, niece, nephew, cousin, grandparent, grandchild, grandniece, grandnephew, or such relatives when related by marriage or domestic partnership.

"Federally recognized Indian tribe" means self-governing American Indian/Alaskan Native (AI/AN) governments recognized under applicable federal and common law. Because of their sovereignty, federally recognized tribes have the inherent power to make and enforce laws on their lands, and to create governmental entities. A federally recognized tribe is an AI/AN tribal entity that is recognized as having a government-to-government relationship with the United States, with the responsibilities, powers, limitations, and obligations attached to that designation, and is eligible for funding and services from the Bureau of Indian Affairs. In addition, for the purpose of this rule, federally recognized Indian tribes are contracted entities that the aging and long-term support administration (ALTSA) may grant funds to carry out functions and to provide case management services and supports to individuals 18 and older who receive medicaid-funded long-term care in their own homes and general fund state programs.

"Fingerprint-based background check" means a search of in-state criminal history records through the Washington state patrol and national criminal history records through the Federal Bureau of Investigation.

"Home care agency (HCA)" means an entity that is licensed by the department of health to provide home care services through a contract arrangement with the department to clients in places of permanent or temporary residence.

"Home care agency long-term care (LTC) worker" means a LTC worker who works for a home care agency.

"Long-term care (LTC) worker" means any of the following:

(1) A direct care worker employed by a home care agency;

(2) An individual provider employed by a consumer directed employer; or

(3) Long-term services and supports trust (WA cares) "qualified family members".

"Name and date of birth check" is a search conducted by the background check central unit (BCCU) of Washington state criminal history and negative action records using the applicant's name and date of birth.

"Negative actions" are listed in WAC 388-113-0030.

History

Statutory Authority: RCW 74.08.090, 74.39A.009, 74.39A.070, 74.39A.074, 74.39A.076, 74.39A.341, 18.88B.010, 18.88B.021, and 18.88B.041. WSR 26-08-045, s 388-71-0503, filed 3/25/26, effective 4/25/26. Statutory Authority: 2022 c 255, RCW 74.09.520, 74.39A.009, 74.39A.090, 74.39A.095, and 74.39A.515. WSR 25-07-060, s 388-71-0503, filed 3/13/25, effective 4/13/25. Statutory Authority: RCW 74.08.090 and 74.39A.250. WSR 22-19-048, § 388-71-0503, filed 9/15/22, effective 10/16/22. Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074. WSR 22-06-088, § 388-71-0503, filed 3/1/22, effective 4/1/22. Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-71-0503, filed 8/30/21, effective 10/1/21.

Wash. Admin. Code § 388-71-0510 What are the qualifications of a LTC worker under this chapter?

In order to be qualified as a long-term care worker, an applicant must:

(1) Not have a disqualifying crime or negative action under chapter 388-113 WAC based on a completed background check;

(2) Not be disqualified based on a character, competence, and suitability determination;

(3) Complete training and certification requirements listed in WAC 388-71-0520 and WAC 388-71-0523; and

(4) If required, have an active home care aide certification or other qualifying credential by the department of health.

History

Statutory Authority: RCW 74.08.090 and 74.39A.250. WSR 22-19-048, § 388-71-0510, filed 9/15/22, effective 10/16/22. Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-71-0510, filed 8/30/21, effective 10/1/21. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.056. WSR 14-14-025, § 388-71-0510, filed 6/24/14, effective 7/25/14. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-0510, filed 12/20/12, effective 1/20/13. Statutory Authority: 2004 c 276 § 206 (6)(b) andTownsend vs. DSHS, U.S. District Court, Western District of Washington, No. C 00-0944Z. WSR 04-16-029, § 388-71-0510, filed 7/26/04, effective 8/26/04. Statutory Authority: RCW 74.08.090, 74.09.520, 43.20A.050, 43.43.842, 74.39A.090, 43.20A.710, 74.39.050, 43.43.830, 74.39.095. WSR 01-11-019, § 388-71-0510, filed 5/4/01, effective 6/4/01. Statutory Authority: RCW 74.08.090, 74.09.520, 43.20A.050, 43.43.842, 74.39A.090, 43.20A.710, 74.39.050, 43.43.830. WSR 00-03-043, § 388-71-0510, filed 1/13/00, effective 2/13/00.

Wash. Admin. Code § 388-71-0511 When is a background check required of an agency provider?

(1) Agency providers are required to complete and pass a name and date of birth background check prior to working with a client.

(2) Agency provider workers are required to complete and pass a name and date of birth background check:

(a) Every two years; and

(b) Any time the home care agency employer requests a new check.

(3) In addition to the name and date of birth background check, agency providers are required to complete and pass a fingerprint-based background check:

(a) If hired after January 7, 2012, and in accordance with provisional hire rules in WAC 388-113-0109;

(b) If they have lived out of state since the last fingerprint-based background check was completed; or

History

Statutory Authority: RCW 74.08.090 and 74.39A.250. WSR 22-19-048, § 388-71-0511, filed 9/15/22, effective 10/16/22. Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-71-0511, filed 8/30/21, effective 10/1/21.

Wash. Admin. Code § 388-71-0513 How does an agency provider complete a background check?

(1) The agency provider must:

(a) Complete the background check authorization form;

(b) Answer all questions on the background check authorization form truthfully;

(d) Not have any automatically disqualifying conviction(s), pending charge(s), or negative action(s) as described in chapter 388-113 WAC;

(e) Review the background check results and if necessary provide documents or other information to BCCU to correct the background check results; and

(f) When requested by BCCU, provide additional information in order to complete a background check as mandated by statute.

(2) It is the responsibility of the home care agency to ensure compliance with subsection (1) of this section for its agency providers.

History

Statutory Authority: RCW 74.08.090 and 74.39A.250. WSR 22-19-048, § 388-71-0513, filed 9/15/22, effective 10/16/22. Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-71-0513, filed 8/30/21, effective 10/1/21. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.056. WSR 14-14-025, § 388-71-0513, filed 6/24/14, effective 7/25/14. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-0513, filed 12/20/12, effective 1/20/13. Statutory Authority: RCW 74.08.090, 74.09.520, 43.20A.050, 43.43.842, 74.39A.090, 43.20A.710, 74.39.050, 43.43.830, 74.39.095. WSR 01-11-019, § 388-71-0513, filed 5/4/01, effective 6/4/01.

Wash. Admin. Code § 388-71-0516 What are the responsibilities of home care agency when providing care to a client?

In providing care to a client, a home care agency must:

(1) Ensure that the assigned home care agency long-term care worker(s) understands the client's plan of care that is signed by the client or legal representative, and which may be translated or interpreted, as necessary for the client;

(2) Provide tasks from services outlined in a client's plan of care, as described in WAC 388-106-0010;

(3) Accommodate the client's individual preferences and unique needs in providing care;

(4) Contact the client, client's representative and case manager when there are changes observed by the assigned home care agency long-term care worker that affect the personal care and other tasks listed on the plan of care;

(5) Ensure that the assigned home care agency long-term care worker(s) observes the client for and consults with the client or representative, regarding change(s) in health, takes appropriate action, and responds to emergencies;

(6) Notify the case manager immediately when the client enters a hospital, or moves to another setting;

(7) Notify the case manager immediately in the event of the client's death;

(8) Notify the department or AAA immediately when unable to staff/serve the client;

(9) Notify the department or AAA when the home care agency will no longer provide services and the home care agency must:

(a) Give at least two weeks' notice; and

(b) Notify the client or the client's representative in writing; and

(10) Comply with time keeping requirements, and keep accurate time sheets of authorized/paid hours that are accessible to the appropriate department or designee staff; under WAC 388-106-0130, the department does not pay for voluntary informal support that may be provided to the client by anyone, including providers; and

(11) Comply with all applicable laws and regulations.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 21-04-037, § 388-71-0516, filed 1/26/21, effective 3/1/21
WSR 13-02-023, § 388-71-0516, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-0517 What are the responsibilities of a home care agency when the home care agency long-term care worker is a family member of the client and the client is receiving in-home medicaid-funded personal care or respite services?

A home care agency must not bill the department for in-home medicaid-funded personal care or respite services when the agency employee providing care is a family member of the client served, unless approved to do so by the department or exempt as provided in RCW 74.39A.326.

History

Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-71-0517, filed 8/30/21, effective 10/1/21. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-0517, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-0523 What are the training and certification requirements for long-term care (LTC) workers providing in-home care?

A LTC worker, hired on or after January 7, 2012, must meet the training requirements described in WAC 388-71-0836 through 388-71-1001. These training requirements also apply to LTC workers who were hired before January 7, 2012, if they did not complete the training requirements in effect at the time within 120 days of the date of hire. Prior to reinstating these individuals to work as a LTC worker, these training requirements and certification, if required, must be met, or the LTC worker must have been rehired as allowed under WAC 388-71-0837. The following chart provides a summary of the training and certification requirements for LTC workers as defined in WAC 388-71-0503. This includes criteria for providers working limited hours for only one person, caring only for the worker's child, parent, sibling, aunt, uncle, cousin, niece, nephew, grandparent, or grandchild including when related by marriage or domestic partnership, providing approved services only for a spouse or registered domestic partner, or providing respite services:

| Who | Status | Orientation training | Safety training | Basic training | Continuing education | Required credential | | --- | --- | --- | --- | --- | --- | --- | | (1) A LTC worker who is a licensed, certified health care professional in good standing through the Washington state department of health, or a LTC worker with special education training who meets the criteria in RCW 18.88B.041 (1)(a)(i)(A). | ARNP, RN, LPN, HCA, NA-C, or other professionals listed in WAC 388-71-0839. | Not required. | Not required. | Not required. | Not required of ARNPs, RNs, or LPNs in chapter 388-71 WAC. Required 12 hours under WAC 388-71-0991 of NA-Cs, HCAs, and other professionals listed in WAC 388-71-0839, such as an individual with special education training with an endorsement granted by the superintendent of public instruction under RCW 28A.300.010. For NA-C and those with special education training 12 hours is required every year while working in long-term care under WAC 388-71-0991. | Required under chapter 246-980 WAC. | | (2) A LTC worker with specific employment history. | A LTC worker who was employed at some point between January 1, 2011, and January 6, 2012, and who completed the basic training requirements in effect on the date of hire. WAC 388-71-0839. | Not required. | Not required. | Not required. | 12 hours is required every year while working in LTC under WAC 388-71-0991. | Not required. | | (3) A LTC worker employed by the consumer directed employer or home care agency. | Hired by a licensed home care agency or the consumer directed employer to provide personal care service as defined in WAC 388-71-0836 and is not exempt under subsection (1) or (2) of this section . | Required. Two hours under WAC 388-71-0860. | Required. Three hours under WAC 388-71-0860. | Required. 70 hours under WAC 388-71-0870 and 388-71-0875. | Required. 12 hours under WAC 388-71-0991. | Required under chapter 246-980 WAC. | | (4) A LTC worker who is an individual provider who works limited personal care hours for only one person. | An individual provider (employed by the consumer directed employer) providing 20 hours or less of nonrespite care for one person per calendar month and does not meet the criteria in subsection (1) or (2) of this section. | Required. Two hours under WAC 388-71-0860. | Required. Three hours under WAC 388-71-0860. | Required. 30 hours under WAC 388-71-0880. | Not required. | Not required. | | (5) A LTC worker who is an individual provider, provides only respite services, and works 300 hours or less in any calendar year. | (a) An individual providing respite care who works no more than 300 hours in the calendar year, is not exempt in subsection (1) or (2) of this section, and does not meet criteria in subsection (6) of this section. (b) Individual providing only in-home respite services for individuals with developmental disabilities, as defined in WAC 388-845-1600, that receive services under Title 71A RCW and for individuals that receive services under chapter 74.39A, that is working 300 hours or less in any calendar year, and that is not exempt in subsection (1) or (2) of this section. | Required. Two hours under WAC 388-71-0860. | Required. Three hours under WAC 388-71-0860. | Required. Nine hours under WAC 388-71-0893. | Not required. | Not required. | | (6) A parent (including when related by marriage or domestic partnership) who is the LTC worker providing in-home care only for the provider's developmentally disabled adult child receiving services under Title 71A RCW. | An individual providing care only for the provider's developmentally disabled adult child receiving services under Title 71A RCW and not exempt under subsection (1) or (2) of this section. | Required. Two hours under WAC 388-71-0895. | Required. Three hours under WAC 388-71-0895. | Required. Seven hours under WAC 388-71-0890. | Not required for LTC workers working as individual providers. 12 hours is required every year following completion of basic training while working in LTC as an agency provider. Parents working as individual providers and caring only for their for children will remain exempt from continuing education after Jan 1, 2027. | Not required. | | (7) A LTC worker caring only for the provider's parent, child (not covered in subsection (6) of this section), sibling, aunt, uncle, cousin, niece, nephew, grandparent, or grandchild, including when related by marriage or domestic partnership. | A LTC worker caring only for the worker's child (not covered in subsection (6) of this section, parent, sibling, aunt, uncle, cousin, niece, nephew, grandparent, or grandchild, including when related by marriage or domestic partnership, who is not exempt in subsection (1) or (2) of this section, and does not meet the criteria in subsection (6) of this section. | Required. Two hours under WAC 388-71-0860. | Required. Three hours under WAC 388-71-0860. | Required. 30 hours under WAC 388-71-0880. | Not required for LTC workers working as an individual provider until January 1, 2027, then 12 hours is required every year while working in LTC under WAC 388-71-0991. 12 hours is required every year following completion of basic training while working in long-term care as an agency provider Parents working as individual providers and caring only for the worker's children will remain exempt from continuing education after Jan 1, 2027. | Not required. | | (8) A LTC worker providing approved services only for a spouse or registered domestic partner. | A LTC worker providing approved services only for a spouse or registered domestic partner who is not exempt in subsection (1) or (2) of this section. | Required. Two hours under WAC 388-71-0860. | Required. Three hours under WAC 388-71-0860. | Required. 30 hours under WAC 388-71-0880 until July 1, 2026. The requirement is 16 hours beginning July 1, 2026. | 12 hours is required every year following completion of basic training while working in LTC under 388-71-0991. | Not required. |

History

Statutory Authority: RCW 74.08.090, 74.39A.009, 74.39A.070, 74.39A.074, 74.39A.076, 74.39A.341, 18.88B.010, 18.88B.021, and 18.88B.041. WSR 26-08-045, s 388-71-0523, filed 3/25/26, effective 4/25/26. Statutory Authority: RCW 18.88B.010, 18.88B.041, 74.08.090, 74.39A.076, 74.39A.341, and chapter 18.80 RCW. WSR 25-07-033, s 388-71-0523, filed 3/11/25, effective 4/11/25. Statutory Authority: RCW 18.88B.021, 18.88B.041, 18.88B.060, 74.08.090, 74.39A.076, and 74.39A.341. WSR 24-05-003, § 388-71-0523, filed 2/8/24, effective 3/10/24. Statutory Authority: RCW 74.08.090 and 74.39A.250. WSR 22-19-048, § 388-71-0523, filed 9/15/22, effective 10/16/22. Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-71-0523, filed 8/30/21, effective 10/1/21. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-0523, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-05415 When will DSHS deny payment to the home care agency?

DSHS will deny payment to the home care agency for services provided to a department client by an agency provider that it employs who:

(1) Does not meet the qualifications in WAC 388-71-0510; or

(2) Is a family member of the client served, except as provided by RCW 74.39A.326 or 50B.04.070.

History

Statutory Authority: RCW 74.08.090, 74.39A.009, 74.39A.070, 74.39A.074, 74.39A.076, 74.39A.341, 18.88B.010, 18.88B.021, and 18.88B.041. WSR 26-08-045, s 388-71-05415, filed 3/25/26, effective 4/25/26. Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-71-05415, filed 8/30/21, effective 10/1/21.

Wash. Admin. Code § 388-71-0548 When is an individual provider subject to an overpayment?

(1) Unless payment is otherwise required by state or federal law, it is an overpayment as defined in RCW 43.20B.010 and 41.05A.170 if an individual provider (IP) is paid by the department and:

(a) Did not actually perform the work;

(b) Payment is for dates of service after the death of the client;

(c) Payment is for services provided when the client was admitted to a hospital, nursing home, or other institutional setting;

(d) Payment is for dates of service when the client was outside of the United States;

(e) Did not have a valid IP services contract at the time the services were provided and had been notified by the department to stop the provision of services;

(f) Had not completed required training or obtained required certification at the time the services were provided and had been notified by the department to stop the provision of services;

(g) Had a disqualifying crime or negative action at the time the services were provided and had been notified by the department to stop the provision of services;

(h) Provided services after being notified by the department to stop the provision of services;

(i) Provided services that are not included in the client's plan of care;

(j) Provided services that exceeded the amount of the client's benefit in the client's plan of care where those services were not necessitated by an emergent and immediate need of the client and the IP is not a family member or household member of the client; or

(k) Received erroneous or duplicate payment(s).

(2) If the department determines an IP was overpaid, even if it was due to department error, the department recovers any moneys that the IP received as a result of overpayments, as authorized under chapter 41.05A RCW or 43.20B RCW.

(a) The department will send the IP notice of the overpayment.

(b) The IP has a right to request an administrative hearing when notice of an overpayment is received from the department.

(c) To request an administrative hearing, an IP must send a written request to the office of financial recovery within twenty-eight days of the IP's receipt of notice of the overpayment that:

(i) States the basis for contesting the overpayment notice;

(ii) Includes a copy of the department's notice with the request; and

(iii) Is sent by certified mail return receipt requested (CMRRR) or another trackable delivery service.

(d) The appeal process will be governed by the Administrative Procedure Act (chapter 34.05 RCW).

History

Statutory Authority: RCW 43.20B.675, 74.09.220, 74.09.290, and 74.09.520. WSR 19-05-008, § 388-71-0548, filed 2/7/19, effective 3/10/19.

Wash. Admin. Code § 388-71-0562 When does a medicaid contracted home care agency have the right to an administrative hearing and how can a hearing be requested?

(1) A medicaid contracted home care agency has the right to an administrative hearing when the department or a department designee terminates its contract or takes other enforcement action related to its contract because the home care agency:

(a) Knowingly employs a long-term care worker who has not completed training within the required time frame.

(b) Knowingly employs a long-term care worker who does not meet the certification or recertification requirements or whose certification has been revoked by the department of health.

(2) In an administrative hearing under subsection (1) or (2) above, the medicaid contracted home care agency may not challenge an action taken by the department of health that affects a long-term care worker's certification. Actions by the department of health must be challenged through an appeal to the department of health, as provided in department of health rules.

(3) To request an administrative hearing, a home care agency must send, deliver, or fax a written request to the office of administrative hearings (OAH). OAH must receive the written request within thirty calendar days of the date the department's notice letter is served upon the home care agency.

(4) The home care agency should keep a copy of the request.

(5) The appeal process will be governed by the Administrative Procedure Act (chapter 34.05 RCW), RCW 74.39A.085, chapter 388-02 WAC, Title 182 WAC and this chapter. If there is a conflict between chapter 388-02 WAC, Title 182 WAC and this chapter, this chapter will govern.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-0562, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-0701 What definitions apply to WAC 388-71-0702 through 388-71-0776?

The following definitions apply to WAC 388-71-0702 through 388-71-0776:

(1) "Abuse" means the willful action or inaction that inflicts injury, unreasonable confinement, intimidation, or punishment of a vulnerable adult.

(a) In instances of abuse of a vulnerable adult who is unable to express or demonstrate physical harm, pain, or mental anguish, the abuse is presumed to cause physical harm, pain, or mental anguish.

(b) Abuse includes sexual abuse, mental abuse, physical abuse, personal exploitation of a vulnerable adult, and improper use of a restraint against a vulnerable adult, which have the following meanings:

(i) "Sexual abuse" means any form of nonconsensual sexual conduct, including but not limited to unwanted or inappropriate touching, rape, sodomy, sexual coercion, sexually explicit photographing, and sexual harassment. Sexual contact may include interactions that do not involve touching, including but not limited to sending a client sexually explicit messages, or cuing or encouraging a client to perform sexual acts. Sexual abuse also includes any sexual conduct between a staff person, who is not also a client, with a client, of a center.

(ii) "Physical abuse" means the willful action of inflicting bodily injury or physical mistreatment. Physical abuse includes, but is not limited to, striking with or without an object, slapping, pinching, choking, kicking, shoving, prodding, or use of chemical or physical restraints unless the restraints are consistent with licensing requirements, and includes restraints that are otherwise being used inappropriately.

(iii) "Mental abuse" means a willful verbal or nonverbal action that threatens, humiliates, harasses, coerces, intimidates, isolates, unreasonably confines, or punishes a vulnerable adult. Mental abuse may include ridiculing, yelling or swearing.

(iv) "Personal exploitation" means an act of forcing, compelling, or exerting undue influence over a vulnerable adult causing the vulnerable adult to act in a way that is inconsistent with relevant past behavior, or causing the vulnerable adult to perform services for the benefit of another.

(2) "Adult day care" or "ADC" means a supervised daytime program that provides services under WAC 388-71-0704 for clients who meet the eligibility requirements in WAC 388-71-0708.

(3) "Adult day center" means an adult day care or adult day health center.

(4) "Adult day health" or "ADH" means a supervised daytime program that provides ADC services under WAC 388-71-0704 and skilled services under WAC 388-71-0706 for clients who meet the eligibility requirements in WAC 388-71-0710.

(5) "Adult day services" is a generic term that refers to adult day care and adult day health services.

(6) "Authorizing practitioner" means a physician, osteopath, nurse practitioner, or physician assistant who has the licensed ability to write medical orders for skilled care and interventions that require a practitioner order.

(7) "Chemical restraint" means the administration of any drug to manage a vulnerable adult's behavior in a way that reduces the safety risk to the vulnerable adult or others, has a temporary effect of restricting the vulnerable adult's freedom of movement, and is not standard treatment for the vulnerable adult's medical or psychiatric condition.

(8) "Chronic-care management" means regular monitoring of the client's chronic health condition, training the client and caregiver, providing treatments or interventions when warranted and regular communication with primary care practitioners and caregivers to help implement and keep current the clinical care plan while ensuring the treatments have the intended effect of improving health, maintaining health, or slowing declining health when the diagnosis is a nonreversible condition.

(9) "Client" or "participant" means a person who receives services at an adult day center.

(10) "Department service plan" means a client's comprehensive assessment reporting evaluation (CARE) assessment including personal care and skilled care needs.

(11) "Direct care staff" are staff in an adult day center that interact with participants by providing care, services, and guidance.

(12) "The discharge plan" is a plan that outlines specific measurable goals expected to occur due to individualized treatments provided to a participant, indicating discharge is appropriate. This plan is developed and addressed on the participant's ADC and ADH negotiated care plan and is updated with each significant change of condition or when the client partially or completely meets the expected measurable goal(s). Planned discharge outcomes reflect the end of treatment because the client meets the measurable outcomes or he or she is unable to participate in or benefit from treatment.

(13) "Involuntary seclusion" means the involuntary confinement of a client to a room or area where the client is physically prevented from leaving.

(14) "Medical device" means any piece of medical equipment used to treat a client's assessed need. A medical device is not always a restraint and should not be used as a restraint, unless assessed and approved by a physician or primary care provider. Some medical devices have considerable safety risks associated with use. Examples of medical devices with known safety risks may be, but are not limited to transfer poles, posey or lap belts, and side rails.

(15) "Maintenance" is continuing clinically appropriate skilled services that are justified as reasonable, necessary, and appropriate to sustain minimal loss of function. Maintenance interventions have discharge measurable goals that outline when maintenance skilled services are no longer beneficial.

(16) "Medically necessary" means the service is reasonably calculated to prevent, diagnose, correct, cure, alleviate, or prevent worsening of conditions in the client that endangers life, causes suffering or pain, results in an illness or infirmity, threatens to cause or aggravate a disability, or causes physical deformity or malfunction.

(17) "Negotiated care plan" means a client centered, goal specific service plan that outlines the specific needs of the client, contains measurable, achievable, and realistic goals for the client, states how the adult day center will meet the assessed and agreed upon needs, when the assessed and agreed upon needs will be met, and by what discipline the assessed and agreed upon needs will be met.

(18) "Physical restraint" means the application of physical force without the use of any device, for the purpose of restraining the free movement of a vulnerable adult's body. "Physical restraint" does not include briefly holding, without undue force, a vulnerable adult in order to calm or comfort him or her, or holding a vulnerable adults hand to safely escort him or her from one area to another.

(19) "Preliminary service plan" means the initial intake, evaluation, and preliminary care plan including the client's strengths, deficits, and potential needs. The adult day center must determine based on the preliminary service plan whether they can meet those needs and accept the client into the adult day program.

(20) "Rehabilitative service" means a service provided using applicable physical therapy, occupational therapy, or speech therapy standards of practice and is considered medically necessary if the type, amount, and duration of service outlined in the plan of care increases the likelihood of meeting one or more of the following goals: Improve function, minimize loss of function, improve cognition or minimize loss of cognition, or decrease risk of injury and disease.

(21) "Significant change" means:

(a) A lasting change, decline, or improvement in the client's baseline physical, mental, or psychosocial status;

(b) The change is significant enough so that the current assessment or negotiated care plan does not reflect the client's current status; and

(c) A new assessment may be needed when the client's condition does not return to baseline within a two week period of time.

(22) "Skilled nursing services" means services that are reasonable and necessary for the treatment of a client's illness or injury and are consistent with the unique nature and severity of the client's illness or injury, his or her particular medical needs, and accepted standards of medical and nursing practices, including WAC 246-840-700, without regard to whether the illness or injury is acute, chronic, terminal, or expected to last for a significant amount of time.

(23) "Specific goals" mean expected outcomes individualized to the client's need(s) that stipulate the measurable, detailed, and expected progress the client may make while receiving the service. The specific goals address the who, what, when, why, and how of the expected final outcome. If a client's specific goal is to prevent a decline in his or her condition, the goal must have measurable outcomes that identify the intervention to prevent the decline and how to measure this prevention. If you cannot measure the expected outcome of the clinical intervention then you are not preventing a decline.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 17-19-098, § 388-71-0701, filed 9/19/17, effective 10/20/17.

Wash. Admin. Code § 388-71-0702 What is the purpose of adult day services?

(1) WAC 388-71-0702 through 388-71-0776 contains the eligibility requirements for community options program entry system (COPES) waiver, roads to community living (RCL), residential support waiver (RSW), or other agency approved funding for adult day care and adult day health services.

(2) These rules also contain the requirements that apply to adult day care and adult day health centers that contract with the department, area agency on aging, other department designee to provide COPES, RSW, and RCL services to department clients, and adult day centers who are owned and operate on a private pay basis. Nothing in these rules may be construed as requiring the department, an area agency on aging, or other designee to contract with an adult day care or adult day health center.

(3) An adult day center is a community-based program designed to meet the needs of adults with impairments through individualized goal specific plans of care. This type of structured, comprehensive, nonresidential program provides a variety of health, social, and related support services in a protective setting. Adult day centers support families and caregivers with the following goals:

(a) Provide an opportunity for the client to live in his or her community;

(b) Provide the client with clinical and nonclinical services to meet unmet needs;

(d) Measure the client's progress through individualized interventions, as outlined in his or her negotiated care plan.

(4) An adult day center evaluates the client's needs and offers services with goal specific interventions to meet those needs and enhance his or her quality of life. The client attends on a scheduled and planned basis. The adult day center evaluates potential clients to determine if center is able to meet their identified needs. Nothing in this generic description may be construed to modify the specific services or eligibility requirements referenced in this chapter of adult day care and adult day health.

History

Statutory Authority: RCW 74.08.090. WSR 18-18-006, § 388-71-0702, filed 8/23/18, effective 9/23/18. Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 17-19-098, § 388-71-0702, filed 9/19/17, effective 10/20/17
WSR 15-01-174, § 388-71-0702, filed 12/23/14, effective 1/23/15. Statutory Authority: RCW 74.04.050, 74.04.057, 74.04.200, 74.08.090, 74.09.520, and 74.39A.030. WSR 03-06-024, § 388-71-0702, filed 2/24/03, effective 7/1/03.

Wash. Admin. Code § 388-71-0704 What services are provided in adult day care?

Adult day care is a supervised nonresidential program providing services as defined in WAC 388-106-0800. Services are appropriate for adults with medical or disabling conditions that do not require the intervention or services of a registered nurse or licensed rehabilitative therapist acting under the supervision of the client's authorizing practitioner. The adult day care center must offer and provide on-site the following services. These services must meet the level of care needed by the client as assessed by the department case manager for waiver funded clients and do not exceed the scope of services that the adult day care center is able to provide.

(1) Assistance with activities of daily living:

(a) Locomotion outside of room, locomotion in room, walks in room;

(b) Body care;

(d) Repositioning;

(e) Medication management that does not require a licensed nurse;

(f) Transfer;

(g) Toileting;

(h) Personal hygiene at a level that ensures client safety while in attendance at the program; and

(i) Bathing at a level that ensures client safety and comfort while in attendance at the program.

(2) Social services on a consultation basis, which may include:

(a) Referrals to other providers for services not within the scope of COPES waiver or RCL reimbursed adult day care services;

(b) Caregiver support and education; or

(3) Routine health monitoring with consultation from a registered nurse that a consulting nurse acting within the scope of practice can provide with or without an authorizing practitioner's order. Examples include:

(a) Obtaining baseline and routine monitoring information on client health status, such as vital signs, weight, and dietary needs;

(b) General health education such as providing information about nutrition, illnesses, and preventative care;

(d) Annual and as needed updating of the client's medical record; or

(e) Assistance as needed with coordination of health services provided outside of the adult day care program.

(4) General therapeutic activities that an unlicensed person can provide or that a licensed person can provide with or without an authorizing practitioner's order. These services are planned for and provided based on the client's abilities, interests, and goals, which are not limited by funding source. Examples include:

(a) Recreational activities;

(b) Diversionary activities;

(d) Cognitive stimulation; or

(e) Group range of motion or conditioning exercises.

(5) General health education that an unlicensed person can provide or that a licensed person can provide with or without an authorizing practitioner's order, including but not limited to topics such as:

(a) Nutrition;

(b) Stress management;

(d) Preventative care.

(6) A nutritional meal and snacks every four hours, including a modified diet if needed and within the scope of the program, as provided under WAC 388-71-0770;

(7) Supervision and/or protection if needed for client safety;

(8) Assistance with arranging transportation to and from the program; and

(9) First aid and provisions for obtaining or providing care in an emergency. note: If the client requires the intervention or services of a registered nurse or licensed rehabilitative therapist acting under the supervision of an authorizing practitioner, consider adult day health services.

History

Statutory Authority: RCW 74.08.090. WSR 18-18-006, § 388-71-0704, filed 8/23/18, effective 9/23/18. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 15-01-174, § 388-71-0704, filed 12/23/14, effective 1/23/15. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.010 and 74.39A.020. WSR 06-05-022, § 388-71-0704, filed 2/6/06, effective 3/9/06. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-71-0704, filed 5/17/05, effective 6/17/05. Statutory Authority: RCW 74.04.050, 74.04.057, 74.04.200, 74.08.090, 74.09.520, and 74.39A.030. WSR 03-06-024, § 388-71-0704, filed 2/24/03, effective 7/1/03.

Wash. Admin. Code § 388-71-0706 What services are provided in adult day health?

Adult day health is a supervised nonresidential program providing skilled nursing and/or rehabilitative therapy services in addition to all services provided in an adult day care center. Adult day health services are only appropriate for adults with medical or disabling conditions that require the skilled intervention or services of a registered nurse or licensed rehabilitative therapist acting under the supervision of the client's authorizing practitioner.

The adult day health center must offer and provide on-site the following services:

(1) All services under WAC 388-71-0704; and

(2) Skilled nursing services other than routine health monitoring with nurse consultation; or

(3) At least one of the following skilled therapy services: physical therapy, occupational therapy, or speech-language pathology or audiology, as defined under chapters 18.74, 18.59 and 18.35 RCW; and

(4) Psychological or counseling services, including assessing for psycho-social therapy need, dementia, abuse or neglect, and alcohol or drug abuse; making appropriate referrals; and providing brief, intermittent supportive counseling. These services are provided by social services professionals.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 15-01-174, § 388-71-0706, filed 12/23/14, effective 1/23/15. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.010 and 74.39A.020. WSR 06-05-022, § 388-71-0706, filed 2/6/06, effective 3/9/06. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-71-0706, filed 5/17/05, effective 6/17/05. Statutory Authority: RCW 74.04.050, 74.04.057, 74.04.200, 74.08.090, 74.09.520, and 74.39A.030. WSR 03-06-024, § 388-71-0706, filed 2/24/03, effective 7/1/03.

Wash. Admin. Code § 388-71-0708 What are the eligibility criteria for enrollment in adult day care?

Clients are eligible for adult day care services if they meet criteria outlined in WAC 388-106-0805.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 15-01-174, § 388-71-0708, filed 12/23/14, effective 1/23/15
WSR 05-11-082, § 388-71-0708, filed 5/17/05, effective 6/17/05. Statutory Authority: 2004 c 276 § 206 (6)(b) and Townsend vs. DSHS, U.S. District Court, Western District of Washington, No. C 00-0944Z. WSR 04-16-029, § 388-71-0708, filed 7/26/04, effective 8/26/04. Statutory Authority: RCW 74.04.050, 74.04.057, 74.04.200, 74.08.090, 74.09.520, and 74.39A.030. WSR 03-06-024, § 388-71-0708, filed 2/24/03, effective 7/1/03.

Wash. Admin. Code § 388-71-0710 What are the eligibility criteria for enrollment in adult day health?

Clients are eligible for adult day health services if they meet the criteria outlined in WAC 388-106-0815 which references WAC 388-106-0300, 388-106-0305, 388-106-0336(9), and 388-106-0337.

History

Statutory Authority: RCW 74.08.090. WSR 18-18-006, § 388-71-0710, filed 8/23/18, effective 9/23/18. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 15-01-174, § 388-71-0710, filed 12/23/14, effective 1/23/15
WSR 05-11-082, § 388-71-0710, filed 5/17/05, effective 6/17/05. Statutory Authority: RCW 74.04.050, 74.04.057, 74.04.200, 74.08.090, 74.09.520, and 74.39A.030. WSR 03-06-024, § 388-71-0710, filed 2/24/03, effective 7/1/03.

Wash. Admin. Code § 388-71-0712 What is considered skilled nursing in adult day health?

(1) Skilled nursing services are medically necessary services provided directly or indirectly by a registered nurse under an authorizing practitioner's supervision, or by a licensed practical nurse under physician or registered nurse supervision, that a licensed nurse acting within the scope of practice can provide or supervise. Authorizing practitioner orders must be obtained when required by applicable state practice laws for licensed nurses. Authorizing practitioner orders must be obtained upon initial service, updated when a significant change occurs changing the nursing intervention or at least annually.

(2) Skilled nursing services must exceed the level of routine health monitoring, general health education, and general therapeutic activities as defined in WAC 388-71-0704, and must be provided with the reasonable expectation that the services will improve, restore, maintain function or slow the client's decline of the disease or functional ability. Skilled nursing services are:

(a) Specific to a client's diagnosis;

(b) Individualized to the client with planned measurable outcome goals; and

(c) Reevaluated every ninety days or sooner when there is a significant health change for effect on improvement or maintenance of health status, or slowing the decline of the disease or functional ability.

(3) Skilled nursing services, including the initial client nursing assessment and development of the nursing plan of care, must be provided or supervised by a registered nurse in accordance with nursing practice standards under chapter 246-840 WAC.

(4) A skilled nursing service is not a qualifying adult day health service merely because the service is ordered by an authorizing practitioner or is provided by a nurse. If, by way of example, the service can be performed by the client or at the client's direction by a person other than a licensed nurse, it is not a qualifying adult day health service.

(5) Skilled nursing services must be medically necessary as defined under WAC 182-500-0070. Medically necessary skilled nursing services include but at [are] not limited to:

(a) Assessment, care and evaluation with collaboration of services of an acute or chronic unstable or unpredictable medical condition, with time specific measurable treatment goals, requiring frequent skilled intervention by a registered nurse or by a licensed practical nurse under the supervision of a registered nurse according to WAC 246-840-705 and ordered by the authorizing practitioner;

(b) Evaluation and management of the care plan when unstable medical conditions or complications require complex nonskilled care and skilled nurse oversight to ensure that the nonskilled care is achieving its purpose;

(c) Time-limited training by licensed nursing staff to teach the client and/or the client's caregiver self-care for newly diagnosed, acute, or episodic medical conditions that require the skills of a licensed nurse to teach, and that will optimize client function, as illustrated by the following examples:

(i) Self administration of an injection;

(ii) Prefilling insulin syringes;

(iii) Irrigating a catheter;

(iv) Caring for a colostomy or urostomy;

(v) Wound dressing changes or aseptic technique; or

(vi) Disease self-management.

(d) Skilled interventions provided directly by a licensed nurse such as:

(i) Inserting or irrigating a catheter;

(ii) Administering medications or oxygen;

(iii) Administering and managing infusion therapy; or

(iv) Treating decubitus ulcers, or other types of wound care.

(e) Provide holistic collaborative care of the client's acute, chronic, unstable or unpredictable medical condition or disease.

(6) Medically necessary skilled nursing services, by way of example, do not include:

(a) Reminding or coaching the client;

(b) Monitoring of a medical condition that does not require frequent skilled nursing intervention or a change in authorizing practitioner treatment orders, or where there is no reasonable expectation that skilled services will maintain, improve, or slow the effect of a progressive disabling condition on the pain, health or functioning of a client;

(c) Medication assistance when the client is capable of self-administration or is having this need met through paid or unpaid caregivers;

(d) Evaluation and management of the care plan when the complexity of care to be provided by nonskilled persons does not require skilled nurse oversight beyond routine health monitoring;

(e) Continued training by nursing staff to teach self-care for newly diagnosed, acute, or episodic medical conditions when it is apparent that the training should have achieved its purpose or that the client is unwilling or unable to be trained;

(f) ADC services that can be provided by an adult day care center, such as routine health monitoring, general health education, or general therapeutic activities; or

(g) Group therapy or training where three or more clients are being simultaneously treated or trained by the nurse.

(7) Skilled nursing services must be documented as provided under WAC 388-71-0746 and 182-502-0020.

History

are] not limited to:(a) Assessment, care and evaluation with collaboration of services of an acute or chronic unstable or unpredictable medical condition, with time specific measurable treatment goals, requiring frequent skilled intervention by a registered nurse or by a licensed practical nurse under the supervision of a registered nurse according to WAC 246-840-705 and ordered by the authorizing practitioner
(b) Evaluation and management of the care plan when unstable medical conditions or complications require complex nonskilled care and skilled nurse oversight to ensure that the nonskilled care is achieving its purpose
(c) Time-limited training by licensed nursing staff to teach the client and/or the client's caregiver self-care for newly diagnosed, acute, or episodic medical conditions that require the skills of a licensed nurse to teach, and that will optimize client function, as illustrated by the following examples:(i) Self administration of an injection
(ii) Prefilling insulin syringes
(iii) Irrigating a catheter
(iv) Caring for a colostomy or urostomy
(v) Wound dressing changes or aseptic technique
or(vi) Disease self-management.(d) Skilled interventions provided directly by a licensed nurse such as:(i) Inserting or irrigating a catheter
(ii) Administering medications or oxygen
(iii) Administering and managing infusion therapy
or(iv) Treating decubitus ulcers, or other types of wound care.(e) Provide holistic collaborative care of the client's acute, chronic, unstable or unpredictable medical condition or disease.(6) Medically necessary skilled nursing services, by way of example, do not include:(a) Reminding or coaching the client
(b) Monitoring of a medical condition that does not require frequent skilled nursing intervention or a change in authorizing practitioner treatment orders, or where there is no reasonable expectation that skilled services will maintain, improve, or slow the effect of a progressive disabling condition on the pain, health or functioning of a client
(c) Medication assistance when the client is capable of self-administration or is having this need met through paid or unpaid caregivers
(d) Evaluation and management of the care plan when the complexity of care to be provided by nonskilled persons does not require skilled nurse oversight beyond routine health monitoring
(e) Continued training by nursing staff to teach self-care for newly diagnosed, acute, or episodic medical conditions when it is apparent that the training should have achieved its purpose or that the client is unwilling or unable to be trained
(f) ADC services that can be provided by an adult day care center, such as routine health monitoring, general health education, or general therapeutic activities
or(g) Group therapy or training where three or more clients are being simultaneously treated or trained by the nurse.(7) Skilled nursing services must be documented as provided under WAC 388-71-0746 and 182-502-0020.[Statutory Authority: RCW 74.08.090, 74.09.520. WSR 15-01-174, § 388-71-0712, filed 12/23/14, effective 1/23/15. Statutory Authority: RCW 74.04.050, 74.04.057, 74.04.200, 74.08.090, 74.09.520, and 74.39A.030. WSR 03-06-024, § 388-71-0712, filed 2/24/03, effective 7/1/03.

Wash. Admin. Code § 388-71-0714 What is considered rehabilitative therapy in adult day health?

(1) Skilled rehabilitative therapy services are medically necessary services provided by or under the supervision of a licensed physical, occupational, or speech-language pathology or audiology therapist that the therapist acting within the scope of practice can provide or supervise directly or indirectly. Authorizing practitioner orders must be initially obtained and updated when a significant change occurs or at least annually when required by applicable state practice laws for licensed therapists.

(a) Persons that can provide rehabilitative care under the direction and supervision of a licensed therapist include occupational therapy aides, occupational therapy assistants, physical therapy aides, physical therapy assistants, and nurses within their respective scopes of practice. Adult day health program aides, specifically trained in rehabilitative techniques, may also provide care under the direction and supervision of a licensed therapist.

(b) Services, group or individual, must be related to an active written plan of care with time specific measurable treatment goals approved by the authorizing practitioner;

(d) Services, group or individual, must be provided with the reasonable expectation that the services will improve, restore, maintain function, or slow decline. Rehabilitative services are:

(i) Specific to a client diagnosis;

(ii) Individualized to the client with planned, measurable outcomes; and

(iii) Reevaluated every ninety days for effect on improvement of health status or slowing the decline.

(2) Skilled rehabilitative therapy is not a qualifying adult day health service merely because the therapy is ordered by an authorizing practitioner or is provided by a therapist or under the supervision of a therapist. If, by way of example, the therapy can be performed independently by the client or at the client's direction by a person other than a licensed therapist, it is not a qualifying adult day health service.

Skilled rehabilitative therapy services must be medically necessary as defined under WAC 182-500-0070.

(3) Medically necessary physical therapy services may, but do not necessarily include:

(a) Assessing baseline mobility level, strength, range of motion, endurance, balance, and ability to transfer;

(b) One to one and group treatment to relieve pain, develop, restore, or maintain functioning, with individualized and measurable client treatment goals;

(c) Establishing a maintenance or restorative program with measurable treatment goals, and providing written and oral instruction to the client, caregivers, or program staff as needed to assist the client in implementing the program;

(d) Training the client or the client's caregivers in the use of supportive, adaptive equipment or assistive devices;

(e) Evaluation and management of the care plan when medical conditions or complications require complex nonskilled care and skilled therapist oversight to ensure that the nonskilled care is achieving its purpose; or

(f) Providing other medically necessary services that can only be provided by or under the direct or indirect supervision of a physical therapist acting within the therapist's scope of practice.

(4) Medically necessary occupational therapy services may, but do not necessarily include:

(a) Administering a basic evaluation to determine baseline level of functioning, ability to transfer, range of motion, balance, strength, coordination, activities of daily living and cognitive-perceptual functioning;

(b) Teaching and training the client, caregivers, or program staff in the use of therapeutic, creative, and self-care activities to improve or maintain the client's capacity for self-care and independence, and to increase the range of motion, strength and coordination;

(c) One to one and group treatment to develop, restore, or maintain functioning with individualized and measurable client treatment goals;

(d) Training the client or the client's caregivers in the use of supportive, adaptive equipment or assistive devices;

(f) Providing other medically necessary services that can only be provided by or under the direct or indirect supervision of an occupational therapist acting within the therapist's scope of practice.

(5) Medically necessary speech-language pathology or audiology services may, but do not necessarily include:

(a) Assessing baseline level of speech, swallowing, auditory, or communication disorders;

(b) Establishing a treatment program to improve speech, swallowing, auditory, or communication disorders;

(c) Providing speech therapy procedures that include auditory comprehension tasks, visual and/or reading comprehensive tasks, language intelligibility tasks, training involving the use of alternative communication devices, or swallowing treatment;

(d) Training the client or the client's caregivers in methods to assist the client in improving speech, communication, or swallowing disorders;

(e) Evaluation and management of the care plan when medical conditions or complications require complex nonskilled care and skilled therapist oversight to ensure that nonskilled care is achieving its purpose; or

(f) Providing other medically necessary services that can only be provided by or under the direct or indirect supervision of a speech-language pathology or audiology therapist acting with the therapist's scope of practice.

(6) Medically necessary skilled rehabilitative therapy services, by way of example, do not include:

(a) Reminding or coaching the client in tasks that are not essential to the skilled therapy or intervention in the client's service plan;

(b) Monitoring of a medical condition that does not require frequent skilled therapist intervention or a change in authorizing practitioner treatment orders, or where there is no reasonable expectation that skilled services will maintain, improve, or slow the effect of a progressive disabling condition on the pain, health or functioning of a client;

(d) Evaluation and management of the care plan when the complexity of the care to be provided by nonskilled persons does not require the skills of a licensed therapist for oversight;

(e) Continued training by therapy staff to teach self-care for newly diagnosed, acute, or episodic medical conditions when it is apparent that the training should have achieved its purpose or that the client is unwilling or unable to be trained;

(f) ADC services that can be provided by an adult day care center, such as routine health monitoring, general health education, or general therapeutic activities; or

(g) Group therapy or training where the ratio of licensed therapists and assisting program staff to clients is inadequate to ensure that:

(i) The group activity contributes to the individual client's planned therapy goals; and

(ii) The complexity of the individual client's need can be met.

(7) Skilled therapy services must be documented as provided under WAC 388-71-0746 and 182-502-0020.

History

Statutory Authority: RCW 74.08.090. WSR 18-18-006, § 388-71-0714, filed 8/23/18, effective 9/23/18. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 15-01-174, § 388-71-0714, filed 12/23/14, effective 1/23/15. Statutory Authority: RCW 74.04.050, 74.04.057, 74.04.200, 74.08.090, 74.09.520, and 74.39A.030. WSR 03-06-024, § 388-71-0714, filed 2/24/03, effective 7/1/03.

Wash. Admin. Code § 388-71-0716 What kind of assessment and service plan is required to determine a client's unmet needs for adult day care?

(1) The department or an authorized case manager must perform a comprehensive assessment reporting evaluation (CARE) to determine a client's need for adult day care, per WAC 388-106-0065. Based on the assessment, the case manager determines whether the client should be referred for day care services or whether the client's needs can be met in other ways.

(2) If the case manager determines an unmet need for an ADC service that may be provided at a day care center, the case manager works with the client and/or the client's representative to develop a service plan that documents the needed services and the number of days per week that the services are to be provided. The case manager refers the client to a waiver-contracted day care center that the client and the case manager agree can potentially meet the client's needs.

(3) Clients receiving adult day care services must be reassessed at least annually.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 15-01-174, § 388-71-0716, filed 12/23/14, effective 1/23/15
WSR 05-11-082, § 388-71-0716, filed 5/17/05, effective 6/17/05. Statutory Authority: RCW 74.04.050, 74.04.057, 74.04.200, 74.08.090, 74.09.520, and 74.39A.030. WSR 03-06-024, § 388-71-0716, filed 2/24/03, effective 7/1/03.

Wash. Admin. Code § 388-71-0718 What is the adult day care center's responsibility in developing the client's negotiated care plan?

(1) Upon the department's or authorized case manager's referral of a COPES,RSW, RCL, or other agency approved client to an ADC center, the ADC center must respond in writing to the department or authorized case manager within two working days, acknowledging receipt of the referral and the center's ability to process and evaluate the referred client.

(2) The case manager will provide the client's department service plan to the ADC center within five working days after the client or client's representative has signed it.

(3) The ADC center must schedule and conduct an intake and evaluation visit with the referred client or the client and his or her authorized representative to determine the client's desire to attend the ADC center and evaluate the ADC center's ability to meet the client's assessed needs and specific goals as defined in the client's department service plan. The intake and evaluation must be based on an interview with the client or the client and his or her authorized representative.

(4) Within ten paid service days from the date the client started attending the ADC center, the ADC center must complete and provide a preliminary service plan to the client or the client and his or her representative and the client's case manager that outlines the client's strengths, deficits, and potential needs. The ADC center must determine whether it can meet the client's needs, how it will meet the client's needs, and whether it will accept the client into the program. The ADC center must not accept a client whose needs the center cannot meet. The ADC center must document in the client's file the date it accepted the client into the ADC program. If the client is not accepted into the ADC program, the preliminary service plan must include the reason(s) why the client was not accepted.

(5) Within thirty calendar days of the date the client was accepted into the ADC program, the ADC center must work with the client or the client and his or her authorized representative to develop and complete a negotiated care plan signed by the client or the client's authorized representative and the ADC center.

(6) The negotiated care plan must limit the frequency of services to the number of days authorized in the department authorized service plan. The negotiated care plan must include:

(a) A list of the care and services the ADC center will provide the client;

(b) Identification of who will provide the client's care and services;

(d) How the ADC center will manage the client's medications and how the client will receive his or her medications when attending the ADC center;

(e) The client's activity preferences and how the ADC center will meet these preferences;

(f) Other preferences and choices about issues important to the client, including, but not limited to:

(i) Food;

(ii) Daily routine;

(iii) Activities;

(iv) Services received and who will provide the services received;

(v) Individuals they interact with;

(vi) Grooming;

(vii) How the ADC center will accommodate the client's preferences and choices; and

(g) If needed, a plan to:

(i) Follow in case of a foreseeable crisis due to the client's assessed needs;

(ii) Reduce tension, agitation, and problem behaviors;

(iii) Respond to the client's special needs, including, but not limited to medical devices and related safety plans, and if medical devices are used, ADC center staff must ensure the medical device will not be used as a physical restraint for discipline or staff convenience and must also ensure clients are free from coercion while attending the ADC center;

(iv) Respond to the client's refusal of care or treatment, including when the ADC center should notify the client's physician or practitioner of the client's refusal; and

(v) Identify any communication barriers the client may have and how the ADC center will use the client's behaviors and nonverbal gestures to communicate with him or her.

(7) The ADC center must:

(a) Ensure medical devices will never be used as a physical restraint for discipline or staff convenience;

(b) Update the negotiated care plan annually and whenever there is a significant change in the client's condition and needs;

(c) Share the negotiated care plan with the client's case manager whenever it is updated, annually, and after a significant change;

(d) Ensure the client's case manager reviews the negotiated care plan to ensure all services are appropriate and all authorized care needs have been included;

(e) Keep the current negotiated care plan in the client's file; and

(f) Offer a copy of the negotiated care plan to the client or the client and his or her authorized representative.

(8) The ADC center must report changes in the client's condition or unanticipated absences more than three consecutive scheduled days of service to the client's case manager within one week.

(a) Unanticipated absences may include but are not limited to absences due to client illness or change in transportation access.

(b) The case manager may follow up with the client or the client and his or her representative and determine if any updates to the assessment, client's department service plan, or service authorizations are needed.

History

Statutory Authority: RCW 74.08.090. WSR 18-18-006, § 388-71-0718, filed 8/23/18, effective 9/23/18. Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 17-19-098, § 388-71-0718, filed 9/19/17, effective 10/20/17
WSR 15-01-174, § 388-71-0718, filed 12/23/14, effective 1/23/15. Statutory Authority: RCW 74.04.050, 74.04.057, 74.04.200, 74.08.090, 74.09.520, and 74.39A.030. WSR 03-06-024, § 388-71-0718, filed 2/24/03, effective 7/1/03.

Wash. Admin. Code § 388-71-0720 What is the adult day health center's responsibility in working with the department or their designee to obtain, use and update the CARE assessment?

(1) The department or an authorized case manager must perform a CARE assessment to determine a client's need for adult day health, per WAC 388-106-0065. Based on the assessment, the case manager determines whether the client should be referred for day health services or whether the client's needs can be met in other ways.

(2) If the client has a department or area agency on aging case manager, the adult day health center or other referral source must notify the case manager of the client's potential adult day health service need. The case manager must assess the client's need for skilled nursing or skilled rehabilitative therapy within the department's normal time frames for client reassessments.

(3) If the client does not have a department or area agency on aging case manager, the adult day health center or other referral source must notify the department of the referral and the client's potential adult day health service need, or refer the client to the department for intake. The department's assigned case manager must assess the client's need for adult day health services within the department's normal time frames for initial client eligibility assessments.

(4) The case manager may consult with the client's authorized practitioner, department or area agency on aging nursing services staff, or other pertinent collateral contacts, concerning the client's need for skilled nursing or rehabilitative therapy.

(5) If the department or area agency on aging case manager determines and documents a potential unmet need for day health services, the case manager works with the client and/or the client's representative to develop a service plan that documents the potential unmet needs and the anticipated number of days per week that the services are needed. The case manager refers the client to a department contracted adult day health center for evaluation and the development of a preliminary service plan.

(6) The department or area agency on aging case manager must reassess adult day health clients at least annually. Clients must also be reassessed if they have a break in service of more than thirty days. The adult day health center must inform the case manager of the break in service so payment authorization can be discontinued.

(7) COPES, RSW, and RCL recipients of adult day health services must be assessed by the department or an authorized case manager for initial or continued eligibility as follows:

(a) Annual reassessment for department clients; or

(b) A new client to the center who potentially could be eligible for state paid ADH services are to be referred to the local department offices for intake and assessment for eligibility.

(8) The department or area agency on aging case manager must review a client's continued eligibility for adult day health services every ninety days, coinciding with the quarterly review completed by the adult day health program. At the case manager's discretion, additional information will be gathered through face to face, collateral or other contact methods to determine continued eligibility. Services will be continued, adjusted, or terminated based upon the case manager's determination during the eligibility review.

History

Statutory Authority: RCW 74.08.090. WSR 18-18-006, § 388-71-0720, filed 8/23/18, effective 9/23/18. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 15-01-174, § 388-71-0720, filed 12/23/14, effective 1/23/15
WSR 05-11-082, § 388-71-0720, filed 5/17/05, effective 6/17/05. Statutory Authority: RCW 74.04.050, 74.04.057, 74.04.200, 74.08.090, 74.09.520, and 74.39A.030. WSR 03-06-024, § 388-71-0720, filed 2/24/03, effective 7/1/03.

Wash. Admin. Code § 388-71-0722 What is the adult day health center's responsibility in developing the client's negotiated care plan?

(1) Upon the department's or authorized case manager's referral of a COPES,RSW, RCL, or other agency approved client to an ADH center, the ADH center must respond in writing to the department or authorized case manager within two working days, acknowledging receipt of the referral and the center's ability to process and evaluate the referred client.

(2) The case manager must provide the client's department service plan to the ADH center within five working days after obtaining the client or client's authorized representative's signature on the service plan.

(3) The ADH center must schedule and conduct an intake and evaluation visit with the referred client or the client and his or her authorized representative to determine the client's desire to attend the ADH center and evaluate the ADH center's ability to meet the client's needs as defined in the client's department service plan.

(4) Within ten paid service days from the date the client started attending the ADH center, the center must complete an intake and evaluation and provide a preliminary service plan to the client or the client and his or her authorized representative and the client's case manager.

(a) The ADH center's intake and evaluation must include multidisciplinary assessments based on interviews and evaluations of the client's strengths and limitations with the client or the client and his or her authorized representative.

(b) If the department service plan indicates a nursing or rehabilitative need during the intake and evaluation period, licensed professionals must conduct evaluations and assessments of the client's clinical or rehabilitative needs.

(i) Client specific problems or needs as identified in the intake and evaluation;

(ii) The needs for which the client chooses not to accept services or refuse care or services;

(iii) What the center will do to ensure health and safety of the client related to the refusal of any care or service;

(iv) Client specific and agreed upon goals;

(v) Client preferences; and

(vi) How the center will meet the client's needs and preferences.

(d) Based on the ADH center intake and evaluation, the ADH center must determine whether it can meet the client's needs, how it will meet the client's needs, and whether it will accept the client into the ADH program.

(i) The ADH center must not accept a client whose needs the center cannot meet.

(ii) If the client is accepted into the ADH program, the ADH center must document the date of acceptance in the client file.

(iii) If the client is not accepted into the ADH program, the preliminary service plan must include the reason(s) why the client was not accepted.

(e) The ADH center must provide the client, or the client's authorized representative, and the client's case manager, a copy of the evaluation and preliminary service plan within ten paid days of service.

(5) The ADH center will be reimbursed under WAC 388-71-0724 for any service days provided from the state of the intake and evaluation, if the case manager has authorized services.

(6) Upon the department's or authorized case manager's approval of the ADH center's preliminary service plan, the ADH center must obtain and provide to the case manager any required practitioner's orders for skilled nursing, rehabilitative therapy services, and medical devices that pertain to those services and interventions the ADH center is providing to the client under WAC 388-71-0712 through 388-71-0714. Orders from authorizing practitioners are not necessary for medical devices that are within the professional scope of practice of occupational or physical therapists working within the day center.

(a) The authorizing practitioner orders must:

(i) Include the frequency of authorized service;

(ii) Include use of and parameters for the authorized medical devices;

(iii) Include how often the client is to be seen by the authorizing practitioner;

(iv) Include the client's consent to follow up with the authorizing practitioner; and

(v) Be reviewed, updated, or revised when a significant change occurs, at least annually, or sooner if required by the prescriber.

(b) The case manager or nursing services staff may follow up with the practitioner, or other pertinent collateral contacts, concerning the client's need for skilled services.

(d) The authorizing practitioner must only authorize services, supports, and interventions that are within the practitioner's professional scope of practice.

(7) Within thirty calendar days of acceptance into the program, the ADH center's multidisciplinary team must work with either the client or the client and his or her authorized representative to develop and complete a negotiated care plan signed by the client or the client's authorized representative and the ADH center. The negotiated care plan may be developed initially in lieu of the preliminary service plan.

(8) The negotiated care plan must be consistent with the department-authorized service plan, include all authorized ADC and ADH services, limit the frequency of services to the number of days in the department authorized service plan, and must include:

(a) A list of the care and services the ADH center will provide the client;

(b) Time specific, measurable, and individualized client goals;

(d) When and how the ADH center will provide the care and services;

(e) How the ADH center will manage the client's medications, including how the client will receive his or her medications when attending the ADH center;

(f) The client's activity preferences and how the ADH center will meet these preferences;

(g) Other preferences and choices about issues important to the client including, but not limited to:

(i) Food;

(ii) Daily routine;

(iii) Activities;

(iv) Services received and who will provide the services received;

(v) Individuals they interact with;

(vi) Grooming; and

(vii) How the ADH center will accommodate the preferences and choices;

(h) Individualized discharging or transition goals;

(i) If needed, a plan to:

(i) Address potential behavioral issues identified in the assessment, service plan, or through the intake and evaluation;

(ii) Follow in case of a foreseeable crisis due to a client's assessed needs;

(iii) Reduce tension, agitation, and problem behaviors;

(iv) Respond to the client's special needs, including, but not limited to medical devices and related safety plans, and if medical devices are used, ADH center staff must ensure the medical device will not be used as a physical restraint for discipline or staff convenience, while attending the ADH center;

(v) Respond to the client's refusal of care or treatment, including when the ADH center should notify the client's physician or practitioner of the client's refusal; and

(vi) Identify any communication barriers the client may have and how the ADH center will use the client's behaviors and nonverbal gestures to communicate with him or her.

(9) The ADH center must:

(a) Ensure medical devices will never be used as a physical restraint for discipline or staff convenience;

(b) Review and update each service in the negotiated care plan every ninety days or more often if the client's condition changes;

(c) Share the negotiated care plan with the client's case manager whenever it is updated, annually, or after significant change;

(d) Ensure the client's case manager reviews the negotiated care plan to ensure all services are appropriate and all authorized care needs have been included;

(e) Obtain the case manager's approval whenever it is updated, annually, or after a significant change;

(f) Keep the current negotiated care plan in the client's file; and

(g) Offer a copy of the negotiated care plan to the client or the client and his or her authorized representative.

(10) The client's case manager must review the negotiated care plan to ensure all services are appropriate and all authorized care needs have been included.

(11) The ADH center must report changes in the client's condition or unanticipated absences of more than three consecutive scheduled days of service to the client's case manager within one week.

(a) Unanticipated absences may include, but are limited to absences due to client illness or a change in transportation access.

(b) The case manager may follow up with the client or the client and his or her authorized representative and determine if any updates to the assessment, client's department service plan, or service authorizations are needed.

History

Statutory Authority: RCW 74.08.090. WSR 18-18-006, § 388-71-0722, filed 8/23/18, effective 9/23/18. Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 17-19-098, § 388-71-0722, filed 9/19/17, effective 10/20/17
WSR 15-01-174, § 388-71-0722, filed 12/23/14, effective 1/23/15. Statutory Authority: RCW 74.04.050, 74.04.057, 74.04.200, 74.08.090, 74.09.520, and 74.39A.030. WSR 03-06-024, § 388-71-0722, filed 2/24/03, effective 7/1/03.

Wash. Admin. Code § 388-71-0723 What is the adult day center's responsibility in the use of medical devices, restraints, and prevention of abuse?

(1) Medical devices. When the adult day center staff use a medical device, it must not be used as a physical restraint for discipline or staff convenience.

(2) Physical restraints. When the adult day center staff provide services for a client, which may include but are not limited to transportation, outings, and services at the facility, the adult day center must ensure the client has a right to be free from physical restraints used for discipline or staff convenience.

(3) Chemical restraints. When the adult day center staff provide services for a client, which may include but are not limited to transportation, outings, and services at the facility, the adult day center must ensure the client is free from chemical restraints used for discipline or staff convenience.

(4) Involuntary seclusion. When the adult day center staff provides services for a client, which may include but are not limited to transportation, outings, and services at the facility, the adult day center must ensure the client's right to be free from involuntary seclusion or isolation used for discipline or staff convenience.

(5) Prevention of abuse. When the adult day center staff provides services for a client, which may include but are not limited to transportation, outings, and services at the facility, the adult day center must:

(a) Ensure the client's right to be free from abandonment, verbal, sexual, physical, and mental abuse, personal exploitation, financial exploitation, neglect, coercion, and involuntary seclusion;

(b) Protect the client who is an alleged victim of abandonment, verbal, sexual, physical, and mental abuse, personal exploitation, financial exploitation, neglect, and involuntary seclusion; and

History

Statutory Authority: RCW 74.08.090. WSR 18-18-006, § 388-71-0723, filed 8/23/18, effective 9/23/18. Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 17-19-098, § 388-71-0723, filed 9/19/17, effective 10/20/17.

Wash. Admin. Code § 388-71-0724 How do I apply for an adult day program state contract?

(1) The department, or an area agency on aging (or other department designee) as authorized by the department, must determine that the adult day care or day health center meets the applicable adult day care or day health requirements and any additional requirements for contracting with the area agency on aging, according to each AAA's procurement procedure, through a state contract.

(2) All ADH centers must also have a core provider agreement with the health care authority in order to bill for providing care and services to the COPES, RSW, and RCL participants.

(3) If a center is contracting for both day care and day health, requirements of both adult day services must be met.

(4) A prospective provider desiring to provide adult day services shall be provided an application form from the department or the area agency on aging. A prospective provider convicted of abuse or neglect of a vulnerable adult is not eligible to provide adult day services in any capacity within the organization per chapter 74.34 RCW.

(5) The prospective provider will provide the area agency on aging with evidence of compliance with, or administrative procedures to comply with, the adult day service rules under this chapter.

(6) The area agency on aging will conduct a site inspection of the adult day center and review of the requirements for contracting.

(7) Within thirty days of completing the site visit, the area agency on aging will advise the prospective provider in writing of any deficiencies in meeting contracting requirements.

(8) The area agency on aging will verify correction of any deficiencies within thirty days of receiving notice from the prospective provider that deficiencies have been corrected, before contracting can take place.

(9) The area agency on aging will provide the department with a written recommendation as to whether or not the center meets contracting requirements.

(10) Minimum application information required to apply for contract(s) with the department, or an area agency on aging includes:

(a) Mission statement, business structure, bylaws, articles of organization or articles of incorporation if applicable and current business license;

(b) Names and addresses of the center's owners, officers, and directors as applicable;

(d) Fiscal policies and procedures;

(e) A business plan to address the future financial needs of the center. This plan must include projected program growth, capital purchases, projected revenue, projected expenses, and plans for fund raising, if applicable. Also include an annual program operating budget including all anticipated revenue sources and expenditures and any fees generated;

(f) The most current financial statement prepared in accordance with generally accepted account principles (GAAP) or the latest audit report of the organization by a certified public accountant;

(g) Program policies and operating procedure manual;

(h) Personnel policies and job descriptions and qualifications of each paid staff position and volunteer position functioning as staff;

(i) Policies and procedures meeting the requirements of mandatory reporting procedures as described in chapter 74.34 RCW to adult protective services for vulnerable adults and local law enforcement for other participants;

(j) Floor plan of the facility;

(k) Local building inspection, fire department, and health department reports with food handler permits if applicable;

(l) Updated TB test results for each staff member according to WAC 388-71-0750;

(m) Sample client case file including all forms that will be used;

(n) Activities calendar with alternative choice activities, for the month prior to application, or a sample calendar if the day service provider is new;

(o) Role and function of the board of directors and advisory committee, if applicable;

(p) Monthly menu or sample if center is new, which accommodates each resident's:

(i) Preferences;

(ii) Food allergies and sensitivities;

(iii) Caloric needs;

(iv) Cultural and ethnic background; and

(v) Physical condition that may make food intake difficult such as being hard for the resident to chew or swallow; and

(q) Certificates of insurance per WAC 388-71-0736.

(11) The area agency on aging or other department designee monitors the adult day center at least annually to determine continued compliance with adult day care and/or adult day health requirements and the requirements for contracting with the department or the area agency on aging.

(a) The area agency on aging will send a written notice to the provider indicating either compliance with contracting requirements or any deficiencies based on the annual monitoring visit and request a corrective action plan. The area agency on aging will determine the date by which the corrective action must be completed.

(b) The area agency on aging will notify the department of the adult day center's compliance with contracting requirements or corrected deficiencies and approval of the corrective action plan for continued contracting.

(12) Adult day care services are reimbursed on an hourly basis up to four hours per day. Service provided four or more hours per day will be reimbursed at the daily rate.

(13) Adult day center reimbursements are adopted by rule with adjustments determined by the state legislature. Providers seeking current reimbursement rates can refer to the billing instructions.

(14) A one-time only initial intake evaluation provided by an adult day health center, including development of a negotiated care plan, is reimbursed at an established rate as may be adopted in rule. Rate adjustments are determined by the state legislature. Separate reimbursement is not available for subsequent evaluations.

(15) Transportation to and from the program site is not reimbursed under the adult day care rate. Transportation arrangements are made with locally available transportation companies or informal resources.

(16) Transportation to and from the program site is reimbursed under the adult day health daily rate. Adult day health is required to assist clients in arranging or providing transportation to and from the program sites.

History

Statutory Authority: RCW 74.08.090. WSR 18-18-006, § 388-71-0724, filed 8/23/18, effective 9/23/18. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 15-01-174, § 388-71-0724, filed 12/23/14, effective 1/23/15. Statutory Authority: RCW 74.04.050, 74.04.057, 74.04.200, 74.08.090, 74.09.520, and 74.39A.030. WSR 03-06-024, § 388-71-0724, filed 2/24/03, effective 7/1/03.

Wash. Admin. Code § 388-71-0728 Can a client receive both adult day care and adult day health?

(1) A COPES, RSW, or RCL eligible client may receive adult day care services on some days and adult day health services on different days if the service plan documents which level of service are to be provided on which days. However, ADC services must be provided on all days that adult day health skilled services are provided, and reimbursement is limited to the day health rate on days that day health services are provided.

(2) Clients receiving services from the department in an adult family home, assisted living, or other licensed community residential facility may not receive COPES, RSW, or RCL funded adult day care, but may receive COPES funded adult day health services when the skilled nursing or rehabilitative services are approved by the client's case manager as part of the client's service plan.

(3) A licensed assisted living facility providing department-approved day care under chapter 388-78A WAC is subject to any applicable provisions of that chapter and is also subject to the rules under this chapter if the facility contracts with an area agency on aging or the department to provide COPES waiver or RCL funded adult day services.

History

Statutory Authority: RCW 74.08.090. WSR 18-18-006, § 388-71-0728, filed 8/23/18, effective 9/23/18. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 15-01-174, § 388-71-0728, filed 12/23/14, effective 1/23/15. Statutory Authority: RCW 74.04.050, 74.04.057, 74.04.200, 74.08.090, 74.09.520, and 74.39A.030. WSR 03-06-024, § 388-71-0728, filed 2/24/03, effective 7/1/03.

Wash. Admin. Code § 388-71-0730 What other funds are available through the area agency on aging?

(1) Except as provided under this section, the adult day services rules under this chapter do not apply to adult day care or day health services funded under chapters 74.38 and 74.41 RCW.

(2) An area agency on aging that elects to provide adult day services using Senior Citizens Services Act funding under chapter 74.38 RCW or respite care funding under chapter 74.41 RCW must contract with an adult day center that meets all administrative and facility requirements under WAC 388-71-0736 through 388-71-0774.

(3) The adult day care or day health services funded under chapters 74.38 or 74.41 RCW must be the same as the day care services required under WAC 388-71-0704 or the day health services required under WAC 388-71-0706. The area agency on aging may require additional services by contract.

(4) The area agency on aging may, by contract, establish eligibility and assessment requirements for day care or day health services in accordance with locally identified needs. However, funding provided under chapters 74.38 or 74.41 RCW may only be used to meet the needs of individuals who are not eligible for adult day care under WAC 388-71-0708 or for adult day health under WAC 388-71-0710, or who are eligible for those services and are not receiving them because of funding limitations.

(5) Nothing in this section or chapter may be construed as requiring an area agency on aging to contract with an adult day center, whether or not the center has a COPES and RCL contract. Nor may anything in this section or chapter be construed as creating an entitlement to state-funded adult day services authorized under chapters 74.38 and 74.41 RCW.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 15-01-174, § 388-71-0730, filed 12/23/14, effective 1/23/15. Statutory Authority: RCW 74.04.050, 74.04.057, 74.04.200, 74.08.090, 74.09.520, and 74.39A.030. WSR 03-06-024, § 388-71-0730, filed 2/24/03, effective 7/1/03.

Wash. Admin. Code § 388-71-0732 What are the client's hearing rights?

(1) If the department or area agency on aging denies, terminates, or reduces a COPES, RSW, or RCL individual client's adult day care or day health services, the client has the right to an administrative hearing as provided under chapter 388-02 WAC. If a client funded with Senior Citizen Services Act or respite care has a complaint, grievance or dispute, the resolution process is a hearing as outlined in the department's area agency on aging policy and procedure manual chapter 6. The area agency on aging would work with the client through this process.

(2) An adult day care or day health center has those hearing or dispute resolution rights that are afforded under RCW 43.20B.675 and the center's contract with the area agency on aging or the department. An adult day health center has any other applicable hearing or dispute resolution rights under WAC 182-502-0220.

(3) Adult day health centers are subject to all applicable provisions of chapter 182-502 WAC, and the department's aging and long term support administration may exercise the department's authority under that chapter to the same extent as the health care authority.

History

Statutory Authority: RCW 74.08.090. WSR 18-18-006, § 388-71-0732, filed 8/23/18, effective 9/23/18. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 15-01-174, § 388-71-0732, filed 12/23/14, effective 1/23/15. Statutory Authority: RCW 74.04.050, 74.04.057, 74.04.200, 74.08.090, 74.09.520, and 74.39A.030. WSR 03-06-024, § 388-71-0732, filed 2/24/03, effective 7/1/03.

Wash. Admin. Code § 388-71-0734 Would the department limit expenditures in the adult day service program?

(1) In order to provide adult day services within the limits of available funding, the department may limit services when program expenditures exceed the budget appropriation or when limiting services is required to prevent expenditures from exceeding the appropriation.

(2) When adult day health program expenditures exceed available funding, the department may limit adult day health services based on the four care level system as determined through the established department assessment and described in chapter 388-105 WAC.

(a) Using the care level determined by the department assessment tool, the department will limit adult day services on a statewide basis to clients whose total scores exceed the assessed need level identified by the department as necessary to provide adult day health services to the extent of available funding.

(b) At least thirty days before implementing the limitation on services under this subsection, the department will notify the area agencies on aging, adult day health centers, and the affected adult day health clients that services are being limited and for what period of time the limitation is estimated to remain in effect.

(c) For purposes of RCW 74.08.080, the reduction in services shall be deemed an assistance adjustment for an entire class of recipients that is required by state laws prohibiting the department from expending funds in excess of appropriations.

(3) The department may adopt additional or alternative rules to control costs, such as, but not limited to, imposing a moratorium on contracting with new adult day centers, limiting services to clients based on level of care need, or reducing the numbers of days per week that clients may receive services.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 15-01-174, § 388-71-0734, filed 12/23/14, effective 1/23/15. Statutory Authority: RCW 74.04.050, 74.04.200, 74.09.520, 74.39A.030. WSR 05-02-064, § 388-71-0734, filed 1/4/05, effective 2/4/05. Statutory Authority: RCW 74.04.050, 74.04.057, 74.04.200, 74.08.090, 74.09.520, and 74.39A.030. WSR 03-06-024, § 388-71-0734, filed 2/24/03, effective 7/1/03.

Wash. Admin. Code § 388-71-0736 What business and administrative documentation does the center need?

(1) Adult day centers must have written documentation of the organizational structure and administration of the program.

(2) Organizational and administrative documentation must include but are not limited to:

(a) Core values and mission statement of the organization;

(b) Ethical standards of the center and professional standards of conduct;

(d) Definition of the target population, including number, age, and needs of participants;

(e) Geographical definition of the service area;

(f) Hours and days of operation of the center or a combination of centers under single ownership must operate at least three days a week for four consecutive hours, with each center providing at least four hours of programming a day;

(g) Description of basic services and any optional services;

(h) Description of service delivery;

(i) Business structure, articles of organization or bylaws, as applicable;

(j) Current business license;

(k) Names and addresses of the center's owners, officers, and directors, as applicable;

(l) Certificates of insurance, including but not limited to property and general liability insurance; business auto if the center uses vehicles to transport clients; professional liability; workers' compensation; employers' liability if applicable; coverage for acts and omissions of employees and volunteers; and certificates of insurance for any subcontractors;

(m) Minutes of last three meetings of the board of directors, if applicable, and the advisory committee;

(n) Role and functions of an advisory committee which must:

(i) Meet at least twice a year; and

(ii) Be representative of the community and include family members of current or past clients and nonvoting staff representatives;

(A) When an adult day center is a subdivision of a multifunction organization, a committee or subcommittee of the governing body of the multifunction organization may serve as the advisory committee; or

(B) A single purpose agency may utilize its governing board as an advisory committee;

(o) An organizational chart illustrating the lines of authority and communication channels of the center, which must be available to all staff and clients;

(p) A calendar of programming (or sample calendar if the center is new), including alternative programming options;

(q) A monthly menu or sample menu if the center is new, which accommodates each resident's:

(i) Preferences;

(ii) Food allergies and sensitivities;

(iii) Caloric needs;

(iv) Cultural and ethnic background; and

(v) Physical condition that may make food intake difficult such as being hard for the resident to chew or swallow;

(r) Current building, health, food service and fire safety inspection reports, and food handler permits, as applicable; and

(s) Quality improvement plans and results.

History

Statutory Authority: RCW 74.08.090. WSR 18-18-006, § 388-71-0736, filed 8/23/18, effective 9/23/18. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 15-01-174, § 388-71-0736, filed 12/23/14, effective 1/23/15. Statutory Authority: RCW 74.04.050, 74.04.057, 74.04.200, 74.08.090, 74.09.520, and 74.39A.030. WSR 03-06-024, § 388-71-0736, filed 2/24/03, effective 7/1/03.

Wash. Admin. Code § 388-71-0738 What operating policies and procedures does the center need?

(1) All policies and procedures must include date of initial development and/or revision along with date of being reviewed and approved on a regular basis, at least annually, by the advisory committee, and conform to the requirements outlined in WAC 388-71-0702 through 388-71-0774, as applicable.

(2) Policies and procedures must include:

(a) Procedures for evaluations, reevaluation, and the development of a negotiated care plan with clients and/or representatives, including provisions for the utilization of a multidisciplinary team for this process;

(b) If applicable, research procedures that comply with chapter 388-04 WAC;

(c) Procedure for developing staffing schedules with staff to participant ratios being at a minimum one staff to six participants;

(d) Policy regarding the utilization of community resources;

(e) Gift policy;

(f) Marketing policy and procedures;

(g) Policy and procedure for contracting for services;

(h) Medication policy including but not limited to: Disposal of wasted or contaminated medications;

(i) Emergency and evacuation policy and procedures for fire safety as approved by the local fire authority must be adopted and posted, including provisions for fire drills, inspection and maintenance of fire extinguishers, and periodic inspection and training by fire department personnel. The center must conduct and document quarterly fire drills and document the center's ability to meet procedures. Improvements must be based on the fire evaluation drills;

(j) Grievance and complaint policies and procedures for staff and participants;

(k) Admission and discharge criteria policy and procedure. Discharge policies must include specific measurable criteria that establish when the participant is no longer eligible for services and under what circumstances the participant may be discharged. Unless the discharge is initiated by the client's department or authorized case manager, the center must notify the client, client representative if applicable, and case manager in writing of the specific reasons for the discharge. The center must also provide the client with adequate information about appeal and hearing rights. The discharge may occur due to the client's choice, other criteria as defined in the center's policy such as standards of conduct or inappropriate behavior, or changes in circumstances making the client ineligible for services under WAC 388-71-0708 or 388-71-0710;

(l) Health Insurance Portability and Accountability Act (HIPAA) policy and procedure;

(m) Confidentiality policy and procedure;

(n) Policy regarding how the center will comply with all applicable nondiscrimination laws, including but not limited to age, race, color, gender, religion, national origin, creed, marital status, sexual orientation, Vietnam era or disabled veteran's status, or sensory, physical, or mental handicap;

(o) A policy and procedure to afford the participants' their bill of rights describing the client's rights and responsibilities must be developed, posted, distributed to, and explained to participants, families, staff, and volunteers. Participants will be provided the bill of rights in the language understood by the individual upon request;

(p) Policies and procedures to ensure that the client's record/chart is appropriately organized and thinned according to the center's policy.

(q) Client record policy and procedures for:

(i) Confidentiality and the protection of records that define procedures governing the use and removal, and conditions for release of information contained in the records;

(ii) The release of client information and circumstances under which a signed authorization from the client or client representative is required; and

(iii) The retention, storage and access to records per the agency's contract with the department and/or the department's designee, including contingency plans in the event the center discontinues operation.

(r) The center must have an advance directive policy as required by the Patient Self Determination Act of 1990 (see 42 C.F.R. § 489.102 and chapter 70.122 RCW); and

(s) A policy and procedure for illness/injury/medical emergency/death must be followed in the event a participant becomes ill, is injured, or dies. The procedures must describe arrangements for hospital inpatient and emergency room service and include directions on how to secure ambulance transportation and complete incident reports.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 15-01-174, § 388-71-0738, filed 12/23/14, effective 1/23/15. Statutory Authority: RCW 74.04.050, 74.04.057, 74.04.200, 74.08.090, 74.09.520, and 74.39A.030. WSR 03-06-024, § 388-71-0738, filed 2/24/03, effective 7/1/03.

Wash. Admin. Code § 388-71-0740 What are the center's fiscal operational responsibilities?

(1) Adult day centers must demonstrate fiscal responsibility. Fiscal policies, procedures, reports, statements and records must be developed in accordance with generally accepted accounting principles (GAAP) and enable the administrator to meet the fiscal reporting needs of the governing body.

(2) Adult day centers must develop a yearly plan to address the future financial needs of the center. The plan must include projected program growth, capital purchases, projected revenue, projected expenses, and plans for fund raising, if applicable.

(3) Adult day centers must create a total center operating budget, including all expenditures, revenue sources and participant fees generated annually.

(4) An annual financial statement or the latest audit report of the organization by a certified public accountant performed at least every two years must be available.

(5) A statement of charges for services (fee schedule), including private pay rates and/or ancillary charges for additional services outside the scope of these rules, must be available.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 15-01-174, § 388-71-0740, filed 12/23/14, effective 1/23/15. Statutory Authority: RCW 74.04.050, 74.04.057, 74.04.200, 74.08.090, 74.09.520, and 74.39A.030. WSR 03-06-024, § 388-71-0740, filed 2/24/03, effective 7/1/03.

Wash. Admin. Code § 388-71-0744 What are the center's requirements for client records?

(1) The adult day center must follow their policies and procedures to ensure that the client's record/chart is appropriately organized and that confidentiality of information is maintained.

(2) Client information forms must be standardized, with each page showing the client's name or identification number.

(3) Individual client files must include:

(a) Personal/biographical data, including addresses, phone numbers, emergency contacts, and client representatives, reviewed and updated as needed;

(b) Application, enrollment, and consent to services forms;

(d) All client information, including but not limited to the intake evaluation, date of acceptance to the center, negotiated care plan, attendance and service records, progress notes, and correspondence;

(e) Signed authorizations concerning the release of client information, photographs, and receipt of emergency medical care, as appropriate;

(f) Client photograph, with client or client representative permission, updated as needed per change in the client's appearances or picture being difficult to clearly view;

(g) Transportation plans regarding how the client will be transported back and forth from the center and who is responsible for the transportation;

(h) Fee determination forms;

(i) Appropriate medical information, with client consent, including but not limited to significant illnesses, accidents, treatments, medical conditions, allergies, medications, tobacco use, and alcohol or substance use;

(j) Advance directives (if any) and a statement signed by the client that he or she has received the center's policies concerning advance directives; and, as applicable;

(k) Authorizing practitioner orders for skilled nursing and/or rehabilitative therapy containing department-required information and in accordance with applicable licensing and practice act regulations.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 15-01-174, § 388-71-0744, filed 12/23/14, effective 1/23/15. Statutory Authority: RCW 74.04.050, 74.04.057, 74.04.200, 74.08.090, 74.09.520, and 74.39A.030. WSR 03-06-024, § 388-71-0744, filed 2/24/03, effective 7/1/03.

Wash. Admin. Code § 388-71-0746 What are the adult day center's client records requirements?

(1) If the client's record is hand-written it must be legibly written in ink, dated, and signed by the recording person with his/her title. Identification of the author may be a signature, initials, or other unique identifier within the requirements of applicable licensing standards and center policy. All hand-written documentation must be legible to someone other than the author. If signature is a unique identifier, such as initials, there must be a key readily available for use by the department or their designee. The negotiated care plan must have the center's author's full name and title on the signature line.

(2) If the client's record is an automated electronic record then it must be within a secured client record system to ensure confidentiality for all records, in accordance with state and federal laws, including but not limited to the Health Insurance Portability and Accountability Act (HIPAA). If electronic signature is a unique identifier then there must be a key readily available for use by the department or their designee. The negotiated care plan must have the center's author's full name and title on the signature line.

(3) Progress notes must be entered into the file chronologically and timely. Adult day health centers' professional interventions must be charted directly after providing the service. Adult day care centers must have progress summary notes at least monthly. Client dates and hours of attendance are to be kept daily.

(4) Consultation, care plan reviews and updating orders, hardcopy or electronic records, must be dated and initialed by the center's reviewer(s) or authorizing practitioner. The authorizing practitioner must update the skilled clinical orders at least annually or when a significant change occurs warranting a change in the skilled clinical intervention. The authorizing practitioner does not need to review the care plan but does need to update skilled clinical orders as outlined above.

(5) Documentation of medication use must include the name of the medication, dosage, frequency of administration, route of administration, site of injection if applicable, date and time and signature or initials of the person administering the medication, title, and date.

(6) If the client records are thinned or archived, per your policy and procedure, all records must be readily available to the federal, state, or agency designee for monitoring purposes.

(7) Department-contracted adult day health centers must comply with all other applicable documentation requirements under WAC 182-502-0020.

History

Statutory Authority: RCW 74.08.090. WSR 18-18-006, § 388-71-0746, filed 8/23/18, effective 9/23/18. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 15-01-174, § 388-71-0746, filed 12/23/14, effective 1/23/15. Statutory Authority: RCW 74.04.050, 74.04.057, 74.04.200, 74.08.090, 74.09.520, and 74.39A.030. WSR 03-06-024, § 388-71-0746, filed 2/24/03, effective 7/1/03.

Wash. Admin. Code § 388-71-0748 What are the adult day centers' record retention requirements?

(1) The adult day center must maintain a secure client record system to ensure confidentiality for all records, whether paper or electronic, in accordance with state and federal laws, including but not limited to the Health Insurance Portability and Accountability Act (HIPAA).

(2) The adult day center must maintain a permanent registry of all clients with dates of admission, attendance and discharge.

(3) The adult day center must follow their written policies concerning record and maintenance and retention, see WAC 388-71-0738 operating policy section.

(4) Client records maintained on the center's premises must be in a secure storage area that includes locking cabinets or storage. Computerized records must be backed up, daily for any changes made in the record that day and a full backup on a weekly basis. Weekly backup records would be stored off-site either in a physical, (cd, tape or thumb drive) or electronic file, (through the cloud backup system) compliant with HIPAA.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 15-01-174, § 388-71-0748, filed 12/23/14, effective 1/23/15. Statutory Authority: RCW 74.04.050, 74.04.057, 74.04.200, 74.08.090, 74.09.520, and 74.39A.030. WSR 03-06-024, § 388-71-0748, filed 2/24/03, effective 7/1/03.

Wash. Admin. Code § 388-71-0750 What are the adult day center's personnel policies and procedures requirements?

(1) Personnel policies and procedures must be in place to ensure that staff is trained and knowledgeable to provide quality services in a safe environment. Policies must include at least the following:

(a) The center must have policies concerning the recruitment, orientation, training, evaluation, and professional development of staff and volunteers.

(b) The center must have job descriptions for each paid staff and volunteer position, which functions as staff, that are in accordance with ADA requirements and that specify qualifications for the job, delineation of tasks, essential functions and lines of supervision and authority.

(c) Each employee must receive, review, and sign a copy of the job description at the time of employment and whenever job descriptions are modified. Volunteers who function as staff must receive written descriptions of responsibilities.

(d) Probationary evaluations and annual performance evaluations, in accordance with job descriptions, must be conducted and must conform to the policy of the funding or parent organization. Both the employee and supervisor will sign and date the written evaluation. Copies will be kept in locked personnel files.

(e) Each staff person or volunteer, who functions as a staff person, is to have tuberculosis (TB) testing according to current local health authorities recommendations.

(f) The center must have policies to restrict a staff person or participant's contact with clients when the staff person or participant has a known communicable disease in the infectious stage that is likely to spread in the center.

(g) Policies must also be established concerning hand washing, universal precautions, infection control, infectious waste disposal, bloodborne pathogens, and laundry and handling of soiled and clean items.

(2) The center must have policies and procedures concerning suspected participant abuse, neglect, or exploitation reporting that include provisions preventing access to any participant until the center investigates and takes action to assure the participants' safety.

(3) The center must not interfere with the lawful investigation of a complaint, coerce a participant, or conceal evidence of alleged improprieties occurring within the center.

(4) The center must have policies that meet the requirements of mandatory reporting procedures as described in chapter 74.34 RCW to adult protective services for vulnerable adults and to local law enforcement for other participants.

(5) Each employee must receive or have access to a copy of the program's personnel policies at the time of employment.

(6) Whenever volunteers function in the capacity of staff, all applicable personnel policies pertain.

(7) The center must conform to federal and state labor laws and be in compliance with equal opportunity guidelines.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 15-01-174, § 388-71-0750, filed 12/23/14, effective 1/23/15. Statutory Authority: RCW 74.04.050, 74.04.057, 74.04.200, 74.08.090, 74.09.520, and 74.39A.030. WSR 03-06-024, § 388-71-0750, filed 2/24/03, effective 7/1/03.

Wash. Admin. Code § 388-71-0752 What are the adult day centers' staffing qualifications and requirements?

(1) Staff selection is dependent on participant needs, program design, and contracting requirements. The center must have the proper balance of professionals and paraprofessionals or nonprofessionals to adequately meet the needs of participants. Services must be delivered by those with adequate professional training. A staff person can have multiple functions, such as an administrator who is also responsible for providing nursing services or social services.

(2) To ensure continuity of direction and supervision, there must be a clear division of responsibility between the governing body and the adult day center administrator.

(3) The administrator must be given full authority and responsibility to plan, staff, direct, and implement the program. The administrator must also have the responsibility for establishing collaborative relations with other community organizations to ensure necessary support services to participants and their families or caregivers.

(4) The administrator must be on site to manage the center's day-to-day operations during hours of operation. If the administrator is responsible for more than one site, or has duties not related to adult day center administration or provision of services, a program director must be designated for each additional site and must report to the administrator.

(5) The administrator must be responsible for the development of a written plan of operation with approval of the governing body and the development, coordination, supervision, fiscal control, and evaluation of services provided through the adult day center.

(6) A nurse or other personnel with a current first aid and CPR card must be on-site whenever participants are attending the adult day care or health program.

(7) Required credentials must be verified to ensure that they are current and in good standing for licensed and certified staff.

(8) Adult day centers may utilize a range of staff under contract or consulting from a larger parent organization or from a private entity to provide services.

(9) Staff commonly utilized by both adult day care and adult day health centers must meet the following requirements:

(a) An activity coordinator must have a bachelor's degree in recreational therapy or a related field and one year of experience (full-time equivalent) in social or health services; or an associate degree in recreational therapy or a related field plus two years of appropriate experience; or three years of paid experience in an activity program and expertise with the population served at the center.

(b) The nurse must be a registered nurse (RN) with valid Washington or multistate credentials in good standing and have at least one-year applicable experience (full-time equivalent) in ambulatory care or hospital nursing or geriatric or preferably in home health or older adult community-based nursing or work with disabled clients. In addition to a registered nurse, an adult day center can utilize a licensed practical nurse (LPN), but the LPN must be supervised in compliance with all applicable nurse practice acts and standards. The LPN must have valid state credentials in good standing and at least one-year applicable experience (full-time equivalent) in ambulatory care of hospital nursing or geriatric or preferably in home health or older adult community-based nursing or work with disabled clients. In the adult day care center, the RN or LPN does not need to be on site during all hours of operation. In the adult day health (ADH) center, the RN or LPN must be on site when the attending participants who need nursing services are attending the ADH program. If there are no participants who have nursing service interventions identified on their negotiated care plan in attendance, then the nurse is not required to be on site during the ADH program time.

(c) The social services professional must have a master's degree in social work, gerontology, or other human services field, or counseling and at least one year of professional work experience (full-time equivalent), or a bachelor's degree in social work, counseling, or a related field and two years of experience in a human services field.

(d) Program assistant and aides or personal care aides must have the appropriate knowledge, skills, and training to meet the individual needs of the participants before they are allowed to provide care and services. The assistant and aide competencies must be documented demonstrating their qualification to meet the needs of the center's participants within their job description.

(e) Consultants from a larger parent organization without formal contracts may be utilized whenever the center is part of a larger organization that has the ability to provide professional services within the larger framework.

(f) Consultants, with appropriate, valid state credentials may be utilized as needed to meet the requirements outlined in this chapter. The rehabilitative consultants must perform the professional assessment of the participant, train the staff regarding the participant's therapy needs and therapeutic interventions, monitor the rehabilitation program and evaluate the participant's progress for discharge planning.

(g) Secretaries and bookkeepers must have at least a high school diploma or equivalent and skills and training to carry out the duties of the position.

(h) If the adult day center provides transportation, drivers must have a valid and appropriate state driver's license, a safe driving record, and training in first aid and CPR. The driver must meet all state requirements for licensure or certification.

(i) Volunteers may be individuals or groups who desire to work with adult day center clients and must take part in program orientation and training. Volunteers and staff must mutually determine the duties of volunteers. Duties to be performed under the supervision of a staff member must either supplement staff in established activities or provide additional services for which the volunteer has special talents. Volunteers will be included in the staff ratio only when they conform to the same standards and requirements as paid staff, meet the job qualification standards of the organization, and have designated responsibilities.

(j) Dietitians must be certified with valid state credentials and have a minimum of one year applicable experience (full-time equivalent).

History

Statutory Authority: RCW 70.128.230, 74.39A.009, 74.39A.070, 74.39A.074, and chapter 18.80 RCW. WSR 24-16-082, § 388-71-0752, filed 8/1/24, effective 9/1/24. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 15-01-174, § 388-71-0752, filed 12/23/14, effective 1/23/15. Statutory Authority: RCW 74.04.050, 74.04.057, 74.04.200, 74.08.090, 74.09.520, and 74.39A.030. WSR 03-06-024, § 388-71-0752, filed 2/24/03, effective 7/1/03.

Wash. Admin. Code § 388-71-0754 What are the adult day center's staff ratio requirements?

(1) Direct care staff in adult day centers will vary based upon the number of participants and their care and service requirements. The centers must provide sufficient numbers of qualified staff to meet the participants' needs, but at a minimum must have one staff to six clients for:

(a) Adequate nutrition and hydration;

(b) Health monitoring, education and referral to health services if needed;

(d) Socialization, recreation, therapeutic activities and stimulation;

(e) Transportation assistance;

(f) Supervision and protection; and

(g) Provision of a safe environment.

(2) The staffing level must be sufficient to serve the number and functioning levels of adult day center participants, meet program objectives, and provide access to other community resources.

(3) There must be sufficient maintenance and housekeeping personnel to assure that the facility is clean, sanitary, and safe at all times.

(4) To ensure adequate care and safety of participants, there must be provision for qualified substitute staff.

(5) As the number of participants with functional impairments, skilled nursing or skilled rehabilitative therapy needs increases, the required staff-participant ratio must be adjusted accordingly.

(6) Direct service staff to participant ratio must be met according to each program the center is contracted to provide, i.e. COPES/RCL and memory care and wellness services (MCWS). The center is required to have daily documentation outlining how they met the staff to resident ratio. This data would include but not be limited to names/titles of employees with date and hours worked and participants' names and date and hours attended.

(7) Staff counted in the staff-participant ratio is those who are trained and able to provide direct service to participants. When there is one participant present, to ensure safety of participant, there must be at least two organizational staff members who have the skills, knowledge and ability to meet the clients need and at least one is currently certified in CPR and first aid.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 15-01-174, § 388-71-0754, filed 12/23/14, effective 1/23/15. Statutory Authority: RCW 74.04.050, 74.04.057, 74.04.200, 74.08.090, 74.09.520, and 74.39A.030. WSR 03-06-024, § 388-71-0754, filed 2/24/03, effective 7/1/03.

Wash. Admin. Code § 388-71-0756 What are the adult day care centers' minimum staff requirements?

(1) The minimum staffing requirements for adult day care centers include an administrator/program director, activity coordinator, a consulting registered nurse, and a consulting social worker.

(2) The administrator/program director must have a master's degree and one year of supervisory experience in health or social services (full-time equivalent); or a bachelor's degree in health, social services or a related field, with two years of supervisory experience (full-time equivalent) in a social or health service setting; or a high school diploma or equivalent and four years of experience in a health or social services field, of which two years must be in a supervisory position, and have expertise with the populations served at the center.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 15-01-174, § 388-71-0756, filed 12/23/14, effective 1/23/15. Statutory Authority: RCW 74.04.050, 74.04.057, 74.04.200, 74.08.090, 74.09.520, and 74.39A.030. WSR 03-06-024, § 388-71-0756, filed 2/24/03, effective 7/1/03.

Wash. Admin. Code § 388-71-0758 What are the adult day health centers' minimum staff requirements?

(1) The minimum staffing requirements for adult day health centers include an administrator, program director, registered nurse, activity coordinator, a PT/OT or speech therapist, and a social worker. The administrator and program director may be the same person.

(2) The program administrator must have a master's degree and one year of supervisory experience in health or social services (full-time equivalent), or a bachelor's degree and two years of supervisory experience in a social or health service setting. The degree may be in nursing.

(3) The program director must have a bachelor's degree in health, social services or a related field with one year of supervisory experience (full-time equivalent) in a social or health service setting. Upon approval by the department, a day health center may request an exception for an individual with an associate's or vocational degree in health, social services, or a related field with four years of experience in a health or social service setting, of which two years must be in a supervisory position.

(4) Registered nurses and licensed practical nurses per WAC 388-71-0752.

(5) Therapists, regardless of specific expertise, such as physical therapists, occupational therapists, speech therapists, recreation therapists, mental health therapists, or any other therapists used, must have valid state credentials and one year of experience in a social or health setting.

(6) Rehabilitative therapeutic assistants must be certified with valid state credentials, have at least one year of applicable experience (full-time equivalent), and meet the requirements of chapter 246-915, 246-847, or 246-828 WAC.

(7) A certified or registered nursing assistant must meet the requirements of chapter 18.88A RCW.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 15-01-174, § 388-71-0758, filed 12/23/14, effective 1/23/15. Statutory Authority: RCW 74.04.050, 74.04.057, 74.04.200, 74.08.090, 74.09.520, and 74.39A.030. WSR 03-06-024, § 388-71-0758, filed 2/24/03, effective 7/1/03.

Wash. Admin. Code § 388-71-0760 What are the adult day centers' employee file requirements?

(1) Each employee must have an individual file containing the employee's application, verification of references, TB status, signed job description, and all performance evaluations. Copies of current license, certificate, or registration and verification of current good standing, and a current certification of CPR and first aid training, if applicable, must also be in the file.

(2) Centers must maintain employee records for the duration of staff employment and at least seven years after termination of employment.

(3) Employee records must contain documentation demonstrating the employee was oriented to the facility, job and possesses the knowledge, skills and ability to perform their assigned duties. The record should also contain documentation demonstrating the employee understands and will follow the center's policies and procedures regarding but not limited to medication disposal, the emergency and evacuation plan, the abuse, neglect, abandonment and financial exploitation of vulnerable adults and universal precaution policies and procedures.

(4) Background checks pursuant to RCW 43.43.830 and 43.43.832 must be performed for all applicants hired, existing employees, and volunteers who function as staff or who have unsupervised access to participants. Unsupervised access to participants is prohibited until a background check has been completed and the employee's suitability for employment has been determined. Background checks must be updated every two years and documentation maintained in the employees' or volunteers' functioning as staff, record.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 15-01-174, § 388-71-0760, filed 12/23/14, effective 1/23/15. Statutory Authority: RCW 74.04.050, 74.04.057, 74.04.200, 74.08.090, 74.09.520, and 74.39A.030. WSR 03-06-024, § 388-71-0760, filed 2/24/03, effective 7/1/03.

Wash. Admin. Code § 388-71-0762 What are the adult day centers' employee education and training requirements?

(1) Provision must be made for orientation of new employees, contractors, and volunteers.

(2) Every year, all staff, contractors, and volunteers, functioning as staff, must receive, at a minimum, quarterly in-service training and staff development that meets their individual training needs to support program services. This must be documented and readily accessible in the personnel file.

(3) Staff, contractors, and volunteers, who function as staff, must receive training regarding the following at a minimum:

(a) How to document in participants' records;

(b) What the center's emergency plan and evacuation procedure is and how to implement;

(d) How to receive and respond to grievances;

(e) What are universal precautions and how to implement in the day to day operations in the center;

(f) Reporting requirements such as but not limited to:

(i) Mandatory reporting for abuse, neglect, abandonment, and exploitation of vulnerable adults; and

(ii) Local health department procedure for disease outbreak.

(4) At a minimum, one staff person per shift must have current training and certification in CPR/first aid.

(5) Staff and volunteers functioning as staff, must receive education and training on all applicable policies and procedures within two weeks of employment.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 15-01-174, § 388-71-0762, filed 12/23/14, effective 1/23/15. Statutory Authority: RCW 74.04.050, 74.04.057, 74.04.200, 74.08.090, 74.09.520, and 74.39A.030. WSR 03-06-024, § 388-71-0762, filed 2/24/03, effective 7/1/03.

Wash. Admin. Code § 388-71-0764 How will medications be provided in an adult day center?

(1) The center must develop written medication policies that support and promote safe medication storage and administration for each participant and meet the requirements of chapters 69.41 RCW and 246-88 WAC and other applicable statutes. These policies must be explained and accessible to all staff, contractors, volunteers, and participants that have responsibility in this area.

(2) Participants who need to take medications while at the center, and who are able to self-medicate, must be encouraged and expected to bring and take their own medications as prescribed. Some participants may need assistance with their medications, and some may need to have their medications administered by qualified program staff.

(3) In order for the center staff to administer any prescribed medication, there must be a written authorization from the participant's authorizing practitioner stating that the medication is to be administered at the program site.

(4) Staff must be trained to observe medication usage and effects, and to document and report any concerns or difficulties with medications.

(5) At a minimum, medication policies must include the following:

(a) How medications will be labeled and stored. Medications must be:

(i) Labeled according to your policy including prescribed and over the counter medications;

(ii) Kept in a locked storage area organized so client's medications are not mixed together; and

(iii) If refrigeration is necessary, medications should be in a locked box, if not in a separate refrigerator dedicated to medication refrigeration.

(b) Procedures for administration of medications, including:

(i) What program staff are allowed and able to administer medications and under what circumstances;

(ii) How nonprescription medications such as aspirin or laxatives are to be used; and

(iii) How the administration of medications will be entered in participant case records as described in WAC 388-71-0744.

History

Statutory Authority: RCW 74.08.090. WSR 18-18-006, § 388-71-0764, filed 8/23/18, effective 9/23/18. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 15-01-174, § 388-71-0764, filed 12/23/14, effective 1/23/15. Statutory Authority: RCW 74.04.050, 74.04.057, 74.04.200, 74.08.090, 74.09.520, and 74.39A.030. WSR 03-06-024, § 388-71-0764, filed 2/24/03, effective 7/1/03.

Wash. Admin. Code § 388-71-0766 What are the adult day centers' facility requirements?

(1) Selection of a location for a center must be based on information about potential participants in the service area and be made in consultation with other agencies, organizations, and institutions serving older individuals and those with functional impairments, as well as considering the availability of a suitable location.

(2) Centers must have available a current floor plan of the facility indicating usage of space with interior measurements, building inspection report from the local, city or county, building department, if applicable, fire department inspection report, and the local health department kitchen inspection report and permit if operating an on-site kitchen.

(3) When possible, the facility should be located at street level. If the facility is not located at street level, it is essential to have a ramp and/or elevators. All new adult day service centers contracted with the department after February 1, 2014 must have a ramp, at least a 1:12 slope, for emergency evacuation if the center has any steps or stairs to be navigated during an emergency evacuation. An evacuation plan for relocation of participants to another building must also be in place in the event of an emergency. The center must post a floor plan of the center and indicate the evacuation route from each room to the outside meeting place.

(4) Each adult day center co-located in a facility housing other services must have its own separate identifiable space for main activity areas during operational hours. Certain space can be shared, such as the kitchen and therapy rooms.

(5) Each center must provide appropriate hardware on doors of storage rooms, closets, bathrooms, and other rooms to prevent participants from being accidentally locked in.

(6) When possible, the location should be within a transit authority's core service area.

(7) The facility must have:

(a) Sufficient space to accommodate a full range of programs and activities necessary for participant needs;

(b) Be adaptable to accommodate variations of activities for group and individual services;

(c) Maintain essential space when providing services to protect the privacy and dignity of each participant in a respectful manner;

(d) Sufficient space available for private discussions; and

(e) Private and designated space allowing staff to work without interruption.

(8) The facility must provide at least sixty square feet of program space for multipurpose use for each day center participant. In determining adequate square footage, only those activity areas commonly used by participants are to be included. Hallways, dining and kitchen areas are to be included only if these areas are used by clients for activities other than meals. Reception or lobby areas, storage areas, offices, restrooms, passageways, treatment rooms, service areas, or specialized spaces used only for therapies are not to be included when calculating square footage.

(9) Storage space.

(a) There must be adequate storage space for program and operating supplies.

(b) Toxic substances, whether for activities or cleaning, must be stored in an area not accessible to participants. Substances must be clearly marked, the contents identified, and stored in original containers.

(10) Restrooms.

(a) The facility's restrooms must be located as near the activity area as possible, preferably no more than forty feet away. The facility must include at least one toilet for every ten participants. The facility must provide privacy for the participant when using the restroom facilities.

(b) Programs that have a large number of participants who require more scheduled toileting or assistance with toileting must have at least one toilet for every eight participants.

(c) The toilets shall be equipped for use by mobility-limited persons and easily accessible from all program areas. One toilet area should be designed to allow assistance from one or two staff. More accessible units may be required based upon the needs of the participants.

(d) Each restroom must contain an adequate supply of soap, toilet tissues, and paper towels.

(e) After month/day/year all newly contracted adult day service facilities or contracted adult day service providers opening another site must have at least one roll in shower for participant use. Showers are to be accessible to those who require bathing as an ADC service.

(11) Rest area.

(a) In addition to space for program activities, the facility must have a designated rest area which provides privacy and maintains dignity for participants who become ill, disruptive, or who may require rest. The designated space must not be used for discipline or staff convenience.

(b) The rest area must be located away from activity areas and near a restroom and the nurse's office. There must be at least one bed, couch, or recliner for every ten participants that can be used for resting or the isolation of a participant who is ill or suspected of coming down with a communicable disease.

(c) If beds are used, the mattresses and pillow must be protected, cleaned and disinfected after each participant use. The bed linens must be clean and changed after each use by different participants to prevent the spread of infection.

(12) Loading zones/parking/entrances/exits.

(a) A loading zone with sufficient space for getting in and out of a vehicle must be available for the safe arrival and departure of participants and the use of emergency personnel.

(b) There must be sufficient parking available to accommodate family caregivers, visitors, and staff.

(c) When necessary, arrangements must be made with local authorities to provide safety zones for those arriving by motor vehicle and adequate traffic signals for people entering and exiting the facility.

(d) Adequate lighting must be provided in all loading and parking zones, entrances, and exits.

(e) An adult day center must be visible and recognizable as a part of the community. The entrance to the facility must be clearly identified. The center must also be appealing and protective to participants and others.

(f) At least two well-identified exits must be accessible from the building.

(13) Atmosphere and design.

(a) The center's design must facilitate the participants' movement throughout the facility and encourage involvement in activities and services.

(b) The environment must reinforce orientation and awareness of the surroundings by providing cues and information about specific rooms, locations, and functions that help the participant to get his/her orientation to time and space.

(c) A facility must be architecturally designed in conformance with the requirements of section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act to accommodate individuals with a disability and meet any state and local barrier-free requirements.

(d) Illumination levels in all areas must be adequate, and careful attention must be given to avoiding glare. Attention must be paid to lighting in transitional areas, such as outside to inside and between different areas of the facility.

(e) Sound transmission must be controlled. Excessive noise, such as fan noise, must be avoided.

(f) Comfortable conditions must be maintained within a comfortable temperature range. Excessive drafts must be avoided uniformly throughout the facility.

(g) Sufficient furniture must be available for the entire population present. Furnishings must accommodate the needs of participants and be attractive, comfortable, sturdy, clean and safe. Straight-backed chairs with arms must be used during activities and meals.

(h) A telephone must be available for participant use. Local calls are to be available at no cost to the participant.

(14) Safety and sanitation.

(a) The facility and grounds must be safe, clean, and accessible to all participants, and must be designed, constructed, and maintained in compliance with all applicable local, state, and federal health and safety regulations.

(b) Nonslip surfaces must be provided on stairs, ramps, and interior floors.

(c) Alarm/warning systems are necessary to ensure the safety of the participants in the facility in order to alert staff to potentially dangerous situations. This system needs to be activated when the center's staff have determined a participant has a potential safety issue of wandering. It is recommended that call bells be installed or placed in the rest areas, restroom stalls, and showers.

(d) An emergency evacuation plan with outside meeting location at a safe distance from the building must be strategically posted in each facility so that all participants, staff, and visitors can view it. If the center provides services to primarily non-English speaking clients the evacuation plan must also contain instructions in the primary language used by clients of the center. The center's emergency disaster plan must be readily available to all staff and reviewed routinely to ensure a safe and secure environment during a disaster.

(e) The facility must be free of hazards, such as high steps, steep grades, and exposed electrical cords. Steps and curbs must be painted and the edges of stairs marked appropriately to highlight them. All steps, stairs, ramps, and bathrooms accessible to those with disabilities must be equipped with securely anchored handrails on both sides.

(f) Emergency first-aid kits and manuals must be visible and accessible to staff. Contents of the kits must be replenished after use and reviewed as needed.

(g) Maintenance and housekeeping must be carried out on a regular schedule and in conformity with generally accepted sanitation standards, without interfering with the program.

(h) If smoking is permitted, the center must follow chapter 70.160 RCW, Smoking in public places.

History

Statutory Authority: RCW 74.08.090. WSR 18-18-006, § 388-71-0766, filed 8/23/18, effective 9/23/18. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 15-01-174, § 388-71-0766, filed 12/23/14, effective 1/23/15. Statutory Authority: RCW 74.04.050, 74.04.057, 74.04.200, 74.08.090, 74.09.520, and 74.39A.030. WSR 03-06-024, § 388-71-0766, filed 2/24/03, effective 7/1/03.

Wash. Admin. Code § 388-71-0770 What are the adult day centers' food and nutrition service requirements?

Centers must provide meal service to all participants as outlined in WAC 388-71-0704 and 388-71-0706.

(1) All meals provided are to meet one-third of the minimum required daily allowance or dietary reference intake as determined by the Food and Nutrition Board of the Institute of Medicine.

(2) The center must ensure that food served meets nutritional needs, takes into consideration individual and ethnic preferences to the extent reasonably possible, caloric need, special dietary requirements, and any physical condition making food intake difficult.

(3) The center must provide a variety of foods and not repeat menus for a minimum of three weeks.

(4) Participant input must be gathered when planning meals.

(5) Menus must be posted at least one week in advance; indicate the month, year, date, day of the week; and include food and snack choices served that contribute to nutritional requirements.

(6) Nutrient concentrates, supplements, and dysphagia-modified diets related to a choking or aspiration risk, are to be served only with the written approval of the participant's authorizing practitioner.

(7) Safe and sanitary handling, storage, preparation, and serving of food must be assured. If meals are prepared on the premises, kitchen appliances, food preparation area, and equipment must meet state and local requirements and pass inspections annually.

(8) All staff and volunteers handling or serving meals must have the appropriate food handler's permits, if applicable.

(9) In the event meals are prepared at a separate kitchen facility, the adult day center must ensure that persons preparing food have a food handler's permit and that the food is transported in airtight containers to prevent contamination.

(10) The center must ensure that the food is transported and served at the appropriate and safe temperature.

History

Statutory Authority: RCW 74.08.090. WSR 18-18-006, § 388-71-0770, filed 8/23/18, effective 9/23/18. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 15-01-174, § 388-71-0770, filed 12/23/14, effective 1/23/15. Statutory Authority: RCW 74.04.050, 74.04.057, 74.04.200, 74.08.090, 74.09.520, and 74.39A.030. WSR 03-06-024, § 388-71-0770, filed 2/24/03, effective 7/1/03.

Wash. Admin. Code § 388-71-0772 What are the adult day centers' emergency procedures requirements?

(1) A written emergency/disaster/earthquake plan must be readily available to all staff at each program site and in all program owned vehicles. Staff must be trained to ensure smooth implementation of the emergency plan.

(2) All staff and volunteers must be trained in evacuation/fire safety procedures.

(3) The center's written illness/injury/medical emergency/death procedure must be followed in the event a participant becomes ill, is injured, or dies. The procedures must be readily available to all staff during program hours and must be explained to staff, volunteers, and participants.

(4) Procedures for fire safety as approved by the local fire authority must be adopted and readily available to all staff, including provisions for fire drills, inspection and maintenance of fire extinguishers, and periodic inspection and training by fire department personnel. The center must conduct and document quarterly fire drills and document the center's ability to meet procedures. Improvements must be based on the fire drill evaluation. The center must post their building's floor plan with evacuation route from each room to the outside predetermined meeting place. Smoke detectors must also be used and serviced on a routine basis per the center's policy.

(5) Each center must provide adequate emergency lighting or flashlights in all areas.

(6) Each center must provide and maintain first-aid kits with manuals in adequate numbers to meet the needs of the participant and staff.

(7) Each center must ensure, in accordance with local emergency procedures, that supplies, food, water and equipment are available in the event power, heat and/or electricity are not available during an emergency.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 15-01-174, § 388-71-0772, filed 12/23/14, effective 1/23/15. Statutory Authority: RCW 74.04.050, 74.04.057, 74.04.200, 74.08.090, 74.09.520, and 74.39A.030. WSR 03-06-024, § 388-71-0772, filed 2/24/03, effective 7/1/03.

Wash. Admin. Code § 388-71-0774 What are the adult day centers' quality assurance plan requirements?

(1) All adult day centers must develop an annual quality improvement plan that identifies specific concerns regarding the quality of care and services to clients. The plan must also include a description of the plan of action that would address the concerns. The plan must have specific measurable objectives, designed to meet requirements of any licensing, funding sources, professional standards, or regulatory compliance.

(2) Policies and procedures for monitoring program quality and determining further action must be developed by the administrator with the advice of the multidisciplinary staff team and the advisory committee, and with the approval of the governing body and center clients and/or representatives.

(3) Quality assurance and improvement plans may include but are not limited to annual program evaluations, utilization reviews, participants' and former participants' satisfaction surveys, and sampling participant care plans to audit for assurances of meeting the WAC requirements.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 15-01-174, § 388-71-0774, filed 12/23/14, effective 1/23/15. Statutory Authority: RCW 74.04.050, 74.04.057, 74.04.200, 74.08.090, 74.09.520, and 74.39A.030. WSR 03-06-024, § 388-71-0774, filed 2/24/03, effective 7/1/03.

Wash. Admin. Code § 388-71-0776 Effective date.

WAC 388-71-0702 through 388-71-0776 is effective [July 1, 2003] [February 1, 2014].

Reviser's note: RCW 34.05.395 requires the use of underlining and deletion marks to indicate amendments to existing rules, and deems ineffectual changes not filed by the agency in this manner. The bracketed material in the above section does not appear to conform to the statutory requirement.

Wash. Admin. Code § 388-71-0836 What definitions apply to the long-term care (LTC) worker training requirements?

The following definitions apply to the LTC worker training requirements:

(1) "Activities of daily living" means self-care abilities related to personal care such as bathing, eating, using the toilet, medication assistance, dressing, and transfer. Instrumental activities of daily living may also be used to assess a person's functional abilities in the home and the community such as cooking, shopping, house cleaning, doing laundry, working, and managing personal finances.

(2) "Care team" means the client and everyone involved in the individual's care. The care team may include family, friends, doctors, nurses, LTC workers, social workers, and case managers. The role of the care team is to support the client's well-being. However, the client directs the care plan.

(3) "Challenge test" means a competency test taken for specialty training without first taking the class for which the test is designed and may only be used when basic training is not required.

(4) "Client" means an individual receiving in-home services.

(5) "Competency" means the integrated knowledge, skills, or behavior expected of a LTC worker after completing training in a required topic area. Learning objectives are associated with each competency.

(6) "Competency testing" means evaluating a student to determine if the student can demonstrate the required level of skill, knowledge, and behavior with respect to the identified learning objectives of a particular course. The department only requires competency testing for nurse delegation core and specialized diabetes training, and the specialty and expanded specialty trainings. Training programs may integrate competency testing within each programs' approved curricula.

(7) "Compliance year" means the 12-month period allowed to complete the required 12 annual hours of continuing education, whether a caregiver's compliance year be the calendar year or birthdate to birthdate, as required by their provider type.

(8) "Core basic training" means the portion of the 70-hour home care aide basic training that covers the core competencies and skills that LTC workers need in order to provide personal care services efficiently and safely. The core basic training hours also includes hours devoted to student practice and demonstration of skills.

(9) "Date of hire" for determining time frames related to training and certification, means the first day the LTC worker is employed by any employer.

(10) "DDA" refers to the developmental disabilities administration.

(11) "Direct care worker" means a paid individual who provides direct, personal care services to persons with disabilities or the elderly requiring LTC (see also the definition of LTC worker, which includes client care workers).

(12) "Department" or "DSHS" means the department of social and health services.

(13) "Enhancement" means additional time provided for skills practice and additional training materials or classroom activities that help a LTC worker to thoroughly learn the course content and skills. Enhancements can include new student materials, videos or DVDs, online materials, and additional student activities.

(14) "Expanded specialty training" means optional curricula that provide caregivers with advanced knowledge and skills related to specialty training or providing person-centered care to clients or residents living with conditions other than developmental disabilities, dementia, and mental health. The optional expanded specialty training may include such topics as traumatic brain injury, diabetes care, and bariatric care. The optional expanded specialty training curricula must be DSHS developed and based on competencies and learning objectives established by DSHS.

(15) "Guardian" means an individual as defined in chapter 11.130 RCW.

(16) "Home care aide" or "certified home care aide" means a LTC worker who has obtained and maintains a home care aide certification through the department of health.

(17) "Hybrid" means a combination of online training and in-person, remote, or virtual classroom instruction.

(18) "Individual provider" or "IP" means a LTC worker employed by the consumer directed employer to provide personal care or respite care services to persons with functional disabilities under a medicaid state plan program, such as the medicaid personal care or community first choice programs, under a federal medicaid waiver program, through the veteran directed home care (VDHC) program, or through the long-term services and supports trust (WA cares) program.

(19) "Learning objectives" means measurable, written statements that clearly describe what a LTC worker must minimally learn to meet each competency. Learning objectives are identified for each competency. Learning objectives provide consistent, common language and a framework for curriculum designers, the curriculum approval process, and testing. Curriculum developers have the flexibility to determine how learning objectives are met and may include additional content deemed necessary to best meet the competency in a particular setting.

(20) "Long-term care (LTC) worker" means:

(a) All persons who provide paid, personal care services for the elderly or persons with disabilities, including but not limited to, individual providers of home care services, direct care workers employed by home care agencies, providers of home care services to persons with developmental disabilities under Title 71A RCW, all direct care workers in state-licensed assisted living facilities, adult family homes, respite care providers, community residential service providers, and any other direct care staff who provide home or community-based services to the elderly or persons with functional disabilities or developmental disabilities.

(b) LTC workers do not include:

(i) Persons employed by the following facilities or agencies: Nursing homes subject to chapter 18.51 RCW, hospitals or other acute care settings, residential habilitation centers under chapter 71A.20 RCW, facilities certified under 42 C.F.R., Part 483, hospice agencies subject to chapter 70.127 RCW, adult day care centers; or

(ii) Persons who are not paid by the state, by a private agency, or facility licensed by the state to provide personal care services.

(21) "Online training" means a course taken through an automated, asynchronous learning management system or other technology that conforms to the online training standards posted on the DSHS website at https://bit.ly/dshs-online-standards.

(22) "Personal care services" means physical or verbal assistance with activities of daily living, or activities of daily living and instrumental activities of daily living that are provided to the client.

(23) "Professional development" for LTC workers means training related to enhancing and improving the skills and knowledge required in their current caregiving role. Information related to home care aide advancement into administrative duties may be included as part of an overall conference experience related to the current caregiving role.

(24) "Remote skills training" means training conducted in a virtual classroom environment, or online when a student either demonstrates a skill live or provides a video recorded file of themselves performing a skill that is forwarded for feedback to an approved instructor or a proctor trained by an approved instructor, or both. A training program must be approved by DSHS to provide remote skills training.

(25) "70-hour home care aide training" means the 70 hours of required training that a new LTC worker must complete within 120 days of hire. It has three components: Core competencies, practice of skills, and population specific topics, which may include specialty and nurse delegation training.

(26) "Specialty training" means curricula that meets the requirements of RCW 18.20.270 and 70.128.230 to provide basic core knowledge and skills that caregivers need to learn and understand to effectively and safely provide care to residents living with mental illness, dementia, or developmental disabilities. The specialty training curricula may be DSHS developed or DSHS approved and must be based on the competencies and learning objectives in WAC 388-112A-0430, 388-112A-0440, or 388-112A-0450.

(27) "Training entity" means an organization, including an independent contractor, who provides or may provide training under this chapter using approved curriculum. Training entities may only deliver approved curriculum.

(28) "Training partnership" means a joint partnership or trust that includes the office of the governor, and the exclusive bargaining representative of individual providers under RCW 74.39A.270 with the capacity to provide training, peer mentoring, and workforce development, or other services to individual providers.

(29) "Virtual classroom" means a synchronous, instructor-led, remote learning environment conducted in real time that conforms to the virtual classroom standards posted on the DSHS website at https://bit.ly/dshs-online-standards. A training program must be approved by DSHS to provide virtual classroom instruction.

History

Statutory Authority: RCW 74.08.090, 74.39A.009, 74.39A.070, 74.39A.074, 74.39A.076, 74.39A.341, 18.88B.010, 18.88B.021, and 18.88B.041. WSR 26-08-045, s 388-71-0836, filed 3/25/26, effective 4/25/26
WSR 25-16-084, s 388-71-0836, filed 8/5/25, effective 10/1/25. Statutory Authority: RCW 18.88B.021, 18.88B.041, 18.88B.060, 74.08.090, 74.39A.076, and 74.39A.341. WSR 24-05-003, § 388-71-0836, filed 2/8/24, effective 3/10/24. Statutory Authority: RCW 74.08.090, 74.39A.070, 74.39A.074, 18.20.270, and 70.128.230. WSR 22-10-024, § 388-71-0836, filed 4/25/22, effective 5/26/22. Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-71-0836, filed 8/30/21, effective 10/1/21. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-0836, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-0837 How does DSHS determine a long-term care worker's date of hire and when may a long-term care worker be eligible to have the date of hire reset?

(1) The department determines a long-term care worker's date of hire according to the first day the long-term care worker is employed by any employer.

(2) The date of hire is specific to each long-term care worker. A long-term care worker, including an individual or agency provider who has worked as a long-term care worker in the past, but who did not complete the training or certification that was required at the time, and a worker who is not currently certified or eligible to reactivate an expired credential, shall receive a new date of hire when beginning work with either a new employer or returning to a former employer after prior employment has ended.

(3) This section does not apply to background check requirements under this chapter.

History

Statutory Authority: RCW 18.88B.021, 18.88B.041, 18.88B.060, 74.08.090, 74.39A.076, and 74.39A.341. WSR 24-05-003, § 388-71-0837, filed 2/8/24, effective 3/10/24. Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-0837, filed 12/9/22, effective 1/9/23. Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-71-0837, filed 8/30/21, effective 10/1/21.

Wash. Admin. Code § 388-71-0839 Which long-term care workers (LTC) are exempt from the 70-hour, 30-hour, 16-hour, nine-hour, or seven-hour basic training requirements?

The following LTC workers are exempt from the 70-hour, 30-hour, 16-hour, nine-hour, or seven-hour basic training requirement:

(1) An individual employed as a LTC worker on January 6, 2012, who complied with the basic training requirements in effect on the date of hire;

(2) An individual previously employed as a LTC worker who completed the basic training requirements in effect on the date of hire, and was employed as a LTC worker at some point between January 1, 2011, and January 6, 2012;

(3) Registered nurses, licensed practical nurses, and advanced registered nurse practitioners licensed under chapter 18.79 or 18.80 RCW;

(4) Nursing assistants certified under chapter 18.88A RCW and persons in an approved training program for certified nursing assistants under chapter 18.88A RCW provided that they complete the training program within 120 days of the date of hire and the department of health has issued a nursing assistant certified credential within 200 days of the date of hire;

(5) A home health aide who was employed by a medicare certified home health agency within the year before being hired as a LTC worker and has met the requirements of 42 C.F.R., Sec. 484.36;

(6) An individual with special education training who has an endorsement granted by the Washington state superintendent of public instruction as described in RCW 28A.300.010; and

(7) A home care aide (HCA) certified under chapter 18.88B RCW.

History

Statutory Authority: RCW 74.08.090, 74.39A.009, 74.39A.070, 74.39A.074, 74.39A.076, 74.39A.341, 18.88B.010, 18.88B.021, and 18.88B.041. WSR 26-08-045, s 388-71-0839, filed 3/25/26, effective 4/25/26. Statutory Authority: RCW 18.88B.010, 18.88B.041, 74.08.090, 74.39A.076, 74.39A.341, and chapter 18.80 RCW. WSR 25-07-033, s 388-71-0839, filed 3/11/25, effective 4/11/25. Statutory Authority: RCW 18.88B.021, 18.88B.041, 18.88B.060, 74.08.090, 74.39A.076, and 74.39A.341. WSR 24-05-003, § 388-71-0839, filed 2/8/24, effective 3/10/24. Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-0839, filed 12/9/22, effective 1/9/23. Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-71-0839, filed 8/30/21, effective 10/1/21. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-0839, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-0841 What is orientation training, who should complete it, and when should it be completed?

(1) Long-term care worker orientation is two hours of orientation training regarding the long-term care worker's role and the applicable terms of employment. Individuals required to complete the 70-hour home care aide basic training must complete long-term care worker orientation before providing care to a client.

(2) Long-term care worker orientation training, unless taken through a department approved online training program, must be provided by qualified instructors who meet the requirements of WAC 388-71-1060.

(3) The department must approve orientation curricula and instructors.

(4) There is no competency test for long-term care worker orientation.

History

Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-0841, filed 12/9/22, effective 1/9/23. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-0841, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-0846 What content must be included in long-term care worker orientation?

(1) For long-term care worker orientation required of those individuals identified in WAC 388-71-0860, long-term care worker orientation is a two hour training that must include introductory information in the following areas:

(a) The care setting and the characteristics and special needs of the population served;

(b) Basic job responsibilities and performance expectations;

(d) The care team;

(e) Process, policies, and procedures for observation, documentation, and reporting;

(f) Resident rights protected by law, including the right to confidentiality and the right to participate in care decisions or to refuse care and how the long-term care worker will protect and promote these rights;

(g) Mandatory reporter law and worker responsibilities as required under chapter 74.34 RCW; and

(h) Communication methods and techniques that may be used while working with a resident or guardian and other care team members.

(2) One hour of completed classroom instruction or other form of training (such as a video or online course) in long-term care orientation training equals one hour of training. The training entity must establish a way for the long-term care worker to receive feedback from an approved instructor or a proctor trained by an approved instructor.

History

Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-0846, filed 12/9/22, effective 1/9/23. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-0846, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-0850 What is safety training, who must complete it, and when should it be completed?

(1) Safety training is part of the long-term care worker requirements. It is a three-hour training that must meet the requirements as described in WAC 388-71-0855, and includes basic safety precautions, emergency procedures, and infection control. Safety training must be completed prior to providing care to the client.

(2) All long-term care workers who are not exempt from home care aide certification as described in RCW 18.88B.041 hired after January 7, 2012, must complete three hours of safety training. This safety training must be provided by qualified instructors who meet the requirements in WAC 388-71-1060.

(3) The department must approve safety training curricula and instructors.

(4) There is no competency test for safety training.

History

Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-0850, filed 12/9/22, effective 1/9/23. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-0850, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-0855 What content must be included in safety training?

Safety training consists of introductory information in the following areas:

(1) Safety planning and accident prevention, including but not limited to:

(a) Proper body mechanics;

(b) Fall prevention;

(d) In-home hazards;

(e) Long-term care worker safety; and

(f) Emergency and disaster preparedness.

(2) Standard precautions and infection control, including but not limited to:

(a) Proper hand washing;

(b) When to wear gloves and how to correctly put them on and take them off;

(d) Protection from exposure to blood and other body fluids;

(e) Appropriate disposal of contaminated/hazardous articles;

(f) Reporting exposure to contaminated articles; and

(g) What to do when sick or injured, including whom to report this to.

(3) Basic emergency procedures, including but not limited to:

(a) Evacuation preparedness;

(b) When and where to call for help in an emergency;

(d) Location of any advanced directivesif available; and

(e) Basic fire emergency procedures.

(4) One hour of completed classroom instruction or other form of training (such as video or online course) equals one hour of training. The training entity must establish a way for the long-term care worker to receive feedback from an approved instructor or a proctor trained by an approved instructor.

History

Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-0855, filed 12/9/22, effective 1/9/23. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-0855, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-0860 Who must complete orientation and safety, by when, and when does an orientation and safety training attestation process need to be completed?

Unless exempted in WAC 388-71-0839, all long-term care workers must complete orientation and safety training prior to providing care to a client.

History

Statutory Authority: RCW 74.08.090, 74.39A.009, 74.39A.070, 74.39A.074, 74.39A.076, 74.39A.341, 18.88B.010, 18.88B.021, and 18.88B.041. WSR 26-08-045, s 388-71-0860, filed 3/25/26, effective 4/25/26. Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-0860, filed 12/9/22, effective 1/9/23. Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-71-0860, filed 8/30/21, effective 10/1/21. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-0860, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-0870 What is the 70-hour home care aide basic training?

(1) The 70-hour home care aide basic training is in addition to orientation and safety training. It is 70 hours and includes:

(a) The core competencies and skills that long-term care workers need in order to provide personal care services effectively and safely;

(b) Practice and demonstration of skills; and

(2) DSHS must approve the 70-hour home care aide basic training curricula.

(3) On-the-job training, as described in WAC 388-71-0932, may be applied to the 70-hour home care aide basic training for an amount that must be approved by the department.

(4) The DSHS developed fundamentals of caregiving (FOC) or another department approved training may be used to teach core basic training but the FOC must include enhancements. Additional student materials are required to ensure the enhancements are well planned and documented for students. Materials must be submitted for approval and approved per WAC 388-71-1026. Examples of enhancements include, but are not limited to:

(a) More time for workers to practice skills including:

(i) The mechanics of completing the skill correctly;

(ii) Client centered communication and problem solving associated with performing the skill;

(iii) The different levels of care required for each skill including independent, supervision, limited, extensive, and total;

(iv) Working with assistive devices associated with a skill.

(v) Helpful tips or best practices in working through common client challenges associated with a skill; and

(vi) Disease specific concerns or challenges associated with a skill.

(b) Augmenting or adding additional materials, student activities, videos, or guest speakers that:

(i) More deeply reinforce and fortify the learning outcomes required for basic training;

(ii) Ensure each student integrates and retains the knowledge and skills needed to provide quality basic personal care; and

(iii) Prepares workers for the certification testing environment and process.

(i) Are out of the scope of practice for a long-term care worker such as content clearly written for registered nurses;

(ii) Are identical to, or a direct replacement of, those already included in FOC;

(iii) Fail to reinforce Washington state laws associated with client rights and client directed care;

(iv) Long-term care workers are not paid to provide; and

(v) Are written above a high school reading level.

(5) The delivery mode of the 70-hour home care aide basic training may be either in-person or virtual classroom instruction, or a hybrid of online and in-person, remote, or virtual classroom instruction. One hour of completed classroom instruction or other form of training (such as virtual classroom, remote, or online course) equals one hour of training.

(a) Online and virtual classroom modules must be interactive, provide the student with access to the instructor, and adhere to the DSHS online and virtual classroom standards posted on DSHS's website https://bit.ly/dshs-online-standards.

(b) The in-person skills training or remote skills training portion of hybrid modules must be no less than 16 hours of the total basic training hours and include in-person or remote instruction on the personal care tasks supporting activities of daily living as described in WAC 388-71-0911.

(6) The long-term care worker must be able to ask the instructor questions during the training.

(7) There is no challenge test for the 70-hour home care aide basic training.

History

Statutory Authority: RCW 74.08.090, 74.39A.070, 74.39A.074, 18.20.270, and 70.128.230. WSR 22-10-024, § 388-71-0870, filed 4/25/22, effective 5/26/22. Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-71-0870, filed 8/30/21, effective 10/1/21. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-0870, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-0873 What are the minimum requirements for training programs to provide remote skills training?

(1) A training program offering remote skills training must meet the following minimum requirements:

(a) Provide students with:

(i) The opportunity to practice, review, and receive coaching for every skill;

(ii) Virtual classroom demonstrations or videos of each skill;

(iii) Access to all supplies and materials required for practice;

(iv) Reasonable alternatives for skills when a live partner would not be safe or practical;

(v) Clearly outlined student performance guidelines for each skill that provide definitions for the levels of performance, such as:

(A) Excellent – Exceeds expectations;

(B) Satisfactory – Meets expectations;

(D) Potential for harm – Fails to meet expectations.

(vi) The opportunity to receive individualized feedback on every skill within seven business days unless other mutual arrangements are made;

(vii) The ability to receive instructional support through multiple formats such as by phone, chat, text, or email, or using the technology provided through a learning management system;

(viii) Equal access to knowledge acquisition through such methods as providing materials in multiple formats, allowing access through different devices, and providing learner-centered approaches for individual situations;

(ix) Accessible instructions for all technology skills required;

(x) Technical support for any technology that students need to access the training;

(xi) The ability to communicate with an instructor, peer mentor, or basic support team in real time to answer questions scheduled with varying hours to accommodate students who may work different shifts;

(xii) Downloadable and printable step-by-step guides for each skill taught.

(b) Include scheduled, flexible opportunities for students to access support during which a student may ask questions and have skills demonstrated.

(c) Support knowledge acquisition of skills equitably using methods designed to accommodate the needs of diverse learning styles and the use of various devices; and

(d) Provide reasonable accommodations to students upon request.

(2) If a student fails to attain a satisfactory skill level for any skill through remote training, the training program will provide opportunities for remediation or additional practice for the skill.

(3) A training program must be approved by DSHS to provide remote skills training. Initial approval shall be provisional for one year during which a training program will be required to:

(a) Confer with DSHS training quality assurance staff no less than quarterly;

(b) Allow DSHS training quality assurance staff access to any materials, processes, training sessions, and documentation when requested; and

(c) Track student certificates of completion and monitor pass/fail data to the extent feasible for all students trained remotely and provide that data to DSHS when requested.

(4) Renewal of approval to provide remote skills training after the one-year provisional period shall be conditional upon a training program's:

(a) Adherence to the standards outlined in this section; and

(b) Satisfactory demonstration, to the extent feasible, that the training program's pass/fail rate for students trained remotely meets or exceeds the statewide average pass/rate for students trained in person.

(5) If data for renewal is insufficient to determine an accurate pass/fail rate, the department may renew provisional certification for an additional year.

History

Statutory Authority: RCW 74.08.090, 74.39A.070, 74.39A.074, 18.20.270, and 70.128.230. WSR 22-10-024, § 388-71-0873, filed 4/25/22, effective 5/26/22.

Wash. Admin. Code § 388-71-0875 Who must complete the 70-hour basic training and by when?

Unless exempt from training in WAC 388-71-0839(1) through (7), long-term care workers required to complete the 70-hour basic training must complete core and population specific competencies within 120 days of the date of hire as described in WAC 388-71-0837.

History

Statutory Authority: RCW 18.88B.010, 18.88B.041, 74.08.090, 74.39A.076, 74.39A.341, and chapter 18.80 RCW. WSR 25-07-033, s 388-71-0875, filed 3/11/25, effective 4/11/25. Statutory Authority: RCW 18.88B.021, 18.88B.041, 18.88B.060, 74.08.090, 74.39A.076, and 74.39A.341. WSR 24-05-003, § 388-71-0875, filed 2/8/24, effective 3/10/24. Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-0875, filed 12/9/22, effective 1/9/23. Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-71-0875, filed 8/30/21, effective 10/1/21. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-0875, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-0880 Who must complete the 30-hour basic training and by when must it be completed?

Unless exempt from the basic training requirements under WAC 388-71-0839, the following individuals must complete the 30-hour basic training under WAC 388-71-0885 within 120 days of the date of hire as described in WAC 388-71-0837:

(1) A long-term care worker who only cares for the worker's child, parent (not covered in WAC 388-71-0890), sibling, aunt, uncle, cousin, niece, nephew, grandparent, or grandchild, including when related by marriage or domestic partnership;

(2) Through June 30, 2026, a long-term care worker providing approved services only for a spouse or registered domestic partner and funded through the United States department of veterans' affairs home and community-based programs; or

(3) A long-term care worker, working as an individual provider, who provides no more than 20 hours of nonrespite care per month, for one person who is not the individual provider's:

(a) Spouse or domestic partner.

(b) Child, parent, sibling, aunt, uncle, cousin, niece, nephew, grandparent, or grandchild, or such relatives when related by marriage or domestic partnership.

History

Statutory Authority: RCW 74.08.090, 74.39A.009, 74.39A.070, 74.39A.074, 74.39A.076, 74.39A.341, 18.88B.010, 18.88B.021, and 18.88B.041. WSR 26-08-045, s 388-71-0880, filed 3/25/26, effective 4/25/26. Statutory Authority: RCW 18.88B.010, 18.88B.041, 74.08.090, 74.39A.076, 74.39A.341, and chapter 18.80 RCW. WSR 25-07-033, s 388-71-0880, filed 3/11/25, effective 4/11/25. Statutory Authority: RCW 18.88B.021, 18.88B.041, 18.88B.060, 74.08.090, 74.39A.076, and 74.39A.341. WSR 24-05-003, § 388-71-0880, filed 2/8/24, effective 3/10/24. Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-71-0880, filed 8/30/21, effective 10/1/21. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-0880, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-0885 What is the thirty hour training?

The thirty hour training is a subset of the seventy hour basic training that must include core and population specific basic training. Topics completed in the subset must be on topics relevant to the care needs of the client(s). There is no challenge test for the thirty hour training.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-0885, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-0888 When do the 70-hour basic training and certification requirements apply to an individual whose required basic training was previously less than 70 hours?

(1) The following long-term care (LTC) workers must complete 70 hours of basic training and become a certified home care aide under WAC 388-71-0523:

(a) An individual provider (IP) who previously provided no more than 20 hours of nonrespite care in any calendar month for one unrelated client and who:

(i) Continues to work for one unrelated client whose authorized monthly hours fluctuate above 20 hours per month; or

(ii) Begins to work for a second client.

(b) A LTC worker (working only as an individual provider) who provides respite services and worked more than 300 respite hours in any calendar year;

(c) A LTC worker (working only as an individual provider) who begins working for an unrelated client who previously only provided personal care to the provider's:

(i) Child, parent, sibling, aunt, uncle, cousin, niece, nephew, grandparent, or grandchild, including when related by marriage or domestic partnership; or

(ii) Spouse or registered domestic partner.

(2) When a LTC worker (providing in-home care) described in subsection (1) of this section is required to complete the 70-hour basic training and become a certified home care aide, the LTC worker will:

(a) Have 120 days from the date of the change to complete the 70-hour basic training and 365 days from the date of the change to become certified as a home care aide; and

(b) Be required to complete continuing education under WAC 388-71-0991.

(3) For the purpose of this section, the date of the change means the date on which the LTC worker:

(a) Began working for a client that is not the individual's:

(i) Child, parent, sibling, aunt, uncle, cousin, niece, nephew, grandparent, or grandchild, including when related by marriage or domestic partnership; or

(ii) Spouse or registered domestic partner.

(b) Exceeded 20 hours of work in one month; or

(4) If a LTC worker is required to or chooses to become a certified home care aide and completes the 70-hour basic training requirements under this section, the individual will be required to continue to comply with the requirement to maintain the credential and complete continuing education requirements even if:

(a) The monthly authorized hours are later reduced to 20 or fewer hours;

(b) The individual no longer works for more than one unrelated client; or

(5) The training and certification requirements for an individual that met the criteria in subsection (4) of this section do not apply if the individual returns to work only for the individual's:

(a) Parent, adult child, sibling, aunt, uncle, cousin, niece, nephew, grandparent, or grandchild, including when related by marriage or domestic partnership; or

(b) Spouse or registered domestic partner.

History

Statutory Authority: RCW 74.08.090, 74.39A.009, 74.39A.070, 74.39A.074, 74.39A.076, 74.39A.341, 18.88B.010, 18.88B.021, and 18.88B.041. WSR 26-08-045, s 388-71-0888, filed 3/25/26, effective 4/25/26. Statutory Authority: RCW 18.88B.010, 18.88B.041, 74.08.090, 74.39A.076, 74.39A.341, and chapter 18.80 RCW. WSR 25-07-033, s 388-71-0888, filed 3/11/25, effective 4/11/25. Statutory Authority: RCW 18.88B.021, 18.88B.041, 18.88B.060, 74.08.090, 74.39A.076, and 74.39A.341. WSR 24-05-003, § 388-71-0888, filed 2/8/24, effective 3/10/24. Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-71-0888, filed 8/30/21, effective 10/1/21. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-0888, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-0890 What are the training requirements for parent providers who are long-term care (LTC) workers for their developmentally disabled adult child receiving services under Title 71A RCW?

Unless exempt from the basic training requirements as defined in WAC 388-71-0839, a parent, including when related by marriage or domestic partnership, who is the LTC worker providing in-home care only for the provider's developmentally disabled adult child receiving services under Title 71A RCW must complete the 12-hour parent provider training, as described in WAC 388-71-0895, within 120 days from the begin date of the authorization to provide department paid, in-home services.

History

Statutory Authority: RCW 74.08.090, 74.39A.009, 74.39A.070, 74.39A.074, 74.39A.076, 74.39A.341, 18.88B.010, 18.88B.021, and 18.88B.041. WSR 26-08-045, s 388-71-0890, filed 3/25/26, effective 4/25/26. Statutory Authority: RCW 18.88B.010, 18.88B.041, 74.08.090, 74.39A.076, 74.39A.341, and chapter 18.80 RCW. WSR 25-07-033, s 388-71-0890, filed 3/11/25, effective 4/11/25. Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-71-0890, filed 8/30/21, effective 10/1/21. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-0890, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-0893 Who must complete the nine-hour basic training and by when must it be completed?

(1) Unless exempt from the basic training requirements under WAC 388-71-0839, a long-term care (LTC) worker working as an individual provider must complete orientation and safety training and nine hours of training within 120 days of the date of hire as described in WAC 388-71-0837 if the provider meets the following criteria:

(a) Provides respite services for individuals with developmental disabilities receiving services under Title 71A RCW; and

(b) Works 300 hours or less (of respite) in a calendar year.

(2) The individual must complete the orientation and safety training before providing care.

(3) The training partnership identified in RCW 74.39A.360 must offer at least 12 of the 14 total hours online and five of these online hours must be individually selected from elective courses.

(4) An individual must complete the nine hours basic training required under this section within 120 days of the LTC worker's date of hire.

History

Statutory Authority: RCW 74.08.090, 74.39A.009, 74.39A.070, 74.39A.074, 74.39A.076, 74.39A.341, 18.88B.010, 18.88B.021, and 18.88B.041. WSR 26-08-045, s 388-71-0893, filed 3/25/26, effective 4/25/26. Statutory Authority: RCW 18.88B.021, 18.88B.041, 18.88B.060, 74.08.090, 74.39A.076, and 74.39A.341. WSR 24-05-003, § 388-71-0893, filed 2/8/24, effective 3/10/24. Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-71-0893, filed 8/30/21, effective 10/1/21.

Wash. Admin. Code § 388-71-0895 What is the twelve hour parent provider training?

(1) The twelve hour parent provider training must include five hours of orientation and safety training as described in WAC 388-71-0841 and 388-71-0850. The remaining seven hours will cover the following topics:

(a) Medicaid personal care;

(b) Assessments completed by the division of developmental disabilities;

(d) State and federal benefits;

(f) Networking; and

(g) Client self-determination.

(2) There is no challenge test for this training.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-0895, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-0897 Who must complete the 21-hour basic training and by when must it be completed?

Effective July 1, 2026, a spouse or registered domestic partner who is a long-term care worker only for a spouse or domestic partner must complete 21 hours of basic training.

History

Statutory Authority: RCW 74.08.090, 74.39A.009, 74.39A.070, 74.39A.074, 74.39A.076, 74.39A.341, 18.88B.010, 18.88B.021, and 18.88B.041. WSR 26-08-045, s 388-71-0897, filed 3/25/26, effective 4/25/26.

Wash. Admin. Code § 388-71-0899 What is the 21-hour basic training?

The 21-hours of basic training must include:

(1) Five hours of orientation and safety training to be completed prior to providing care;

(2) Ten hours of basic training taken from WAC 388-71-0906; and

(3) At least six hours of additional focused training based on the care-receiving spouse's or partner's needs and selected by the caregiver, to be chosen from DSHS approved courses.

History

Statutory Authority: RCW 74.08.090, 74.39A.009, 74.39A.070, 74.39A.074, 74.39A.076, 74.39A.341, 18.88B.010, 18.88B.021, and 18.88B.041. WSR 26-08-045, s 388-71-0899, filed 3/25/26, effective 4/25/26.

Wash. Admin. Code § 388-71-0906 What topics must be taught in the core competencies of the 70-hour home care aide basic training?

Basic training must include all of the competencies under WAC 388-71-0911 for the following topics:

(1) Communication skills;

(2) Long-term care worker self-care;

(3) Problem solving;

(4) Client rights and maintaining dignity;

(5) Abuse, abandonment, neglect, financial exploitation, and mandatory reporting;

(6) Client directed care;

(7) Cultural sensitivity;

(8) Body mechanics;

(9) Fall prevention;

(10) Skin and body care;

(11) Long-term care worker roles and boundaries;

(12) Supporting activities of daily living;

(13) Food preparation and handling;

(14) Medication assistance;

(15) Infection control and bloodborne pathogens; and

(16) Grief and loss.

History

Statutory Authority: RCW 70.128.230, 74.39A.009, 74.39A.070, and 74.39A.074. WSR 24-01-134, § 388-71-0906, filed 12/19/23, effective 1/19/24. Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-0906, filed 12/9/22, effective 1/9/23. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-0906, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-0911 What are the core competencies and learning objectives for the 70-hour home care aide basic training?

Home care aide basic training includes core competencies that describe the behavior and skills that a long-term care worker must exhibit when working with clients and the learning objectives associated with each competency as follows:

(1) Communicate effectively and in a respectful and appropriate manner with clients, family members, and care team members:

(a) Recognize how verbal and nonverbal cues impact communication with the client and care team;

(b) Engage and respect the client through verbal and nonverbal communication;

(d) Recognize and acknowledge clients' communication including indicators of pain, confusion, or misunderstanding;

(e) Utilize communication strategies to deal with difficult situations; and

(f) Recognize common barriers to effective communication and identify how to eliminate them.

(2) Regarding long-term care worker self-care:

(a) Identify behaviors, practices, and resources to reduce stress and avoid burnout;

(b) Recognize common barriers to self-care and ways to overcome them; and

(c) Recognize aspects of a long-term care worker's job that can lead to stress and burnout, common signs and symptoms of stress and burnout, and the importance of taking action to practice self-care to avoid burnout.

(3) Regarding the competency of effective problem solving, use effective problem solving skills to:

(a) Explain why it is necessary to understand and utilize a problem solving method;

(b) Implement a problem solving process/method; and

(4) Regarding the competency of client rights and dignity, take appropriate action to promote and protect a client's legal and human rights as protected by federal and Washington state laws including:

(a) Protect a client's confidentiality, including what is considered confidential information, to whom a long-term care worker is allowed or not allowed to give confidential information, and how to respond if a non-care team member asks for confidential information;

(b) Promote client's dignity and privacy, and encourage, and support a client's maximum independence when providing care;

(c) Maintain a restraint-free environment, including physical, chemical, and environmental restraints. Use common, safe alternatives to restraint use; and

(d) Protect and promote the client's right to live free of abuse, neglect, abandonment, and financial exploitation.

(5) Regarding the competency of recognizing indicators of abuse and understanding the mandatory reporting requirements, recognize the signs of abuse and report suspected abuse, abandonment, neglect, and financial exploitation:

(a) Describe long-term care worker's responsibilities as a mandatory reporter as defined in RCW 74.34.020 through 74.34.053; and

(b) Identify common indications of abuse, abandonment, neglect, and financial exploitation.

(6) Regarding the competency of client directed care, take appropriate action when following a client's direction regarding care:

(a) Describe a long-term care worker's role in client directed care including determining, understanding, and supporting a client's choices;

(b) Describe the importance and impact of client directed care on a client's independence, self-determination, and quality of life;

(d) Report concerns when a client refuses care or makes choices that present a possible safety concern.

(7) Regarding the competency of cultural sensitivity, provide culturally appropriate care:

(a) Describe how cultural background, lifestyle practices, and traditions can impact care; and

(b) Use methods to determine and ensure that these are respected and considered when providing care.

(8) Regarding the competency of body mechanics, utilize current best practices and evidence-based methods of proper body mechanics while performing tasks as outlined in the care plan.

(9) Regarding the competency on fall prevention:

(a) Identify fall risk factors and take action to reduce fall risks for a client; and

(b) Take proper steps to assist when a client is falling or has fallen.

(10) Regarding the competency of skin and body care, use personal care practices that promote and maintain skin integrity:

(a) Explain the importance of observing a client's skin, when to observe it, and what to look for including common signs and symptoms of skin breakdown;

(b) Identify risk factors of skin breakdown;

(d) Describe what a pressure ulcer is, what it looks like, and what actions to take if a client appears to be developing or develops a pressure ulcer;

(e) Describe current best practices that protect and maintain a client's skin integrity including position changes when sitting or lying for extended periods, and proper positioning and transfer techniques;

(f) Implement current best practices that promote healthy skin including hygiene, nutrition, hydration, and mobility; and

(g) Identify when to report skin changes and who to report them to.

(11) Regarding the competency on long-term care worker roles and boundaries, adhere to basic job standards, expectations, and requirements and maintain professional boundaries:

(a) Identify when, how, and why to obtain information from appropriate sources about a client's condition or disease for which they are receiving services, and describe how to use this information to provide appropriate, individualized care;

(b) Describe a client's baseline based on information provided in the care plan and explain why it is important to know a client's baseline;

(d) Report changes from baseline and concerns to the appropriate care team member(s);

(e) Identify basic job standards and requirements (such as coming to work on time) and describe how maintaining these standards are critical to a client's safety and well-being;

(f) Explain the purpose of a care plan and describe how it is created, used, and modified;

(g) Use a client's care plan to direct a long-term care worker's job tasks and any client directed care tasks;

(h) Identify what is required of a long-term care worker, as described in WAC 388-71-0946, prior to performing a nurse-delegated task;

(i) Describe the role of a care team and a long-term care worker's role in the care team;

(j) Describe professional boundaries and the importance of maintaining them; and

(k) Identify signs of unhealthy professional boundaries, barriers to keeping clear professional boundaries, and ways to avoid or eliminate them.

(12) Regarding the competency on supporting activities of daily living, perform required personal care tasks to the level of assistance needed and according to current best practices and evidence-based guidelines:

(a) Demonstrate, in the presence of a qualified instructor, all critical steps required for personal care tasks including but not limited to:

(i) Helping an individual walk;

(ii) Transferring an individual from bed to wheelchair;

(iii) Turning and repositioning an individual in bed;

(iv) Providing oral care;

(v) Cleaning and storing dentures;

(vi) Shaving a face;

(vii) Providing fingernail care;

(viii) Providing foot care;

(ix) Providing a bed bath;

(x) Assisting an individual with a weak arm to dress;

(xi) Putting knee-high elastic stockings on an individual;

(xii) Providing passive range of motion for one shoulder;

(xiii) Providing passive range of motion for one knee and ankle;

(xiv) Assisting an individual to eat;

(xv) Assisting with peri-care;

(xvi) Assisting with the use of a bedpan;

(xvii) Assisting with catheter care;

(xviii) Assisting with condom catheter care; and

(xix) Providing medication assistance;

(b) In the process of performing the personal care tasks, use proper body mechanics, listen attentively, speak clearly and respectfully while explaining what the long-term care worker is doing, incorporate client preferences, maintain privacy and dignity, support the client's level of ability, and assure the client's comfort and safety;

(d) Describe any safety concerns related to each task and how to address the concerns;

(e) Demonstrate an understanding of bowel and bladder functioning, including factors that promote healthy bowel and bladder functioning, and the signs, symptoms, and common causes of abnormal bowel and bladder function; and

(f) Identify the importance of knowing a client's bowel and bladder functioning baseline and when to report changes.

(13) Regarding the competency on food preparation and handling, plan and prepare meals using a basic knowledge of nutrition and hydration, incorporating any diet restrictions or modifications, and prevent food borne illness by preparing and handling food in a safe manner:

(a) Describe how nutrition and hydration can impact a client's health;

(b) Plan, shop, and prepare meals for a client according to the guidelines of good nutrition and hydration, incorporating any dietary requirements and restrictions from the care plan and client preferences;

(d) Understand that diet modification is required for certain health conditions, including dysphagia, and describe how to identify diet modifications required for a client;

(e) Recognize when a client's food choices vary from specifications on the care plan, describe when to report concerns and who to report them to;

(f) Describe what causes food borne illness, the risks associated with food borne illness and examples of potentially hazardous foods;

(g) Describe appropriate food handling practices, including:

(i) Avoiding cross contamination from one food to another;

(ii) Safe storage requirements for cooling of leftover foods, including:

(A) Depth;

(B) Types of containers and temperatures;

(D) Safe food storage and holding temperatures for both cold and hot foods;

(iii) Best practices for thawing and re-heating food; and

(iv) Using clean gloves (if possible), and clean utensils when preparing food;

(h) Describe the importance and correct procedure for cleaning and disinfecting food contact surfaces; and

(i) Describe why a long-term care worker with certain types of illnesses, symptoms, or both must not prepare food.

(14) Regarding the competency of medication assistance, appropriately assist with medications:

(a) Identify what a long-term care worker is allowed and not allowed to do when assisting with medications;

(b) Define terms related to medication assistance including prescription drugs, over the counter medications, and as needed (PRN) medications, medication side effects, and drug interactions;

(d) Store medications according to safe practices and the label instructions;

(e) Describe, in the proper sequence, each of the five rights of medication assistance; and

(f) Identify what to do for medication-related concerns, including describing ways to work with a client who refuses to take medications, identifying when and to whom to report when a client refuses medication or there are other medication-related concerns, and identifying what is considered a medication error, when to report a medication error, and who to report it to.

(15) Regarding the competency of infection control and bloodborne pathogens, implement best practices to prevent and control the spread of infections:

(a) Identify commonly occurring infections, ways that infections are spread, and symptoms of infections;

(b) Describe the purpose, benefit, and proper implementation of standard precautions in infection control;

(c) Implement current best practices for controlling the spread of infection, including the use of hand washing and gloves;

(d) Demonstrate proper hand washing and putting on and taking off gloves;

(e) Identify immunizations that are recommended for adults to reduce the spread of virus and bacteria;

(f) Describe laundry and housekeeping measures that help in controlling the spread of infection;

(g) Describe proper use of cleaning agents that destroy micro-organisms on surfaces;

(h) Describe what bloodborne (BB) pathogens are and how they are transmitted;

(i) Identify the major BB pathogens, diseases, and high-risk behaviors for BB diseases;

(j) Identify measures to take to prevent BB diseases;

(k) Describe what to do if exposed to BB pathogens and how to report an exposure; and

(l) Explain the importance of emotional issues and support for clients and long-term care workers.

(16) Regarding the competency on grief and loss, support yourself and the client in the grieving process:

(a) Define grief and loss;

(b) Describe common losses a client and long-term care worker may experience;

(d) Describe why self-care is important during the grieving process; and

(e) Identify beneficial ways and resources to work through feelings of grief and loss.

(17) Long-term care workers who complete DSHS approved basic training meet the training requirements for adult family homes in RCW 70.128.250.

(18) Regarding the competency on identifying indicators of hearing loss, which may be part of the basic training or population specific hours:

(a) Identify common symptoms associated with hearing loss; and

(b) Identify what to do for hearing loss related concerns, including describing ways to communicate with a client who is experiencing hearing loss and identifying when and to whom to report when a client's hearing ability changes.

History

Statutory Authority: RCW 70.128.230, 74.39A.009, 74.39A.070, and 74.39A.074. WSR 24-01-134, § 388-71-0911, filed 12/19/23, effective 1/19/24. Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-0911, filed 12/9/22, effective 1/9/23. Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-71-0911, filed 8/30/21, effective 10/1/21. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-0911, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-0916 What is the population specific component of the 70-hour home care aide training and what required training may be used as population specific training?

(1) Population specific basic training is training on topics unique to the care needs of the population that the home or provider serves. Topics may include but are not limited to:

(a) Dementia;

(b) Mental health;

(d) Young adults with physical disabilities; and

(e) Aging and older adults.

(2) Population specific classes may include but are not limited to:

(a) DSHS developed or approved specialty training, such as:

(i) Dementia specialty training;

(ii) Mental health specialty training; and

(iii) Developmental disabilities specialty training.

(b) DSHS developed or approved curriculum on population specific topics, such as:

(i) Traumatic brain injury, surviving and thriving; and

(ii) Navigating challenging behaviors.

History

Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-0916, filed 12/9/22, effective 1/9/23. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-0916, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-0932 What is on-the-job training?

(1) Effective July 1, 2012, on-the-job training is a method of training where the long-term care worker successfully demonstrates in the 70-hour home care aide basic training, the core competencies for personal care or infection control skills while working with a client on the job, instead of in a practice training setting.

(2) A qualified instructor as described in WAC 388-71-1055, provides on-the-job training and directly observes, coaches, and reinforces skills training for up to two long-term care workers at a time. The qualified instructor who provides the on-the-job training:

(a) Need not be the instructor who taught the core competency training; and

(b) May be the immediate supervisor in a home care agency of the long-term care worker receiving this training.

(3) The person who oversees on-the-job training must:

(a) Submit DSHS required forms and become an approved instructor for the core competency of basic training;

(b) Verify on a DSHS approved skills checklist or other department approved form, the long-term care worker's successful completion of the demonstrated skills; and

(4) The department must approve the number of on-the-job hours included in the 70-hour home care aide basic training.

History

Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-0932, filed 12/9/22, effective 1/9/23. Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-71-0932, filed 8/30/21, effective 10/1/21. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-0932, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-0936 What is nurse delegation core training?

(1) Nurse delegation core training is required before certified or registered nursing assistants or certified home care aides being may be delegated a nursing task.

(2) DSHS approves instructors for nurse delegation core training.

History

Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-0936, filed 12/9/22, effective 1/9/23. Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-71-0936, filed 8/30/21, effective 10/1/21. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-0936, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-0941 What is nurse delegation specialized diabetes training?

(1) Nurse delegation specialized diabetes training is the required course for nursing assistants, certified or registered, and certified home care aides who will be delegated the task of insulin injections.

(2) DSHS approves the instructors for the nurse delegation specialized diabetes training.

History

Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-0941, filed 12/9/22, effective 1/9/23. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-0941, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-0946 Who is required to complete the nurse delegation core training and nurse delegation specialized focus on diabetes training and by when?

(1) Before performing any delegated nursing task, long-term care workers must:

(a) Successfully complete the DSHS designated nurse delegation core training, "nurse delegation for nursing assistants & home care aides";

(b) Be one or more of the following:

(i) Certified home care aide under chapter 18.88B RCW;

(ii) Nursing assistant certified under chapter 18.88A RCW.

(2) If the long-term care worker is exempt from the home care aide certification under WAC 246-980-025, the long-term care worker must be a nursing assistant registered and complete the core competencies of basic training, unless they already completed the 28 hours of revised fundamentals of care or a department approved alternative;

(3) If nurse delegation is needed to implement a care plan or negotiated service agreement earlier than home care aide certification can be obtained, the long-term care worker must become a nursing assistant registered and complete core competencies (the core basic training) of the 70-hour home care aide basic training.

(4) Before long-term care workers may perform the task of insulin injections, the long-term care workers must:

(a) Meet the requirements in subsection (1)(a) and (b) of this section; and

(b) Successfully complete the DSHS designated nurse delegation specialized diabetes training.

History

Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-0946, filed 12/9/22, effective 1/9/23. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-0946, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-0953 May nurse delegation core and specialized diabetes training occur in the same year as the seventy-hour long-term care worker basic training?

Nurse delegation core and specialized diabetes training may be required in the same year as basic training if delegated tasks need to be performed. If completed within one hundred and twenty days of hire, the nurse delegation core and specialized diabetes training hours may be applied towards the population specific component of the seventy-hour long-term care worker basic training.

History

Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-71-0953, filed 8/30/21, effective 10/1/21. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-0953, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-0956 Is competency testing required for the nurse delegation core training and specialized diabetes training?

Passing the DSHS competency test is required for successful completion of nurse delegation core training and specialized diabetes training, as provided in WAC 388-71-1106 through 388-71-1130.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-0956, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-0958 Is there a challenge test for nurse delegation core or specialized diabetes training?

There is no challenge test for nurse delegation core or specialized diabetes training.

History

Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-0958 , filed 12/9/22, effective 1/9/23.

Wash. Admin. Code § 388-71-0961 What knowledge and skills must nurse delegation core training include?

Only the DSHS developed curriculum for nurse delegation entitled, "nurse delegation for nursing assistants & home care aides," meets the training requirement for nurse delegation core training.

History

Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-0961, filed 12/9/22, effective 1/9/23.

Wash. Admin. Code § 388-71-0962 What knowledge and skills must nurse delegation specialized diabetes training include?

Nurse delegation specialized diabetes training consists of three modules on diabetes, insulin, and injections. Only the curriculum developed by DSHS, "nurse delegation for nursing assistants: special focus on diabetes," may be used for the nurse delegation specialized diabetes training.

History

Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-0962, filed 12/9/22, effective 1/9/23.

Wash. Admin. Code § 388-71-0970 What documentation is required for completion of each training?

(1) Orientation, safety, basic training, including core and population specific, the 30-hour training, the seven-hour parent provider training, on-the-job training, continuing education, nurse delegation core and specialized diabetes training, specialty and expanded specialty training, and adult education training must be documented by a certificate, transcript, or proof of completion of training issued by a qualified instructor or qualified training entity that includes:

(a) The name of the student;

(b) The title of the training as approved by the department;

(d) The number of hours of the training;

(e) The name and identification number of the training entity;

(f) The instructor's name;

(g) For core basic training and the 75-hour certificate, the instructor's name and identification number;

(h) The instructor's signature or an authorized signature from the training entity the qualified instructor is training on behalf of; and

(i) The completion date of the training.

(2) The long-term care worker must be given documentation of the proof of completion of the training that the student should retain. A home care agency must keep a copy of the proof of completion as specified in subsection (1) of this section on file.

(3) An instructor who is approved for Core Basic may sign a 75-hour certificate from the same training program.

History

Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-0970, filed 12/9/22, effective 1/9/23. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-0970, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-0971 Prior to hiring a long-term care (LTC) worker, what training and certification requirements must be reviewed by the home care agency or consumer directed employer?

Before hiring a LTC worker, the home care agency, as defined under RCW 74.39A.009; or the consumer directed employer (CDE) under chapter 74.39A RCW; must review and verify the highest level of training or certification achieved by the individual.

(1) When the individual is a home care aide certified under chapter 18.88B RCW, the home care agency or CDE must:

(a) Verify that the individual's home care aide certification is current and in good standing; and

(b) Confirm and document that the individual either holds current home care aide certification, or if not required to obtain certification, is in compliance with continuing education as required under WAC 388-71-0991 only for the compliance year in which they are hired.

(2) When the individual is exempt from the 70-hour home care aide training and certification requirements under WAC 388-71-0839, the home care agency or CDE must review and verify the following:

(a) Documents demonstrating the individual's exemption status from training and certification which may include:

(i) Washington state provider active credential number, showing that the individual's license or certification is current and in good standing;

(ii) A letter from a former or current employer documenting work history during the exemption period described in WAC 388-71-0839;

(iii) Employment history records from the Washington state employment security department documenting work history information during the exemption period;

(iv) Federal tax statements documenting work history information during the exemption period; or

(v) Documentation showing completion of the basic training as required under WAC 388-71-0839;

(b) For the year in which they are hired, documentation of completion of 12 hours of continuing education, or information on when the continuing education must be completed, that complies with WAC 388-71-0991.

(3) Individuals who have worked as LTC workers in the past, but who did not complete the basic training or certification required at the time, may be eligible to have the date of hire reset in accordance with this section and WAC 388-71-0980.

(a) Individuals who are eligible to reset their date of hire as provided in WAC 388-71-0980 must submit a new application and fee to the department of health and adhere to the training or certification requirement under this chapter.

(b) Individuals who are not eligible to reset the date of hire as provided in WAC 388-71-0980 must not be paid to provide personal care assistance until they complete required training and become certified as a LTC worker.

(4) The home care agency as defined under RCW 74.39A.009; or the CDE under chapter 74.39A RCW must comply with continuing education documentation requirements under WAC 388-71-0970.

(a) Individuals are held accountable for continuing education completion by their new employer on the date of hire and shall provide at new hire, documentation of their continuing education compliance for the calendar year hired; or

(b) Individuals who work for multiple employers or move between employers must on the date of hire, provide documentation of continuing education compliance for the calendar year in which they are hired, if hired after their birthdate.

History

Statutory Authority: RCW 74.08.090, 74.39A.009, 74.39A.070, 74.39A.074, 74.39A.076, 74.39A.341, 18.88B.010, 18.88B.021, and 18.88B.041. WSR 26-08-045, s 388-71-0971, filed 3/25/26, effective 4/25/26. Statutory Authority: RCW 18.88B.010, 18.88B.041, 74.08.090, 74.39A.076, 74.39A.341, and chapter 18.80 RCW. WSR 25-07-033, s 388-71-0971, filed 3/11/25, effective 4/11/25. Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-0971, filed 12/9/22, effective 1/9/23. Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-71-0971, filed 8/30/21, effective 10/1/21.

Wash. Admin. Code § 388-71-0973 What documentation is required for a long-term care worker to apply for the home care aide certification or recertification?

(1) Successful completion of the 70-hour home care aide basic training, the two hours of orientation, and the three hours of safety training (referred to collectively as the 75 hours of training) must be documented on a DSHS approved 75-hour training certificate, transcript, or proof of completion by an approved training entity verifying that a total of 75 hours of training have occurred.

(2) An approved training entity issuing and signing a DSHS 75-hour training certificate must verify that the long-term care worker has the certificates or transcript required documenting two hours of DSHS-approved orientation, three hours of DSHS-approved safety training, and the 70-hour home care aide basic training, as described in this chapter. When applying to the department of health for home care aide certification, the long-term care worker may only submit a 75-hour training certificate that has been issued by the department or the training partnership.

(3) For annual home care aide recertification, successful completion of 12 hours of DSHS-approved continuing education training must be documented on a certificate(s) or transcript(s) issued by a department approved training entity.

(4) The long-term care worker, certified home care aide, and employer must retain any 12-hour continuing education training certificates, transcripts, or other approved proof of completion as described in WAC 388-71-0970(1) as long as the worker is employed.

History

Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-0973, filed 12/9/22, effective 1/9/23. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-0973, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-0975 Who is required to obtain certification as a home care aide, and by when?

In order to be authorized to provide department paid in-home services, all long-term care workers must obtain home care aide certification as provided in chapter 246-980 WAC unless exempt for the 70-hour basic training as described in WAC 388-71-0875.

History

Statutory Authority: RCW 18.88B.021, 18.88B.041, 18.88B.060, 74.08.090, 74.39A.076, and 74.39A.341. WSR 24-05-003, § 388-71-0975, filed 2/8/24, effective 3/10/24. Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-71-0975, filed 8/30/21, effective 10/1/21. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-0975, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-0977 Once an individual is required to obtain certification as a home care aide, may that individual revert to exempt status?

(1) If an individual is required to or chooses to become a certified home care aide and completes the 70-hour training requirements under this section, the individual will be required to continue to comply with these requirements to maintain the credential and complete continuing education requirements even if:

(a) The monthly authorized hours are later reduced to 20 or fewer hours;

(b) The individual no longer works for a second unrelated client; or

(2) The training and certification requirements for an individual that met the criteria in subsection (1) of this section do not apply when the individual returns to work only for the individual's:

(a) Spouse or registered domestic partner; or

(b) Parent, adult child, sibling, aunt, uncle, cousin, niece, nephew, grandparent, or grandchild, including when related by marriage or domestic partnership.

History

Statutory Authority: RCW 74.08.090, 74.39A.009, 74.39A.070, 74.39A.074, 74.39A.076, 74.39A.341, 18.88B.010, 18.88B.021, and 18.88B.041. WSR 26-08-045, s 388-71-0977, filed 3/25/26, effective 4/25/26. Statutory Authority: RCW 18.88B.010, 18.88B.041, 74.08.090, 74.39A.076, 74.39A.341, and chapter 18.80 RCW. WSR 25-07-033, s 388-71-0977, filed 3/11/25, effective 4/11/25. Statutory Authority: RCW 18.88B.021, 18.88B.041, 18.88B.060, 74.08.090, 74.39A.076, and 74.39A.341. WSR 24-05-003, § 388-71-0977, filed 2/8/24, effective 3/10/24. Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-71-0977, filed 8/30/21, effective 10/1/21.

Wash. Admin. Code § 388-71-0980 When may a home care agency or consumer directed employer employ a long-term care (LTC) worker who has not completed the 70-hour basic training or certification requirements?

(1) If an individual has previously worked as a LTC worker, but did not complete the training or certification requirements under RCW 18.88B.041, 74.39A.074, and 74.39A.076, and this chapter, a home care agency or consumer directed employer must not employ the individual to work as a LTC worker until the individual has completed the required training certification unless the date of hire has been reset as described under subsection (2) of this section.

(2) The date of hire may be reset according to WAC 388-71-0837.

(3) Unless exempt from the 70-hour basic training as described in WAC 388-71-0875, individuals who meet the criteria in subsection (2) of this section are allowed a new 120 days to complete the 70-hour home care aide basic training and a new 365 days to become certified as a home care aide, if required by WAC 246-980-020.

(4) Individuals who meet the criteria in subsection (2) of this section must submit a new application and fee to the department of health.

History

Statutory Authority: RCW 74.08.090, 74.39A.009, 74.39A.070, 74.39A.074, 74.39A.076, 74.39A.341, 18.88B.010, 18.88B.021, and 18.88B.041. WSR 26-08-045, s 388-71-0980, filed 3/25/26, effective 4/25/26. Statutory Authority: RCW 18.88B.021, 18.88B.041, 18.88B.060, 74.08.090, 74.39A.076, and 74.39A.341. WSR 24-05-003, § 388-71-0980, filed 2/8/24, effective 3/10/24. Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-0980, filed 12/9/22, effective 1/9/23. Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-71-0980, filed 8/30/21, effective 10/1/21. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-0980, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-0981 Is the department authorized by RCW 74.39A.086 to take enforcement action for noncompliance related to training and certification requirements?

The department is authorized under RCW 74.39A.086 to take enforcement action for noncompliance related to training and certification requirements.

History

Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-71-0981, filed 8/30/21, effective 10/1/21.

Wash. Admin. Code § 388-71-0985 What is continuing education and what topics may be covered in continuing education?

(1) Continuing education is annual training designed to promote professional development and increase a person's knowledge, expertise, and skills. DSHS must approve continuing education curricula and instructors.

(2) Continuing education courses may be repeated for credit, however:

(a) The same course may not be repeated within an individual's current continuing education compliance year as defined in WAC 388-71-0836 and 388-112-0010; and

(b) If a course becomes available in an individual's preferred language, the translated course will be considered a new course.

(3) Continuing education must be on a topic relevant to any of the following options:

(a) The care setting;

(b) Care needs of clients;

(d) Long-term care worker professional development as defined in WAC 388-71-0836 and 388-112A-0010.

(4) Nurse delegation core and nurse delegation specialized diabetes training hours when not applied to basic training hours may count toward continuing education.

(5) Specialty training, except if completed through a challenge test or counted toward basic training requirements, may be used to meet continuing education requirements.

(6) Successful completion of a department of health approved home care aide certified alternative bridge program may be applied for up to 12 hours of continuing education in the year it was completed.

History

Statutory Authority: RCW 74.08.090, 74.39A.009, 74.39A.070, 74.39A.074, 74.39A.076, 74.39A.341, 18.88B.010, 18.88B.021, and 18.88B.041. WSR 26-08-045, s 388-71-0985, filed 3/25/26, effective 4/25/26
WSR 25-16-084, s 388-71-0985, filed 8/5/25, effective 10/1/25. Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-0985, filed 12/9/22, effective 1/9/23. Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-71-0985, filed 8/30/21, effective 10/1/21. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-0985, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-0991 Who is required to complete continuing education training and when must a long-term care (LTC) worker or certified home care aide complete continuing education?

(1) All LTC workers who are certified home care aides must comply with the continuing education requirements under chapter 246-980 WAC.

(2) LTC workers, who are exempt from home care aide certification as described in RCW 18.88B.041, unless exempt from continuing education as described under WAC 388-71-1001 must complete and provide documentation of 12 hours of continuing education within 45 calendar days of being hired or by the LTC worker's birthday in the calendar year hired, whichever is later; and

(a) Must complete 12 hours of continuing education by the LTC worker's birthday each calendar year worked thereafter; or

(b) If the 45 calendar day time period allows the LTC worker to complete continuing education in January or February of the following year, the credit hours earned will be applied to the calendar year in which the LTC worker was hired.

(3) If the renewal period following initial certification as a home care aide (HCA) or nursing assistant (NA-C), is less than a full year from the date of certification, no continuing education will be due for the first renewal period.

(4) Unless exempt under WAC 388-71-1001, LTC workers who are caring for a:

(a) Spouse or domestic partner; or

(b) Parent, sibling, aunt, uncle, cousin, niece, nephew, grandparent, or grandchild, including when related by marriage or domestic partnership must complete continuing education on or before their birthday in the year after basic training was completed.

(5) A certified home care aide or LTC worker exempt from home care aide certification as described in RCW 18.88B.041 who did not complete the continuing education requirements by the time frame described in this section must not be paid to provide care after that date, unless the person is returning to employment, and their date of hire is reset according to WAC 388-71-0837.

History

Statutory Authority: RCW 74.08.090, 74.39A.009, 74.39A.070, 74.39A.074, 74.39A.076, 74.39A.341, 18.88B.010, 18.88B.021, and 18.88B.041. WSR 26-08-045, s 388-71-0991, filed 3/25/26, effective 4/25/26. Statutory Authority: RCW 18.88B.010, 18.88B.041, 74.08.090, 74.39A.076, 74.39A.341, and chapter 18.80 RCW. WSR 25-07-033, s 388-71-0991, filed 3/11/25, effective 4/11/25. Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-0991, filed 12/9/22, effective 1/9/23. Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-71-0991, filed 8/30/21, effective 10/1/21. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-0991, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-1001 Which long-term care (LTC) workers are exempt from the continuing education requirement?

(1) Until January 1, 2025, continuing education is not required for individual providers caring for only the provider's:

(a) Biological, step, or adoptive child, or

(b) Sibling, aunt, uncle, cousin, niece, nephew, grandparent, or grandchild, including when related by marriage or domestic partnership.

(2) Beginning January 1, 2025, and until January 1, 2027, continuing education is not required for LTC workers (working as individual providers) caring only for the provider's parent, child, sibling, aunt, uncle, cousin, niece, nephew, grandparent, or grandchild, including when related by marriage or domestic partnership.

(3) Continuing education is not required for LTC workers working as individual providers that:

(a) Provide no more than 20 hours of nonrespite care in any calendar month to only one person who is not the provider's parent, child, sibling, aunt, uncle, cousin, niece, nephew, grandparent, or grandchild, including when related by marriage or domestic partnership; or

(b) Provide respite services and work 300 hours or less of respite in any calendar year.

(4) Continuing education is not required for registered nurses, licensed practical nurses, and advanced registered nurse practitioners licensed under chapter 18.79 or 18.80 RCW, even if voluntarily certified as a home care aide under chapter 18.88B RCW.

(5) Beginning January 1, 2025, LTC workers working as individual providers covered under this section may voluntarily take continuing education and be paid for up to 12 hours of continuing education annually.

(6) Parents working as individual providers and caring only for their children will remain exempt from continuing education after January 1, 2027.

History

Statutory Authority: RCW 74.08.090, 74.39A.009, 74.39A.070, 74.39A.074, 74.39A.076, 74.39A.341, 18.88B.010, 18.88B.021, and 18.88B.041. WSR 26-08-045, s 388-71-1001, filed 3/25/26, effective 4/25/26. Statutory Authority: RCW 18.88B.010, 18.88B.041, 74.08.090, 74.39A.076, 74.39A.341, and chapter 18.80 RCW. WSR 25-07-033, s 388-71-1001, filed 3/11/25, effective 4/11/25. Statutory Authority: RCW 18.88B.021, 18.88B.041, 18.88B.060, 74.08.090, 74.39A.076, and 74.39A.341. WSR 24-05-003, § 388-71-1001, filed 2/8/24, effective 3/10/24. Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-1001, filed 12/9/22, effective 1/9/23. Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-71-1001, filed 8/30/21, effective 10/1/21. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-1001, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-1026 What must be submitted to DSHS for curriculum approval?

(1) If a training entity modifies a department developed curricula in any manner, the training entity must submit the curriculum to the department for approval.

(2) Training must not be offered before receiving department curriculum and instructor approval.

(3) Online classes when applicable, must adhere to the DSHS online class standards in effect at the time of approval. These online standards are posted on the DSHS website https://bit.ly/dshs-online-standards.

(4) For orientation and safety training:

(a) Submit an outline of what will be covered in each training offered including a table of contents that shows where the required introductory topics as listed in WAC 388-71-0846 for orientation and WAC 388-71-0855 for safety training are covered in the training.

(b) Department required orientation and safety training application forms must be submitted to the department at least 45 days in advance of when the training is expected to be offered.

(5) For continuing education:

(a) Continuing education curriculum delivery models must only include instructor led, online instructor led (such as a webinar), or an online interactive self-paced learning with access to an approved instructor or a proctor trained by an approved instructor.

(b) For continuing education classes, submit on a department developed form, a summary that includes the topic, a brief description of what it will cover, a course outline, the number of training hours, and a description of how the training is relevant to the care setting, care needs of the clients, or long-term care worker career development.

(c) For online training courses, submit the information requested in (b) of this subsection and submit a description of how the instructor or training entity will assess that the students have integrated the information being taught. The training entity must establish a way for the long-term care worker to receive feedback from an approved instructor or a proctor trained by an approved instructor.

(d) One hour of completed classroom instruction or other form of training (such as an online course) equals one hour of continuing education.

(e) Department required continuing education training application forms must be submitted at least 45 days in advance of the training. The department must approve the curriculum and instructor before the training may be offered.

(6) For the 70-hour home care aide basic training, the 30-hour basic training, and the seven-hour parent provider training:

(a) If the instructor or training entity uses the DSHS developed fundamentals of caregiving learner's guide or its substitute with enhancements, they must submit the DSHS required form with all required information.

(b) If the instructor or training entity does not use the DSHS developed fundamentals of caregiving learner's guide or its substitute with enhancements to teach the 70-hour home care aide basic training, the 30-hour basic training, and for the seven-hour parent provider training, they must submit to DSHS the following for approval:

(i) A completed DSHS curriculum checklist indicating where all of the competencies and learning objectives, described in this chapter, are located in the long-term care worker materials from the proposed curriculum for that course;

(ii) Any materials long-term care workers will receive, such as a textbook or long-term care worker manual, learning activities, audio-visual materials, handouts, and books;

(iii) The table of contents or outline, including the allotted time for each section;

(iv) Demonstration skills checklists for the personal care tasks described in WAC 388-71-0911 (12)(a) and (b), and infection control skills such as hand washing and putting on and taking off gloves; and

(v) The teacher's guide or manual that includes for each section of the curriculum:

(A) The goals and objectives;

(B) Methods of teaching, including learning activities that incorporate adult learning principles;

(C) Methods used to determine whether each long-term care worker understands the material covered and can demonstrate all skills;

(D) A list of sources or references that were used to develop the curriculum and if the primary source or reference is not a published citation, the instructor must provide detail on how the content is evidence based;

(E) Description of how the curriculum was designed to accommodate long-term care workers with either limited English proficiency, learning disabilities, or both; and

(F) Description and proof of how input was obtained from consumers and long-term care worker representatives in the development of the curriculum.

(c) Curricula submitted for the core competency section of the basic training as described in WAC 388-71-0911 must include how much time long-term care workers will be given to practice skills and how instructors will evaluate and ensure each long-term care worker can proficiently complete each skill.

(d) Entities that submit curriculum for population specific component of home care aide basic training must submit a list of competencies and learning objectives used to develop the population specific basic training curriculum.

(7) For specialty training:

(a) For specialty training that is not DSHS developed curriculum or another department approved specialty training curriculum, submit the required specialty training application form and any additional learning objectives added to the competency and learning objectives checklist, the enhancements that have been added, and additional student materials or handouts.

(b) To be approved, an alternative curriculum must at a minimum include:

(i) All the DSHS published learning outcomes and competencies for the course;

(ii) Student materials that support the curriculum, a teacher's guide or manual, and learning resource materials such as learning activities, audio-visual materials, handouts, and books;

(iii) The recommended sequence and delivery of the material; and

(iv) The teaching methods or approaches that will be used for different sections of the course, including for each lesson:

(A) Learning activities that incorporate adult learning principles and address the learning readiness of the student population;

(B) Practice of skills to increase competency;

(D) An emphasis on facilitation by the teacher; and

(E) An integration of knowledge and skills from previous lessons to build skills;

(v) A list of the sources or references, if any, used to develop the curriculum;

(vi) Methods of teaching and student evaluation for students with either limited-English proficiency, learning disabilities, or both; and

(vii) A plan for updating material.

(8) Substantial changes to a previously approved curriculum must be approved before they are used.

History

Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-1026, filed 12/9/22, effective 1/9/23. Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-71-1026, filed 8/30/21, effective 10/1/21. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-1026, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-1031 What are the requirements and process for curriculum approval for orientation, safety, the 70-hour core basic training, the 30-hour basic training, the seven-hour parent provider training, and continuing education?

History

Statutory Authority: RCW 18.88B.010, 18.88B.021, 18.88B.041, 74.08.090, 74.39A.009, 74.39A.070, 74.39A.074, 74.39A.076, and 74.39A.341. WSR 25-14-021, s 388-71-1031, filed 6/24/25, effective 7/25/25. Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-1031, filed 12/9/22, effective 1/9/23. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-1031, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-1045 What are a training entity's responsibilities?

The training entity is responsible for:

(1) Coordinating and teaching classes;

(2) Assuring that the curriculum used is DSHS-approved and taught as designed;

(3) Selecting qualified guest speakers, where applicable;

(4) Establishing a method whereby the long-term care worker can receive feedback from an approved instructor or a proctor trained by an approved instructor;

(5) Administering or overseeing the administration of the DSHS competency and challenge tests;

(6) Maintaining training records electronically or on paper including long-term care worker certificates, transcripts, or proof of successful completion of training, and attendance records for a minimum of six years;

(7) Reporting training data to DSHS when requested by the department; and

(8) Issuing or reissuing training certificates or transcripts to long-term care workers.

History

Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-1045, filed 12/9/22, effective 1/9/23. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-1045, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-1050 Must training entities and their instructors be approved by DSHS?

Training entities and their instructors must be approved by DSHS as follows:

(1) For DSHS contracted training entities:

(a) DSHS must approve or approve and contract with a training entity and its instructor(s) to conduct orientation, safety, 70-hour basic training, population specific training, specialty training, 30-hour training, seven-hour DDA parent provider training, nurse delegation core training, and nurse delegation specialized diabetes training, on-the-job training, and continuing education.

(b) DSHS may select training entities using any applicable contracting procedures. Contractors must meet the minimum qualification for instructors under this chapter and any additional qualifications established through the contracting procedure.

History

Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-1050, filed 12/9/22, effective 1/9/23. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-1050, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-1051 Can DSHS deny or terminate a contract or rescind approval of an instructor or training entity?

(1) DSHS may deny a person or organization seeking a contract with DSHS to conduct orientation, safety, 70-hour basic training, population specific training, specialty training, 30-hour training, seven-hour DDA parent provider training, nurse delegation core training, and nurse delegation specialized diabetes training, on-the-job training, or continuing education. No administrative remedies are available to dispute DSHS' decision not to contract with or approve a person or organization, except as may be provided through the contracting process.

(2) DSHS may terminate an existing training contract in accordance with the terms of the contract. The contractor's administrative remedies are limited to those specified in the contract.

(3) DSHS may terminate an existing training approval of a person or entity to conduct orientation, safety, 70-hour basic training, population specific training, specialty training, 30-hour training, seven-hour DDA parent provider training, nurse delegation core training, and nurse delegation specialized diabetes training, on-the-job training, or continuing education.

History

Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-1051, filed 12/9/22, effective 1/9/23. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-1051, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-1055 What are the minimum qualifications for an instructor for basic (including 30-hour and seven-hour DDA parent providers), population specific, on-the-job, nurse delegation core, and nurse delegation specialized diabetes trainings?

An instructor for basic (including 30-hour and seven-hour DDA parent providers), population specific, on-the-job, nurse delegation core, and nurse delegation specialized diabetes training must meet the following minimum qualifications:

(1) Be at least 21 years of age;

(2) Has not had a professional health care, adult family home, enhanced services facility, assisted living facility, or social services license or certification revoked in Washington state; and

(3) Meets one or more of the following education or work experience requirements upon initial approval or hire:

(a) Is a registered nurse with work experience within the last five years with the elderly or persons with disabilities requiring long-term care in a community setting; or

(b) Has an associate degree or higher degree in the field of health or human services and six months of professional or caregiving experience within the last five years in an adult family home, enhanced services facility, assisted living facility, supported living through DDA, or home care setting; or

(c) Has a high school diploma, or equivalent, and one year of professional or caregiving experience within the last five years in an adult family home, enhanced services facility, assisted living facility, supported living through DDA, or home care setting.

(4) Meets one or more of the following teaching experience requirements:

(a) 100 hours of teaching adults in an appropriate setting on topics directly related to the basic training or basic training topics that may be offered as continuing education; or

(b) 40 hours of teaching basic training while being mentored by an instructor who is approved to teach basic training;

(5) Except for instructors for nurse delegation core and specialized diabetes training, completion of a class on adult education that meets the requirements in WAC 388-71-1066;

(6) The instructor must be experienced in caregiving practices and demonstrate competency with respect to teaching the course content or units being taught;

(7) Instructors who will administer tests must have experience or training in assessment and competency testing; and

(8) Community instructors for nurse delegation core and specialized diabetes trainings must have a current Washington or multistate registered nurse (RN) license in good standing without practice restrictions.

History

Statutory Authority: RCW 70.128.230, 74.39A.009, 74.39A.070, 74.39A.074, and chapter 18.80 RCW. WSR 24-16-082, § 388-71-1055, filed 8/1/24, effective 9/1/24. Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-1055, filed 12/9/22, effective 1/9/23. Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-71-1055, filed 8/30/21, effective 10/1/21. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-1055, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-1060 What are the minimum qualifications for an instructor of orientation, safety, and continuing education?

(1) An instructor for orientation and safety [training] must be a registered nurse or other person with specific knowledge, training, and work experience relevant to the topics required in orientation and safety training.

(2) An instructor for continuing education must be a registered nurse or other person that is proficient in the content they cover in the course or have specific knowledge, training, or experience in the provision of direct, personal care, or other relevant services to the elderly or persons with disabilities requiring long-term care.

Wash. Admin. Code § 388-71-1064 What are the minimum qualifications for community instructors for adult education training using DSHS curriculum?

(1) The minimum qualifications for community instructors of adult education training using DSHS curriculum, in addition to the general qualifications in WAC 388-71-1055 (1) and (2), include:

(a) The instructor must be experienced in adult education practices and capable of demonstrating competency in the entire course content;

(b) Education:

(i) Has a bachelor's degree or is a registered nurse with at least one year of education in seminars, conferences, continuing education, or in college classes in subjects directly related to adult education, such as, but not limited to English as a second language (ESL), adult basic education, and adult secondary education (one year of education equals 24 semester credits in a semester system, 36 quarter credits in a quarter system, or at least 80 hours of seminars, conferences, and continuing education); and

(ii) Successful completion of the DSHS adult education training curriculum prior to beginning to train others;

(i) Two years of experience teaching long-term care workers; or

(ii) 200 hours of experience teaching adult education or closely related subjects;

(d) Successful completion of the DSHS instructor qualification/demonstration process; and

(e) Instructor approved and contracted by the department as a community instructor.

(2) Instructors that administer tests must have experience or training in assessment and competency testing.

History

Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-1064, filed 12/9/22, effective 1/9/23. Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-71-1064, filed 8/30/21, effective 10/1/21.

Wash. Admin. Code § 388-71-1066 What must be included in a class on adult education and which instructors must complete it?

(1) A class on adult education must include content, student practice, and evaluation of student skills by the instructor in:

(a) Adult education theory and practice principles;

(b) Instructor facilitation techniques;

(d) Administering competency testing; and

(e) Working with adults with special training needs like limited English as a second language proficiency, learning disabilities, or both.

(2) Instructors who request approval to teach either core basic training, specialty training as described in chapter 388-112A, or both, must complete the DSHS adult education class or an adult education class that meets the criteria in subsection (1) of this section and provide a copy of the certificate of completion.

History

Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-71-1066, filed 8/30/21, effective 10/1/21. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-1066, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-1067 What are the minimum qualifications for community instructors for mental health specialty training?

(1) The minimum qualifications for community instructors for mental health specialty training, in addition to the general qualifications in WAC 388-71-1055 (1) and (2), include:

(a) The instructor must be experienced in mental health caregiving practices and capable of demonstrating competency in the entire course content;

(b) Education:

(i) Bachelor's degree, registered nurse, or mental health specialist, with at least one year of education in seminars, conferences, continuing education, or accredited college classes, in subjects directly related to mental health, including, but not limited to, psychology (one year of education equals 24 credits in a semester system, 36 credits in a quarter system, or at least 80 hours of seminars, conferences, and continuing education); and

(ii) Successful completion of the mental health specialty training class before the instructor trains others;

(d) Teaching experience:

(i) 200 hours experience teaching long-term care related subjects;

(ii) Successful completion of an adult education class that meets the requirements of WAC 388-71-1066;

(iii) Successful completion of the DSHS instructor qualification/demonstration process; and

(iv) The instructor has been approved and contracted by the department as a community instructor;

(e) Instructors who will administer tests must have experience or training in assessment and competency testing; and

(2) Five years of full-time equivalent direct work experience with people who have a mental illness may substitute for either:

(a) The credential described in subsection (1)(b)(i) of this section; or

(b) The one year of education in college classes or 80 hours in seminars, conferences, continuing education described in subsection (1)(b)(i) of this section.

(3) If your status is an approved instructor for mental health specialty training, you may instruct a new mental health specialty training curriculum after submitting to the department a copy of a certificate of completion for that curriculum and a copy of a certificate of completion of an adult education class that meets the requirements of WAC 388-71-1066.

History

Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-1067, filed 12/9/22, effective 1/9/23.

Wash. Admin. Code § 388-71-1068 What are the minimum qualifications for community instructors for dementia specialty training?

(1) The minimum qualifications for community instructors for mental health specialty training, in addition to the general qualifications in chapter 388-71-1055 (1) and (2), include:

(a) The instructor must be experienced in dementia caregiving practices and capable of demonstrating competency in the entire course content;

(b) Education:

(i) Bachelor's degree, registered nurse, or mental health specialist, with at least one year of education in seminars, conferences, continuing education, or college classes, in dementia or subjects directly related to dementia, such as, but not limited to, psychology (one year of education equals 24 credits in a semester system, 36 credits in a quarter system, or at least 80 hours of seminars, conferences, or continuing education); and

(ii) Successful completion of the dementia specialty training, prior to beginning to train others;

(d) Teaching experience:

(i) 200 hours experience teaching long-term care related subjects;

(ii) Successful completion of an adult education class that meets the requirements of WAC 388-71-1066;

(iii) Successful completion of the DSHS instructor qualification/demonstration process; and

(iv) The instructor has been approved and contracted by the department as a community instructor; and

(e) Instructors who will administer tests must have experience or training in assessment and competency testing.

(2) Five years of full-time equivalent direct work experience with people who have dementia may substitute for either:

(a) The credential (bachelor's degree, registered nurse, or mental health specialist) described in subsection (1)(b)(i) of this section; or

(b) The one year of education in college classes or 80 hours in seminars, conferences, continuing education described in subsection (1)(b)(i) of this section.

(3) If your status is an approved instructor for dementia specialty training, you may instruct a new dementia specialty training curriculum after submitting to the department a copy of a certificate of completion for that curriculum and a copy of a certificate of completion of an adult education class that meets the requirements of WAC 388-71-1066.

History

Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-1068, filed 12/9/22, effective 1/9/23.

Wash. Admin. Code § 388-71-1069 What are the minimum qualifications for community instructors to teach expanded specialty trainings?

(1) The minimum qualifications for community instructors for mental health specialty training, in addition to the general qualifications in WAC 388-71-1055 (1) and (2), include:

(a) The instructor must be experienced in caregiving practices related to the expanded specialty topic and capable of demonstrating competency in the entire course content;

(b) Education:

(i) Bachelor's degree, registered nurse, paramedic, emergency medical technician (EMT), mental health specialist, or a specialist with nationally recognized credentials in the expanded specialty topic with at least 80 hours of education in seminars, conferences, continuing education, or accredited college classes, in subjects directly related to expanded specialty topics; and

(ii) Successful completion of the expanded specialty training class before the instructor trains others;

(c) Work experience: Two years full-time equivalent direct work or volunteer experience with people in the specialty topic population; and

(d) Teaching experience:

(i) 200 hours experience teaching;

(ii) Successful completion of an adult education class that meets the requirements of WAC 388-71-1066;

(iii) Successful completion of the DSHS instructor qualification/demonstration process; and

(iv) The instructor has been approved and contracted by the department as a community instructor;

(e) Instructors who will administer tests must have experience or training in assessment and competency testing; and

(2) Five years of full-time equivalent direct work experience with people in the specialty topic population may substitute for either:

(a) The credential or degree described in subsection (1)(b)(i) of this section; or

(b) The 80 hours in seminars, conferences, continuing education described in subsection (1)(b)(i).

History

Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-1069, filed 12/9/22, effective 1/9/23.

Wash. Admin. Code § 388-71-1076 What is a guest speaker, and what are the minimum qualifications to be a guest speaker?

(1) A guest speaker is a person selected by an approved instructor to teach on a specific topic. A guest speaker:

(a) May only teach a specific subject in which the guest speaker has knowledge, background, and experience that establishes expertise on the topic they will teach;

(b) May not teach the entire course;

(d) Must cover the DSHS competencies and learning objectives for the topic the guest speaker is teaching.

(2) The approved instructor must:

(a) Ensure the guest speaker meets these minimum qualifications;

(b) Maintain documentation of the guest speaker's qualifications and experience;

(d) Be responsible for ensuring the required content is taught.

(3) DSHS does not approve guest speakers.

History

Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-1076, filed 12/9/22, effective 1/9/23. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-1076, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-1081 What are the requirements for the training partnership to conduct training?

(1) The training partnership must:

(a) Verify, document using the department's attestation process, keep on file, and make available to the department upon request, that all instructors meet the minimum instructor qualifications in WAC 388-71-1055 and 388-71-1060 for the course they plan to teach;

(b) Teach using a complete DSHS-developed or approved curriculum;

(c) When requested by DSHS, notify DSHS in writing of their intent to conduct training prior to providing training, when changing training plans, including:

(i) Name and schedule of training(s) the partnership will conduct;

(ii) Name of approved curriculum(s) the partnership will use; and

(iii) Name of the instructor(s) for only the core basic training.

(d) Ensure that DSHS competency tests are administered when conducting nurse delegation core or specialized diabetes training;

(e) Keep a copy of long-term care worker certificates on file for six years and give the original certificate to the student;

(f) Keep attendance records and testing records of long-term care workers trained and tested on file for six years; and

(g) Report training data to DSHS when requested by the department.

(2) The department may conduct a random audit at any time to review training and instructor qualifications.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-1081, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-1091 What physical resources are required for classroom training and testing?

(1) The training entity must provide accessible classroom facilities to students and provide adequate space for learning activities, comfort, lighting, lack of disturbance, and tools for effective teaching and learning, such as white boards and charts. The training entity must maintain appropriate supplies and equipment for teaching and practice of caregiving skills in the class being taught.

(2) The training entity must provide testing sites with adequate space for testing, comfort, lighting, and lack of disturbance appropriate for the written or skills test being conducted. The training entity must maintain appropriate supplies and equipment necessary for the particular test must be provided.

History

Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-1091, filed 12/9/22, effective 1/9/23. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-1091, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-1096 What standard training practices must be maintained for classroom training and testing?

The training entity must maintain the following training standards for classroom training and testing:

(1) Training must not exceed eight hours within one day;

(2) Training provided in short time segments must include an entire unit, skill, or concept;

(3) Training must include regular breaks; and

(4) Long-term care workers attending classroom training must not be expected to leave the class to attend job duties, except in an emergency.

History

Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-1096, filed 12/9/22, effective 1/9/23. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-1096, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-1106 What components must competency testing include?

(1) Competency testing must include the following components:

(a) Skills demonstration of ability to perform and implement specific caregiving approaches, and activities as appropriate to the training;

(b) Written evaluation to show the level of comprehension and knowledge of the training's learning objectives; and

(2) Instructors or proctors who conduct competency testing must have experience or training in assessing competencies.

History

Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-1106, filed 12/9/22, effective 1/9/23. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-1106, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-1111 What experience or training must individuals have to be able to perform competency testing?

The following trainings must include the DSHS developed competency test:

(1) Dementia specialty training;

(2) Mental health specialty training;

(3) Developmental disabilities specialty training;

(4) Expanded specialty training;

(5) Nurse delegation core training; and

(6) Nurse delegation specialized diabetes training.

History

Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-1111, filed 12/9/22, effective 1/9/23. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-1111, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-1120 How must competency test administration be standardized?

To standardize competency test administration, testing must include the following components:

(1) The person teaching the course must administer or supervise the administration of all testing; and

(2) The tester must follow the DSHS guidelines for:

(a) The maximum length of time allowed for testing;

(b) The amount and nature of instruction given to students before beginning a test;

(d) The accommodation guidelines for students with disabilities; and

(e) Accessibility guidelines for students with limited English proficiency.

History

Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-1120, filed 12/9/22, effective 1/9/23. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-1120, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-1125 What form of identification must long-term care workers show before taking a competency test?

Students must provide photo identification before taking a competency or challenge test.

History

Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-1125, filed 12/9/22, effective 1/9/23. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-1125, filed 12/20/12, effective 1/20/13.

Wash. Admin. Code § 388-71-1130 How many times may a competency test be taken?

(1) A competency test that is part of a course may be taken twice. If the test is failed a second time, the person must retake the course before any additional tests are administered.

(2) If a challenge test is available for a course, it may be taken only once. If the test is failed, the person must take the classroom course.

History

Statutory Authority: RCW 18.20.270, 70.128.230, 74.08.090, 74.39A.070, and 74.39A.074. WSR 23-01-022, § 388-71-1130, filed 12/9/22, effective 1/9/23. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 13-02-023, § 388-71-1130, filed 12/20/12, effective 1/20/13.

Chapter 388-76 Adult family home minimum licensing requirements.

Wash. Admin. Code § 388-76-10000 Definitions.

"Abandonment" means action or inaction by a person or entity with a duty of care for a vulnerable adult that leaves the vulnerable person without the means or ability to obtain necessary food, clothing, shelter, or health care.

"Abuse" means the intentional, willful, or reckless action or inaction that inflicts injury, unreasonable confinement, intimidation, or punishment of a vulnerable adult.

(1) In instances of abuse of a vulnerable adult who is unable to express or demonstrate physical harm, pain, or mental anguish, the abuse is presumed to cause physical harm, pain, or mental anguish.

(2) Abuse includes sexual abuse, mental abuse, physical abuse, and personal exploitation of a vulnerable adult, and improper use of restraint against a vulnerable adult which have the following meanings:

(a) "Sexual abuse" means any form of nonconsensual sexual conduct, including but not limited to, unwanted or inappropriate touching, rape, sodomy, sexual coercion, sexually explicit photographing, and sexual harassment. Sexual abuse also includes any sexual conduct between a staff person, who is not also a resident or client, of a facility or a staff person of a program authorized under chapter 71A.12 RCW, and a vulnerable adult living in that facility or receiving service from a program authorized under chapter 71A.12 RCW, whether or not consensual.

(b) "Physical abuse" means the willful action of inflicting bodily injury or physical mistreatment. Physical abuse includes, but is not limited to, striking with or without an object, slapping, pinching, choking, kicking, shoving, or prodding.

(c) "Mental abuse" means a willful verbal or nonverbal action that threatens, humiliates, harasses, coerces, intimidates, isolates, unreasonably confines, or punishes a vulnerable adult. Mental abuse may include ridiculing, yelling, or swearing.

(d) "Personal exploitation" means an act of forcing, compelling, or exerting undue influence over a vulnerable adult causing the vulnerable adult to act in a way that is inconsistent with relevant past behavior, or causing the vulnerable adult to perform services for the benefit of another.

(e) "Improper use of restraint" means the inappropriate use of chemical, physical, or mechanical restraints for convenience or discipline or in a manner that:

(i) Is inconsistent with federal or state licensing or certification requirements for facilities, hospitals, or programs authorized under chapter 71A.12 RCW;

(ii) Is not medically authorized; or

(iii) Otherwise constitutes abuse under this section.

"Adult family home" or "AFH" means:

(1) A residential home in which a person or an entity is licensed to provide personal care, special care, room, and board to more than one but not more than six adults who are not related by blood, adoption, or marriage to a provider, entity representative, resident manager, or caregiver, who resides in the home. An adult family home may be licensed to provide care to up to eight adults if the home receives approval under WAC 388-76-10031 or 388-76-10032.

(2) As used in this chapter, the term "entity" includes corporations, partnerships, and limited liability companies, and the term "adult family home" includes the person or entity that is licensed to operate an adult family home.

"Affiliated with an applicant" means any person listed on the application as a partner, officer, director, resident manager, entity representative, or majority owner of the applying entity, or is the spouse or domestic partner of the applicant.

"Affiliated entity" means any entity owned, controlled, or managed by the applicant or licensed provider, or associated with a parent or subsidiary entity applying for, or holding, an adult family home license.

"Applicant" means:

(1) An individual, partnership, corporation, or other entity seeking a license to operate an adult family home; and

(2) For the following sections only, also includes an entity representative solely for the purposes of fulfilling requirements on behalf of the entity:

(a) WAC 388-76-10020(1);

(b) WAC 388-76-10035(1);

(d) WAC 388-76-10120;

(e) WAC 388-76-10125;

(f) WAC 388-76-10129;

(g) WAC 388-76-10130;

(h) WAC 388-76-10146(4);

(i) WAC 388-76-10265;

(j) WAC 388-76-10500; and

(k) WAC 388-76-10505.

"Capacity" means the maximum number of persons receiving personal or special care who are permitted in an adult family home at a given time. Capacity includes:

(1) The total capacity, which is the number of residents and any children or adults related to the provider who receive personal or special care and services in the home; and

(2) The licensed capacity, which is the number of residents the adult family home may admit and retain (resident capacity), which is the number listed on the license.

"Caregiver" means any person 18 years of age or older responsible for providing direct personal or special care to a resident and who is not the provider, entity representative, a student, or volunteer.

"Chemical restraint" means the administration of any drug to manage a vulnerable adult's behavior in a way that reduces the safety risk to the vulnerable adult or others, has a temporary effect of restricting the vulnerable adult's freedom of movement, and is not standard treatment for the vulnerable adult's medical or psychiatric condition.

"Consent" means express written consent granted after the vulnerable adult or their legal representative has been fully informed of the nature of the services to be offered and that the receipt of services is voluntary.

"Dementia" means a condition documented through the assessment process required by WAC 388-76-10335.

"Department" means the Washington state department of social and health services.

"Department case manager" means the department authorized staff person or designee assigned to negotiate, monitor, and facilitate a care and services plan for residents receiving services paid for by the department.

"Developmental disability" means the same as defined under WAC 388-823-0015.

"Direct supervision" means oversight by a person who has demonstrated competency in the basic training and specialty training if required, or who has been exempted from the basic training requirements and is:

(1) On the premises; and

(2) Quickly and easily available to the caregiver.

"Domestic partners" means two adults who meet the requirements for a valid state registered domestic partnership as established by RCW 26.60.030 and who have been issued a certificate of state registered domestic partnership.

"Entity representative" means the individual designated by an entity provider or entity applicant as its representative for the purposes of fulfilling the training and qualification requirements under this chapter that only an individual can fulfill where an entity cannot. The entity representative is responsible for overseeing the operation of the home. The entity representative does not hold the license on behalf of the entity.

"Essential Support Person" means an individual who is:

(1) At least 18 years of age;

(2) Designated by the resident, or by the resident's representative, if the resident is determined to be incapacitated or otherwise legally incapacitated; and

(3) Necessary for the resident's emotional, mental, or physical well-being during situations that include, but are not limited to:

(a) Circumstances involving compassionate care or end-of-life care;

(b) Circumstances where visitation from a familiar person will assist with important continuity of care or the reduction of confusion and anxiety for residents with cognitive impairments; or

(c) Other circumstances where the presence of an essential support person will prevent or reduce significant emotional distress to the resident.

"Financial exploitation" means the illegal or improper use, control over, or withholding of the property, income, resources, or trust funds of the vulnerable adult by any person or entity for any person's or entity's profit or advantage other than for the vulnerable adult's profit or advantage. Some examples of financial exploitation are given in RCW 74.34.020(7).

"Financial solvency" means that the applicant or provider has sufficient funds to operate the home. An applicant or provider is considered financially solvent when they have no delinquent debt. At the department's discretion, the department may consider an applicant or provider financially solvent if their only delinquent debt is for medical reasons.

"Home" means adult family home.

"Household member" means a person who uses the address of the adult family home as their primary address and who is not a resident.

"Imminent danger" or "immediate threat" means serious physical harm to, or death of a resident has occurred, or there is a serious threat to the resident's life, health, or safety.

"Indirect supervision" means oversight by a person who is quickly and easily available to the caregiver, but not necessarily on-site and:

(1) Has demonstrated competency in the basic and specialty training, if required; or

(2) Is exempt from basic training requirements.

"Inspection" means a review by department personnel to determine the health, safety, and well-being of residents, and the adult family home's compliance with this chapter and chapters 70.128, 70.129, 74.34 RCW, and other applicable rules and regulations. The department's review may include an on-site visit.

"Management agreement" means a written, executed agreement between the adult family home and another individual or entity regarding the provision of certain services on behalf of the adult family home.

"Mandated reporter" means an employee of the department or the department of children, youth, and families; law enforcement officer; social worker; professional school personnel; individual provider; an operator of a facility or a certified residential services and supports agency under chapter 71A.12 RCW, an employee of a facility; an employee of a social service, welfare, mental health, adult day health, adult day care, home health, home care, hospice; or certified residential services and supports agency, county coroner or medical examiner; Christian Science practitioner; or health care provider subject to chapter 18.130 RCW. For the purpose of the definition of a mandated reporter, "Facility" means a residence licensed or required to be licensed under chapter 18.20 RCW (assisted living facilities), chapter 18.51 RCW (nursing homes), chapter 70.128 RCW (adult family homes), chapter 72.36 RCW (soldiers' homes), chapter 71A.20 RCW (residential habilitation centers), or any other facility licensed by the department.

"Mechanical restraint" means any device attached or adjacent to the vulnerable adult's body that they cannot easily remove and restricts freedom of movement or normal access to the vulnerable adult's body. "Mechanical restraint" does not include the use of devices, materials, or equipment that are:

(a) Medically authorized, as required; and

(b) Used in a manner that is consistent with federal or state licensing or certification requirements for facilities, hospitals, or programs authorized under chapter 71A.12 RCW.

"Medical device" as used in this chapter, means any piece of medical equipment used to treat a resident's assessed need.

(1) A medical device is not always a restraint and should not be used as a restraint;

(2) Some medical devices have considerable safety risks associated with use; and

(3) Examples of medical devices with known safety risks when used are transfer poles, Posey or lap belts, and side rails.

"Medication administration" means giving resident medications by a person legally authorized to do so, such as a physician, pharmacist, or nurse.

"Medication organizer" means a container with separate compartments for storing oral medications organized in daily doses.

"Mental illness" is defined as an axis I or II diagnosed mental illness as outlined in volume IV of the Diagnostic and Statistical Manual of Mental Disorders (a copy is available for review through the home and community living administration).

"Minimal" means violations that result in little or no negative outcome or little or no potential harm for a resident.

"Moderate" means violations that result in negative outcome and actual or potential harm for a resident.

"Multiple home provider" means a provider who is licensed to operate more than one adult family home.

"Neglect" means:

(1) A pattern of conduct or inaction by a person or entity with a duty of care that fails to provide the goods and services that maintain physical or mental health of a vulnerable adult, or that fails to avoid or prevent physical or mental harm or pain to a vulnerable adult; or

(2) An act or omission by a person or entity with a duty of care that demonstrates a serious disregard of consequences of such a magnitude as to constitute a clear and present danger to the vulnerable adult's health, welfare, or safety, including but not limited to, conduct prohibited under RCW 9A.42.100.

"Nurse delegation" means a registered nurse transfers the performance of selected nursing tasks to competent nursing assistants, home care aides, or qualified long-term care workers in selected situations. The registered nurse delegating the task retains the responsibility and accountability for the nursing care of the resident.

"Over-the-counter medication" means any medication that can be purchased without a prescriptive order, including but not limited to, vitamin, mineral, or herbal preparations.

"Permanent restraining order" means a restraining order or order of protection issued either following a hearing, or by stipulation of the parties. A "permanent restraining order" order may be in force for a specific time period (for example, one year), after which it expires.

"Personal care services" means both physical assistance and prompting and supervising the performance of direct personal care tasks as determined by the resident's needs and does not include assistance with tasks performed by a licensed health professional.

"Physical restraint" means application of physical force without the use of any device, for the purpose of restraining the free movement of a vulnerable adult's body. "Physical restraint" does not include briefly holding without undue force a vulnerable adult in order to calm or comfort them, or holding a vulnerable adult's hand to safely escort them from one area to another.

"Placement agency" means an "elder or vulnerable adult referral agency" as defined in chapter 18.330 RCW and means a business or person who receives a fee from or on behalf of a vulnerable adult seeking a referral to care services or supportive housing or who receives a fee from a care services provider or supportive housing provider because of any referral provided to or on behalf of a vulnerable adult.

"Practitioner" means a physician, osteopathic physician, podiatric physician, pharmacist, licensed practical nurse, registered nurse, advanced registered nurse practitioner, dentist, and physician assistant licensed in the state of Washington.

"Prescribed medication" means any medication (legend drug, controlled substance, and over-the-counter) that is prescribed by an authorized practitioner.

"Provider" means:

(1) Any individual who is licensed to operate an adult family home and meets the requirements of this chapter;

(2) Any corporation, partnership, limited liability company, or other entity that is licensed under this chapter to operate an adult family home and meets the requirements of this chapter; and

(3) For the following sections only, also includes an entity representative solely for the purposes of fulfilling requirements on behalf of the entity:

(a) WAC 388-76-10020(1);

(b) WAC 388-76-10035(1);

(d) WAC 388-76-10120;

(e) WAC 388-76-10125;

(f) WAC 388-76-10129;

(g) WAC 388-76-10130;

(h) WAC 388-76-10146(4);

(i) WAC 388-76-10265;

(j) WAC 388-76-10500; and

(k) WAC 388-76-10505.

"Psychopharmacologic medications" means the class of prescription medications, which includes but is not limited to, antipsychotics, antianxiety medications, and antidepressants, capable of affecting the mind, emotions, and behavior.

"Recurring" or "repeated" means that the department has cited the adult family home for a violation of applicable licensing laws or rules and the circumstances of (1) or (2) of this definition are present and if the previous violation in subsection (1) or (2) of this definition was pursuant to a law or rule that has changed at the time of the new violation, a citation to the equivalent current rule or law is sufficient:

(1) The department previously imposed an enforcement remedy for a violation of the same section of law or rule for substantially the same problem following any type of inspection within the preceding 36 months.

(2) The department previously cited a violation under the same section of law or rule for substantially the same problem following any type of inspection on two occasions within the preceding 36 months.

"Resident" means any adult living in the adult family home and who is unrelated to the provider and who receives personal or special care from the adult family home. Except as specified elsewhere in this chapter, for decision-making purposes, the term "resident" includes the resident's surrogate decision maker acting under state law.

"Resident manager" means a person employed or designated by the provider to manage the adult family home and who meets the requirements of this chapter.

"Resident representative" means:

(1) A court-appointed guardian or conservator of a resident, if any;

(2) An individual otherwise authorized by state or federal law to act on behalf of the resident in order to support the resident in decision making; access medical, social, or other personal information of the resident; manage financial matters; or receive notifications including, but not limited to:

(a) Agents under power of attorney;

(b) Representative payees; and

(3) If there is no individual who meets the criteria under sections (1) or (2) of this subsection, an individual chosen by the resident to act on behalf of the resident in order to support the resident in decision making; access medical, social, or other personal information of the resident; manage financial matters; or receive notifications.

(4) The term "resident representative" does not include any individual described in section (1) of this subsection who is affiliated with the adult family home where the resident resides, or its licensee or management company, unless the affiliated individual is a family member of the resident.

"Serious" means violations that either result in one or more negative outcomes and significant actual harm to residents that does not constitute imminent danger, or there is a reasonable predictability of recurring actions, practices, situations, or incidents with potential for causing significant harm to a resident, or both.

"Severity" means the seriousness of a violation as determined by actual or potential negative outcomes for residents and subsequent actual or potential for harm. Outcomes include any negative effect on the resident's physical, mental, or psychosocial well-being (such as safety, quality of life, quality of care).

"Significant change" means:

(1) A lasting change, decline, or improvement in the resident's baseline physical, mental, or psychosocial status;

(2) The change is significant enough so either the current assessment, or negotiated care plan, or both, do not reflect the resident's current status; and

(3) A new assessment may be needed when the resident's condition does not return to baseline within a two week period of time.

"Special care" means care beyond personal care services as defined in this section.

"Staff" means any person who is employed or used by an adult family home, directly or by contract, to provide care and services to any residents.

Staff must meet all the requirements in this chapter and chapter 388-112A WAC.

"Temporary restraining order" means a restraining order or order of protection that expired without a hearing, was dismissed following an initial hearing, or was dismissed by stipulation of the parties before an initial hearing.

"Uncorrected" means the department has cited a violation of WAC or RCW following an inspection and the violation remains uncorrected at the time of a subsequent inspection for the specific purpose of verifying whether such violation has been corrected.

"Unsupervised" means not in the presence of:

(1) Another employee or volunteer from the same business or organization; or

(2) Any relative or guardian of any of the children or individuals with developmental disabilities or vulnerable adults to which the employee, student, or volunteer has access during the course of their employment or involvement with the business or organization.

"Usable floor space" means resident bedroom floor space exclusive of:

(1) Toilet rooms;

(2) Closets;

(3) Lockers;

(4) Wardrobes;

(5) Vestibules; and

(6) The space required for the door to swing if the bedroom door opens into the resident bedroom.

"Vulnerable adult" means a person:

(1) 60 years of age or older who has the functional, mental, or physical inability to care for themselves; or

(2) Subject to a guardianship under RCW 11.130.265 or adult subject to conservatorship under RCW 11.130.360; or

(3) Who has a developmental disability as defined under RCW 71A.10.020; or

(4) Admitted to any facility; or

(5) Receiving services from home health, hospice, or home care agencies licensed or required to be licensed under chapter 70.127 RCW; or

(6) Receiving services from an individual provider; or

(7) Who self-directs their own care and receives services from a personal aide under chapter 74.39 RCW.

"Water hazard" means any body of water over 24 inches in depth that can be accessed by a resident, and includes but is not limited to:

(1) In-ground, above-ground, and on-ground pools;

(2) Hot tubs, spas;

(3) Fixed-in-place wading pools;

(4) Decorative water features;

(5) Ponds; or

(6) Natural bodies of water such as streams, lakes, rivers, and oceans.

"Working day" means any day the department is open for business.

History

Statutory Authority: RCW 18.20.090, 18.51.070, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 26-05-046, s 388-76-10000, filed 2/12/26, effective 3/15/26. Statutory Authority: RCW 18.20.090, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 25-16-099, s 388-76-10000, filed 8/6/25, effective 9/6/25. Statutory Authority: RCW 70.128.040 and 70.128.066. WSR 23-12-075, § 388-76-10000, filed 6/6/23, effective 8/1/23. Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 20-05-016, § 388-76-10000, filed 2/6/20, effective 3/8/20. Statutory Authority: Chapters 70.128 and 74.34 RCW. WSR 18-07-068, § 388-76-10000, filed 3/16/18, effective 4/16/18. Statutory Authority: Chapter 70.128 RCW. WSR 16-20-095, § 388-76-10000, filed 10/4/16, effective 11/4/16
WSR 16-06-004, § 388-76-10000, filed 2/17/16, effective 4/1/16
WSR 15-03-037, § 388-76-10000, filed 1/12/15, effective 2/12/15. Statutory Authority: RCW 74.39A.056 and chapters 74.34, 18.20 RCW. WSR 14-14-028, § 388-76-10000, filed 6/24/14, effective 7/25/14. Statutory Authority: Chapter 70.128 RCW. WSR 12-01-004, § 388-76-10000, filed 12/7/11, effective 1/7/12. Statutory Authority: RCW 70.128.040, chapter 74.39A RCW. WSR 10-16-082, § 388-76-10000, filed 7/30/10, effective 1/1/11. Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10000, filed 1/15/10, effective 2/15/10
WSR 09-03-029, § 388-76-10000, filed 1/12/09, effective 2/12/09. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10000, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10002 Department authority.

Under chapter 70.128 RCW, the department is authorized to take actions in response to adult family home noncompliance or violations of requirements of this chapter or rules adopted under chapters 70.128, 70.129, and 74.34 RCW.

History

Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10002, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-76-10003 Department access.

(1) During the initial licensing of the home, the applicant must allow the department staff to inspect the entire premises including all of the home's rooms, buildings, grounds, and equipment and all pertinent records.

(2) During inspections after initial licensing is complete, the adult family home must allow the department staff to examine all areas and articles in the home that are used to provide care or support to residents, including the physical premises and residents' records and accounts. The physical premises includes the buildings, grounds, and equipment, as well as all areas of the home for the purpose of checking smoke detectors, fire extinguishers, and posting of the emergency evacuation floor plan. The personal records of adult family home staff unrelated to the operation of the adult family home are not subject to department inspection. A separate bedroom used by adult family home staff will not be subject to review and inspection unless it is used to provide direct care to a resident.

(3) During complaint investigations, the adult family home must give department staff access to the entire premises and all records related to the residents or operation of the home. Department staff are authorized to interview the provider, family members, and individuals residing in the home including residents.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 20-05-016, § 388-76-10003, filed 2/6/20, effective 3/8/20. Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10003, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-76-10004 Exemptions.

(1) An adult family home may request an exemption to a specific requirement in this chapter. The request must demonstrate to the department that the exemption will:

(a) Not jeopardize or adversely affect any resident's health, safety, rights, or quality of life;

(b) Not change the fundamental nature of the adult family home operations;

(d) Allow the home to provide a comparable level of service to residents through the use of alternative procedures, materials, or equipment; and

(e) Not violate state or federal laws.

(2) A request for exemption must be submitted to the director of residential care services in writing and must:

(a) Identify the specific section of this chapter for which the exemption is sought;

(b) State the reason the requested exemption is needed; and

(c) Provide an explanation of how the home will meet the requirements in subsection (1) of this section if the exemption is approved.

(3) The adult family home must retain in the adult family home a copy of each approved exemption.

(4) Exemption to a requirement of this chapter may be granted at the sole discretion of the director of residential care services after evaluation of the criteria in subsection (1) of this section. The adult family home is not entitled to an administrative appeal of the department's denial of a request for an exemption.

History

Statutory Authority: RCW 70.128.040 and 70.128.066. WSR 23-12-075, § 388-76-10004, filed 6/6/23, effective 8/1/23.

Wash. Admin. Code § 388-76-10005 License—Required.

(1) Any person or entity must have a license by the department to operate an adult family home.

(2) No person or entity may provide personal care, special care, and room and board for more than one resident without a license.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10005, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10010 License—Valid and not transferable.

(1) The adult family home is not required to renew the license each year.

(2) The license remains valid unless:

(a) The department takes enforcement action to suspend or revoke the license per law;

(b) The home voluntarily surrenders the license and closes the home;

(d) The home fails to pay the annual licensing fee.

(3) The home license is:

(a) Not transferable; and

(b) Valid only for the provider and address listed on the license.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10010, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10015 License—Adult family home—Compliance required.

(1) The licensed adult family home must comply with all the requirements established in chapters 70.128, 70.129, 74.34 RCW, this chapter and other applicable laws and regulations including chapter 74.39A RCW; and

(2) The provider is ultimately responsible for the day-to-day operation of each licensed home.

(3) The provider must promote the health, safety, and well-being of each resident residing in each licensed adult family home.

History

Statutory Authority: Chapter 70.128 RCW. WSR 12-01-004, § 388-76-10015, filed 12/7/11, effective 1/7/12. Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10015, filed 1/15/10, effective 2/15/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10015, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10020 License—Ability to provide care and services.

The provider must have the:

(1) Understanding, ability, emotional stability and physical health necessary to meet the psychosocial, personal, and special care needs of the vulnerable adults under the home's care; and

(2) Ability to meet all personal and business financial obligations.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 20-05-016, § 388-76-10020, filed 2/6/20, effective 3/8/20. Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10020, filed 1/15/10, effective 2/15/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10020, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10025 License annual fee.

(1) The adult family home must pay the license fee that is established in the state's operating budget, as described in RCW 70.128.060.

(2) Each year, the home's annual license fee is due during the same month in which the home was initially licensed. For example, if the home was licensed in June, 2010, then the annual licensing fee will be due in June of each year.

(3) The home must ensure that the department receives the annual license fee when it is due.

(4) If the home does not pay the fee when it is due, the department will impose remedies.

History

Statutory Authority: RCW 70.128.040. WSR 12-16-087, § 388-76-10025, filed 7/31/12, effective 8/31/12. Statutory Authority: Chapter 70.128 RCW. WSR 12-01-004, § 388-76-10025, filed 12/7/11, effective 1/7/12. Statutory Authority: RCW 70.128.040. WSR 09-21-075, § 388-76-10025, filed 10/16/09, effective 11/16/09. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10025, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10030 Adult family home capacity.

(1) In determining the home's licensed capacity, the department must consider the:

(a) Structural design of the house;

(b) Number and accessibility of bathrooms;

(d) Total number of people living in the home who require personal or special care, including:

(i) Related children and adults; and

(ii) Other household members;

(e) The number of people for whom the home provides adult day care; and

(f) The ability for the home to safely evacuate all people living in the home.

(2) The licensed capacity number will be listed on the adult family home license and the home must ensure that the number of residents in the home does not exceed the licensed capacity.

(3) The adult family home licensed capacity may be adjusted due to changes to the household mix or structure, including the number of others receiving personal or special care in the home.

History

Statutory Authority: RCW 70.128.040 and 70.128.066. WSR 23-12-075, § 388-76-10030, filed 6/6/23, effective 8/1/23. Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10030, filed 1/15/10, effective 2/15/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10030, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10031 License requirements—Seven or eight bed adult family homes—Licensure.

(1) An adult family home submitting an application to increase the licensed capacity of a currently licensed adult family home to seven or eight residents must:

(a) Be able to demonstrate to the department the applicant's history of financial solvency and successful management experience as an adult family home provider;

(b) Maintain the initial license for the adult family home identified on the capacity increase application for a period of no less than 24 months prior to application;

(d) Demonstrate to the department the ability to comply with the emergency evacuation standards in WAC 388-76-10865; and

(e) Receive at least two full inspections prior to application, with no enforcement action taken against the home during the time period starting with the older of the two most recent inspections and ending at the time the capacity increase is approved. Between June 6, 2024, and January 1, 2026, for adult family homes applying to increase bed capacity under RCW 70.128.066, the department may:

(i) Complete the first inspection upon receipt of an application to increase bed capacity if the home has otherwise met the requirements of RCW 70.128.066.

(ii) Complete a second inspection upon receipt of an application to increase bed capacity if at least six months have passed since the first inspection.

(2) The adult family home must provide the following items to the department with the application:

(a) Documentation verifying the installation of an automatic sprinkler system that meets the requirements of chapter 51-54A WAC if the home serves residents who require assistance during an evacuation;

(b) Any outstanding fees associated with licensure or additional inspections;

(d) An attestation signed by the provider that states an increase in the number of beds will not adversely affect the provider's ability to meet the health, safety, rights, or quality of life needs of the current and prospective residents in the home.

(3) At the time of application for a license capacity increase to seven or eight residents, the adult family home must provide a written notice to all residents and the residents' representatives that the home has applied for a license capacity increase. This notice must:

(a) Be provided at least 60 days prior to admitting a seventh or eighth resident;

(b) Be written in a manner or language that is understood by the residents and the residents' representatives;

(c) Inform residents and resident representatives that the department will consider their comments regarding the quality of care and quality of life offered by the home and their views regarding the addition of one or two more residents; and

(d) Provide contact information for the regional residential care services licensing office where the resident or their representative can share their comments.

(4) An adult family home licensed for seven or eight beds that does not have an automatic sprinkler system must not serve residents that require assistance during evacuation as defined by WAC 388-76-10870 and will have a limit placed on their license by the department.

History

Statutory Authority: RCW 70.128.040 and 70.128.066. WSR 25-04-035, s 388-76-10031, filed 1/28/25, effective 3/4/25
WSR 23-12-075, § 388-76-10031, filed 6/6/23, effective 8/1/23.

Wash. Admin. Code § 388-76-10032 License requirements—Seven or eight bed adult family homes—Change of ownership.

An applicant submitting an application for a change of ownership of an adult family home with a licensed capacity of seven or eight residents must be a currently licensed adult family home provider that has held that license for a period of no less than 24 months; and

(1) Maintain a license for six or more residents in their currently licensed home for at least the 12 months immediately prior to application; and

(2) Receive at least two full inspections prior to application, with no enforcement action taken against the home during the time period starting with the older of the two most recent inspections and ending at the time the capacity increase is approved.

History

Statutory Authority: RCW 70.128.040 and 70.128.066. WSR 23-12-075, § 388-76-10032, filed 6/6/23, effective 8/1/23.

Wash. Admin. Code § 388-76-10035 License requirements—Multiple adult family home providers.

The department will only consider an application for more than one home if the applicant has:

(1) Evidence of successful completion of the adult family home administrator training to meet the applicable requirements of chapter 388-112A WAC;

(2) The ability to operate more than one home;

(3) The following plans for each home the applicant intends to operate. Each of the following plans must be updated and maintained:

(a) A twenty-four hour a day, seven day a week staffing plan;

(b) A plan for managing the daily operations of each home; and

(4) A demonstrated history of financial solvency related to the ability to provide care and services; and

(5) A different resident manager at each home who is responsible for the care of each resident at all times.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 20-05-016, § 388-76-10035, filed 2/6/20, effective 3/8/20. Statutory Authority: Chapter 70.128 RCW. WSR 18-20-015, § 388-76-10035, filed 9/21/18, effective 10/22/18
WSR 12-01-004, § 388-76-10035, filed 12/7/11, effective 1/7/12. Statutory Authority: RCW 70.128.040. WSR 10-04-008, § 388-76-10035, filed 1/22/10, effective 2/22/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10035, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10036 License requirements—Multiple adult family home management.

When there is more than one home licensed to a provider, the adult family home must ensure that:

(1) Each home has one person responsible for managing the overall delivery of care to all residents in the home;

(2) The designated responsible person is the provider, entity representative or a resident manager; and

(3) Each responsible person is designated to manage only one adult family home at a given time.

History

Statutory Authority: RCW 70.128.040. WSR 10-04-008, § 388-76-10036, filed 1/22/10, effective 2/22/10
WSR 09-03-030, § 388-76-10036, filed 1/12/09, effective 2/12/09.

Wash. Admin. Code § 388-76-10037 License requirements—Multiple adult family homes—Additional homes.

The department will only accept and process an application for an additional license as follows:

(1) For a second home, if the applicant has maintained the first adult family home license for at least twenty-four months with no enforcement actions as listed in RCW 70.128.160(2) related to a significant violation of chapters 70.128, 70.129 or 74.34 RCW, this chapter, or other applicable laws and regulations; and

(2) For a third or additional homes as follows:

(a) When twelve months have passed since the previous adult family home license was granted and the department has taken no enforcement actions against the applicant's currently licensed adult family homes during the twelve months prior to application; or

(b) When less than twelve months have passed since the previous adult family home license was granted; and

(i) The applications are due to the change in ownership of existing adult family homes that are currently licensed; and

(ii) No enforcement action was taken against any of the applicant's currently licensed homes during the twelve months prior to application.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 20-05-016, § 388-76-10037, filed 2/6/20, effective 3/8/20. Statutory Authority: Chapter 70.128 RCW. WSR 15-03-037, § 388-76-10037, filed 1/12/15, effective 2/12/15
WSR 12-01-004, § 388-76-10037, filed 12/7/11, effective 1/7/12.

Wash. Admin. Code § 388-76-10040 License requirements—Qualified person must live-in or be on-site.

(1) The adult family home provider or entity representative must:

(a) Live in the home; or

(b) Employ or contract with a resident manager who lives in the home and is responsible for the care and services of each resident at all times.

(2) The provider, entity representative, or resident manager is exempt from the requirement to live in the home if:

(a) The home has twenty-four hour staffing coverage; and

(b) A staff person who can make needed decisions is always present in the home.

History

Statutory Authority: RCW 70.128.040. WSR 10-04-008, § 388-76-10040, filed 1/22/10, effective 2/22/10
WSR 09-03-030, § 388-76-10040, filed 1/12/09, effective 2/12/09. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10040, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10041 License—Change of personnel.

An entity provider must:

(1) Notify the department when officers, directors, or entity representatives change, or when any owner is added and what percent of ownership is granted;

(2) Provide at least one point of contact for the owner, board of directors, or other governing body and if the entity has a board of directors, the provider must post in the home in a visible location in a common area information on at least one board meeting per twelve month period where all residents, their representatives, adult family home staff, the department, representatives of resident advocacy programs, and the long-term care ombuds can view it; and

(3) Provide written notice to all residents and the department when the entity representative changes as soon as possible upon realizing the need for a change.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 20-05-016, § 388-76-10041, filed 2/6/20, effective 3/8/20.

Wash. Admin. Code § 388-76-10050 License—Relinquishment.

(1) If an adult family home does not have any residents, it may relinquish its license at any time.

(2) The home must relinquish its license if it has not provided care and services to residents for twenty-four months.

(3) The department may revoke the adult family home license if:

(a) The home does not relinquish the license as required under subsection (2); and

(b) There is no credible evidence that residents were cared for in the home during the period of time specified in subsection (2).

History

Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10050, filed 1/15/10, effective 2/15/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10050, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10055 Application—Generally.

The applicant must send a completed application to the department for any of the following actions:

(1) To receive an initial adult family home license;

(2) To change ownership of the adult family home;

(3) To change the location or address of the adult family home; or

(4) To increase the licensed capacity of the adult family home.

History

Statutory Authority: RCW 70.128.040 and 70.128.066. WSR 23-12-075, § 388-76-10055, filed 6/6/23, effective 8/1/23. Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10055, filed 1/15/10, effective 2/15/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10055, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10057 Application—General qualifications.

Before sending the application to the department, the applicant must ensure that the people listed on the application meet any applicable minimum qualifications listed in WAC 388-76-10130 through 388-76-10145.

History

Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10057, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-76-10063 Application—General training requirements.

An applicant must ensure that any individual provider, entity representative, or resident manager listed on the application has successfully completed the training that is required for their role under this chapter and chapter 388-112A WAC.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 20-05-016, § 388-76-10063, filed 2/6/20, effective 3/8/20. Statutory Authority: Chapter 70.128 RCW. WSR 18-20-015, § 388-76-10063, filed 9/21/18, effective 10/22/18. Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10063, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-76-10064 Adult family home administrator training requirements.

(1) Applicants and entity representatives must successfully complete the department approved adult family home administration class as required in chapter 388-112A WAC.

(2) An applicant who operates or is the entity representative in a currently licensed home and has already taken the adult family home administrator training is not required to take the class again. However, a currently licensed provider or current entity representative who has not successfully completed the adult family home administrator training must take the class before submitting an application for a new license.

(3) Under exceptional circumstances, the department may waive the administrator training class for up to four months if the application meets all the other requirements for licensure and all the components of WAC 388-76-10074 or the requirements for a provisional license per RCW 70.128.064.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 20-05-016, § 388-76-10064, filed 2/6/20, effective 3/8/20. Statutory Authority: Chapter 70.128 RCW. WSR 18-20-015, § 388-76-10064, filed 9/21/18, effective 10/22/18
WSR 16-01-171, § 388-76-10064, filed 12/22/15, effective 1/22/16
WSR 12-01-004, § 388-76-10064, filed 12/7/11, effective 1/7/12. Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10064, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-76-10065 Application—Required information.

To apply for a license, an applicant must:

(1) Provide all information required on the application form;

(2) Provide any additional information requested by the department; and

(3) Send the complete application form to the department.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10065, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10070 Application—Fees required.

(1) The applicant must pay all processing and license fees established in the state omnibus appropriations act and any amendment or additions made to that act.

(2) The applicant must submit the required fees with the application form.

History

Statutory Authority: Chapter 70.128 RCW. WSR 12-01-004, § 388-76-10070, filed 12/7/11, effective 1/7/12. Statutory Authority: RCW 70.128.040. WSR 09-21-075, § 388-76-10070, filed 10/16/09, effective 11/16/09. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10070, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10073 Application—Processing fees required.

The processing fee, required in the state omnibus appropriations act and any amendment or additions made to that act, applies to any application submitted to the department, including but not limited to an application for licensure, change of ownership, or a change of location.

History

Statutory Authority: Chapter 70.128 RCW. WSR 12-01-004, § 388-76-10073, filed 12/7/11, effective 1/7/12. Statutory Authority: RCW 70.128.040. WSR 09-21-075, § 388-76-10073, filed 10/16/09, effective 11/16/09.

Wash. Admin. Code § 388-76-10074 Application—Waiver of fees.

The department may authorize a one-time waiver of the application fees for a change of ownership or relocation, if the situation meets all of the following conditions:

(1) The current provider has experienced an exceptional circumstance such as the diagnosis of a terminal or debilitating illness that prevents them from running the adult family home;

(2) Residents will be forced to move if a new provider is not licensed;

(3) Full payment of the licensing fee would cause the applicant a financial hardship;

(4) The application has been approved for priority processing by the local field office per WAC 388-76-10107; and

(5) Neither the applicant nor the current provider has requested a waiver of fees in the past.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 20-05-016, § 388-76-10074, filed 2/6/20, effective 3/8/20. Statutory Authority: Chapter 70.128 RCW. WSR 16-01-171, § 388-76-10074, filed 12/22/15, effective 1/22/16.

Wash. Admin. Code § 388-76-10075 Application—Becomes void.

The department must consider the application void when the applicant:

(1) Does not return information to the department within sixty calendar days of the department's first request for additional information for an incomplete application; or

(2) Has not obtained an adult family home license within one calendar year of first submitting the application to the department.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10075, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10080 Application—Coprovider.

Couples who are legally married or domestic partners under Washington state law:

(1) May not apply for separate licenses; and

(2) May apply jointly to be coproviders, if they are both qualified. One person may apply to be a provider without requiring the other person to apply.

History

Statutory Authority: Chapter 70.128 RCW. WSR 12-01-004, § 388-76-10080, filed 12/7/11, effective 1/7/12. Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10080, filed 1/15/10, effective 2/15/10
WSR 09-03-030, § 388-76-10080, filed 1/12/09, effective 2/12/09. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10080, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10085 Application—Affiliated facilities.

The applicant must include in the application a list of all facilities or homes in which the applicant, persons affiliated with the applicant, or affiliated entities provided care and services to children or vulnerable adults within the last ten years.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 20-05-016, § 388-76-10085, filed 2/6/20, effective 3/8/20. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10085, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10090 Application—Entity application.

An entity submitting an application must:

(1) Include a list of all facilities or homes in which the applicant or persons affiliated with the applicant, managerial employee, or owner of five percent or more of the entity provided care and services to children or vulnerable adults within the last ten years;

(2) Designate an entity representative who:

(a) Fulfills the training and qualification requirements under this chapter that only an individual can fulfill where an entity cannot;

(b) Is responsible on behalf of the entity for the operations of the adult family home;

(d) May act as the resident manager in only one home;

(e) May be an officer, director, member, or owner of the entity, but in the case that they are not, the entity provider must have a plan under WAC 388-76-10201 to ensure that at no time will the entity provider lack an entity representative that meets the requirements of subsection (2)(a) of this section; and

(f) May be designated as the entity representative for only one entity provider;

(3) Designate a resident manager for the home if the entity representative is not the designated resident manager in subsection (2)(d) of this section; and

(4) Identify all DSHS licensed facilities or homes owned by any affiliated entity.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 20-05-016, § 388-76-10090, filed 2/6/20, effective 3/8/20. Statutory Authority: RCW 70.128.040. WSR 10-04-008, § 388-76-10090, filed 1/22/10, effective 2/22/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10090, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10095 Application—Identification of property owner—Required.

(1) Applicants must name the property owner of the building if the building to be used as an adult family home is leased, under contract, or rented and the property owner takes an active interest in the operation of the home.

(2) An active interest includes but is not limited to:

(a) The charging of rent as a percentage of the business;

(b) Assistance with start-up and/or operational costs;

(d) Recruitment of residents;

(e) Management oversight;

(f) Assessment and/or negotiated care plan development of residents;

(g) The provision of personal or special care of residents; or

(h) Property ownership by an affiliated entity.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 20-05-016, § 388-76-10095, filed 2/6/20, effective 3/8/20. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10095, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10100 Application—Subject to review.

(1) Adult family home license applications are subject to review under this chapter.

(2) The department will not process an incomplete application and will return the application requesting the missing information.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10100, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10105 Application—Change of ownership.

(1) Under this section, "control of the provider" means the possession, directly or indirectly, of the power to direct the management, operation and/or policies of the adult family home, whether through ownership, voting control, by agreement, by contract, or otherwise.

(2) A change of ownership of an adult family home requires both a new license application and a new license.

(3) A change of ownership occurs when there is a change in:

(a) The provider; or

(b) The control of a provider.

(4) Events that constitute a change of ownership include, but are not limited to:

(a) The form of legal organization of the adult family home is changed, such as when an adult family home forms:

(i) A partnership;

(ii) A corporation;

(iii) A limited liability company; or

(iv) When it merges with another legal organization;

(b) The adult family home transfers business operations and management responsibility to another party, whether or not there is a partial or whole transfer of real property, personal property, or both;

(d) If the adult family home is an entity and the entity:

(i) Is dissolved;

(ii) Merges with another entity, resulting in a change in the control of the provider;

(iii) Consolidates with one or more entities to form a new entity; or

(iv) Whether by a single transaction or multiple transactions over any time period, transfers fifty percent or more of its shares to one or more of the following:

(A) New or former owners; or

(B) Present owners, each having less than five percent of the ownership interest before the initial transaction; or

(e) Any other event or combination of events that results in a substitution, elimination, or withdrawal of the provider's control of the adult family home.

(5) Events which do not by themselves constitute a change in ownership include:

(a) For a nonprofit entity only, a change of a member or members of the board of directors;

(b) A change in entity representative; or

(c) Two people are both licensed as a married couple or domestic partners to operate an adult family home and an event, such as separation, divorce, or death, results in only one person operating the home.

(6) The new owner:

(a) Must obtain a new license from the department before transfer of ownership;

(b) Must not begin operation of the adult family home until the department has granted the license unless a provisional license has been requested and granted for exceptional circumstances per RCW 70.128.064;

(d) Is subject to the provisions of chapters 70.128, 70.129, 74.34 RCW, this chapter and other applicable laws and regulations;

(e) Must ensure that any funds in the resident's accounts at the time of the ownership change remain in an equivalent account. If any funds in resident's accounts are moved, the new owner must promptly notify residents or resident's representative in writing of the name, address, and location of the new depository; and

(f) Must provide the department with a copy of the written notice of the change of ownership that was given to each resident, or applicable resident representatives.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 20-05-016, § 388-76-10105, filed 2/6/20, effective 3/8/20. Statutory Authority: Chapter 70.128 RCW. WSR 12-01-004, § 388-76-10105, filed 12/7/11, effective 1/7/12. Statutory Authority: RCW 70.128.040. WSR 10-14-058, § 388-76-10105, filed 6/30/10, effective 7/31/10
WSR 10-04-008, § 388-76-10105, filed 1/22/10, effective 2/22/10
WSR 09-03-030, § 388-76-10105, filed 1/12/09, effective 2/12/09. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10105, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10106 Change of ownership—Notice to department and residents.

(1) The current adult family home owner must provide written notice to the department and residents or applicable resident representatives sixty calendar days prior to the date of the proposed change of ownership; and

(2) The home must include the following information in the written notice:

(a) Names of the present owner and prospective owner, and if the present or prospective owner is an entity, include the names of each partner, member, officer, and director of the entity, and of any affiliated entities;

(b) Name and address of the adult family home for which the ownership is being changed;

(d) The resident's right to decide whether they want to stay or move; and

(e) Any change in the home's policies or operations that could impact a resident's ability to continue to live in the home. For example, if the new owner will be changing the home's policy on serving medicaid eligible residents, that change might impact a resident's ability to continue receiving services in the home.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 20-05-016, § 388-76-10106, filed 2/6/20, effective 3/8/20. Statutory Authority: RCW 70.128.040. WSR 10-14-058, § 388-76-10106, filed 6/30/10, effective 7/31/10.

Wash. Admin. Code § 388-76-10107 Priority processing—Change of ownership and relocation.

(1) In order to prevent disruption to residents, currently licensed providers may request in writing that the department give priority processing to an applicant seeking to be licensed as the new provider of an existing, licensed adult family home in the event of a change of ownership or relocation.

(2) If priority processing is granted, the requirement that written notification be provided to the department and residents or applicable resident representatives sixty days prior to the change of ownership may be waived. Notice will be required as early as possible if this requirement is waived.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 20-05-016, § 388-76-10107, filed 2/6/20, effective 3/8/20. Statutory Authority: Chapter 70.128 RCW. WSR 16-01-171, § 388-76-10107, filed 12/22/15, effective 1/22/16. Statutory Authority: RCW 70.128.040. WSR 10-14-058, § 388-76-10107, filed 6/30/10, effective 7/31/10.

Wash. Admin. Code § 388-76-10110 Application—Change of location or address.

(1) A change of the adult family home location or address requires both a new license application and a new license.

(2) The home must not start operations of the home at a new location until the department has granted the license for the new location.

(3) The home must notify each resident or resident representative, in writing at least thirty days before the effective date of the change of the home location or address.

History

Statutory Authority: RCW 70.128.040. WSR 10-04-008, § 388-76-10110, filed 1/22/10, effective 2/22/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10110, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10115 Granting or denying a license—Generally.

In making a determination of whether to grant an adult family home license, the department must consider:

(1) Separately and jointly each person and entity named in an application, including each person or entity affiliated with the applicant;

(2) Information in the application;

(3) Other documents and information the department deems relevant which may include, but not be limited to:

(a) Inspection and complaint investigation findings in each facility or home in which the applicant, person affiliated with the applicant, or owner of five percent or more of the entity provided care or services to children or vulnerable adults; and

(b) Credit information.

(4) The history of convictions and other circumstances described in WAC 388-76-10120 and 388-76-10125 for each individual listed on the application including, but not limited to the following:

(a) Applicant;

(b) Person affiliated with the applicant;

(d) Caregiver;

(e) An owner who:

(i) Exercised daily control over the operations; or

(ii) Owns fifty-one percent or more of the entity.

(f) Any person who may have unsupervised access to residents in the home; and

(g) Any person who lives in the home and is not a resident.

History

Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10115, filed 1/15/10, effective 2/15/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10115, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10120 License—Must be denied.

WAC 388-76-10120

The adult family home license will not be granted if:

(1) The applicant has not successfully completed a department-approved adult family home administration and business planning class except as provided in WAC 388-76-10064;

(2) It has been less than 20 years since the applicant surrendered or relinquished an adult family home license after receiving notice of the department's initiation of a denial, suspension, nonrenewal, or revocation of the license; or

(3) The applicant, the spouse, or domestic partner of an applicant who is a sole proprietor, the spouse or domestic partner of an entity representative with an ownership interest in the business, or any partner, officer, director, managerial employee, or majority owner of the applying entity:

(a) Has a history of significant noncompliance with federal or state laws or regulations in the provision of care or services to children or vulnerable adults;

(b) Has prior violations of federal or state laws or regulations relating to residential care facilities resulting in revocation, suspension, or nonrenewal of a license or contract with the department within the past 10 years;

(c) Has a conviction or pending criminal charge for a crime that is automatically disqualifying under chapter 388-113 WAC; or

(d) Has one or more of the following disqualifying negative actions:

(i) A court has issued a permanent restraining order or order of protection, either active or expired, against the person that was based upon abuse, neglect, financial exploitation, or mistreatment of a child or vulnerable adult;

(ii) The person is a registered sex offender;

(iii) The person is on a registry based upon a final finding of abuse, neglect, or financial exploitation of a vulnerable adult, unless the finding was made by adult protective services prior to October 2003;

(iv) A founded finding of abuse or neglect of a child was made against the person, unless the finding was made by child protective services prior to October 1, 1998;

(v) The individual was found in any dependency action to have sexually assaulted or exploited any child or to have physically abused any child;

(vi) The individual was found by a court in a domestic relations proceeding under Title 26 RCW, or under any comparable state or federal law, to have sexually abused or exploited any child or to have physically abused any child;

(vii) The individual has had a contract or license denied, terminated, revoked, or suspended due to abuse, neglect, financial exploitation, or mistreatment of a child or vulnerable adult; or

(viii) The individual has relinquished a license or terminated a contract because an agency was taking an action against the individual related to alleged abuse, neglect, financial exploitation, or mistreatment of a child or vulnerable adult.

(4) The applicant is the operator of one or more currently licensed adult family homes and does not meet the requirements of being a multiple home provider under RCW 70.128.065.

History

Statutory Authority: RCW 70.128.040, 70.128.065, and 45 C.F.R. § 1324.11 (e)(2). WSR 26-17-004, s 388-76-10120, filed 8/5/26, effective 9/20/26. Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 20-05-016, § 388-76-10120, filed 2/6/20, effective 3/8/20. Statutory Authority: RCW 74.39A.056 and chapters 74.34, 18.20 RCW. WSR 14-14-028, § 388-76-10120, filed 6/24/14, effective 7/25/14. Statutory Authority: RCW 70.128.040. WSR 12-16-087, § 388-76-10120, filed 7/31/12, effective 8/31/12. Statutory Authority: Chapter 70.128 RCW. WSR 12-01-004, § 388-76-10120, filed 12/7/11, effective 1/7/12. Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10120, filed 1/15/10, effective 2/15/10
WSR 09-03-028, § 388-76-10120, filed 1/12/09, effective 2/12/09. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10120, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10125 License—May be denied.

WAC 388-76-10125

The adult family home license may be denied if the applicant or the applicant's spouse, domestic partner, or any partner, officer, director, managerial employee, or majority owner of the applying entity:

(1) Has any conviction or pending criminal charge for crime that is not automatically disqualifying under chapter 388-113 WAC, but that the department determines is reasonably related to the competency of the person to be involved in the ownership or operation of an adult family home;

(2) Has abused, neglected, or financially exploited a vulnerable adult, unless denial is required under WAC 388-76-10120;

(3) Has engaged in the illegal use, sale, or distribution of drugs or excessive use of alcohol or drugs without the evidence of rehabilitation;

(4) Has been found in any final decision of a federal or state agency to have abandoned, neglected, abused, or financially exploited a vulnerable adult, unless such decision requires a license denial under WAC 388-76-10120;

(5) Has had a license for the care of children or vulnerable adults denied, suspended, revoked, or not renewed in connection with the operation of any facility for the care of children or vulnerable adults, relinquished or returned a license, or did not seek license renewal following written notification that the licensing agency intended to deny, suspend, or revoke the license, unless such action requires a license denial under WAC 388-76-10120;

(6) Has a history of prior violations of chapter 70.128 RCW or any law regulating residential care facilities that resulted in revocation, suspension, or nonrenewal of a license;

(7) Has been enjoined from operating a facility for the care and services of children or adults;

(8) Has had a medicaid or medicare provider agreement or any other contract for the care and treatment of children or vulnerable adults, terminated, cancelled, suspended, or not renewed by any public agency, including a state medicaid agency;

(9) Has been the subject of a sanction, corrective, or remedial action taken by federal, state, county, or municipal officials or safety officials related to the care or treatment of children or vulnerable adults;

(10) Has obtained or attempted to obtain a license from the department by fraudulent means or misrepresentation;

(11) Knowingly, or with reason to know, made a false statement of material fact on their application for a license or any data attached to the application, or in any matter involving the department;

(12) Permitted, aided, or abetted the commission of any illegal act on the adult family home premises;

(13) Willfully prevented or interfered with or failed to cooperate with any inspection, investigation, or monitoring visit made by the department, including refusal to permit authorized department representatives to interview residents or have access to their records;

(14) Failed or refused to comply with:

(a) A condition imposed on a license or a stop placement order; or

(b) The requirements of chapters 70.128, 70.129, 74.34 RCW, this chapter, or other applicable laws and regulations;

(15) Misappropriated property of a resident, unless such action requires a license denial under WAC 388-76-10120;

(16) Exceeded licensed capacity in the operation of an adult family home;

(17) Operated a facility for the care of children or adults without a license or with a revoked license;

(18) When providing care to children or vulnerable adults, has had resident trust funds or assets seized by the Internal Revenue Service or a state entity for failure to pay income or payroll taxes;

(19) Failed to meet financial obligations as the obligations fell due in the normal course of owning or operating a business involved in the provision of care and services to children or vulnerable adults;

(20) Has failed to meet personal financial obligations, or if the applicant is an entity, has failed to meet the entity's financial obligation, or both;

(21) Interfered with a long-term care ombuds or department staff in the performance of their duties;

(22) Has not demonstrated financial solvency or management experience in its currently licensed homes, or has not demonstrated the ability to meet other relevant safety, health, and operating standards pertaining to the operation of multiple homes, including ways to mitigate the potential impact of vehicular traffic related to the operation of the homes;

(23) The home is currently licensed:

(a) As an assisted living facility; or

(b) To provide care for children in the same home, unless:

(i) It is necessary in order to allow a resident's child(ren) to live in the same home as the resident or to allow a resident who turns 18 to remain in the home;

(ii) The applicant provides satisfactory evidence to the department of the home's capacity to meet the needs of children and adults residing in the home; and

(iii) The total number of residents receiving care and services in the home does not exceed the number permitted by the licensed capacity of the home;

(24) Failed to give the department access to all parts of the home as authorized under RCW 70.128.090; or

(25) Has demonstrated any other factors that give evidence the individual lacks the appropriate character, competence, and suitability to provide care or services to vulnerable adults.

History

Statutory Authority: RCW 70.128.040, 70.128.065, and 45 C.F.R. § 1324.11 (e)(2). WSR 26-17-004, s 388-76-10125, filed 8/5/26, effective 9/20/26. Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 20-05-016, § 388-76-10125, filed 2/6/20, effective 3/8/20. Statutory Authority: Chapter 70.128 RCW. WSR 15-03-037, § 388-76-10125, filed 1/12/15, effective 2/12/15. Statutory Authority: RCW 74.39A.056 and chapters 74.34, 18.20 RCW. WSR 14-14-028, § 388-76-10125, filed 6/24/14, effective 7/25/14. Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10125, filed 1/15/10, effective 2/15/10
WSR 09-03-028, § 388-76-10125, filed 1/12/09, effective 2/12/09. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10125, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10129 Qualifications—Adult family home personnel.

(1) The adult family home must ensure that any person employed or used by the adult family home, directly or by contract, is qualified and meets all of the applicable requirements of this chapter and chapter 388-112A WAC. This may include, but is not limited to:

(a) The provider;

(b) Entity representative;

(d) Staff; and

(e) Caregivers.

(2) Every home must have a designated resident manager. The provider or entity representative can also be the designated resident manager, but an individual can only be the designated resident manager for one home at a time.

(3) For entities licensed after the effective date of this section, an individual can only be the entity representative for one entity provider.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 20-05-016, § 388-76-10129, filed 2/6/20, effective 3/8/20. Statutory Authority: Chapter 70.128 RCW. WSR 18-20-015, § 388-76-10129, filed 9/21/18, effective 10/22/18. Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10129, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-76-10130 Qualifications—Provider, entity representative, and resident manager.

The adult family home must ensure that the provider, entity representative on behalf of an entity provider, and resident manager have the following minimum qualifications:

(1) Be twenty-one years of age or older;

(2) Have a United States high school diploma or high school equivalency certificate as provided in RCW 28B.50.536, or any English or translated government document of the following:

(a) Successful completion of government approved public or private school education in a foreign country that includes an annual average of one thousand hours of instruction a year for twelve years, or no less than twelve thousand hours of instruction;

(b) Graduation from a foreign college, foreign university, or United States community college with a two-year diploma, such as an associate's degree;

(c) Admission to, or completion of course work at a foreign or United States college or university for which credit was awarded;

(d) Graduation from a foreign or United States college or university, including award of a bachelor's degree;

(e) Admission to, or completion of postgraduate course work at, a United States college or university for which credits were awarded, including award of a master's degree; or

(f) Successful passage of the United States board examination for registered nursing, or any professional medical occupation for which college or university education was required;

(3) Completion of the training requirements that were in effect on the date they were hired or became licensed providers, including the requirements described in chapter 388-112A WAC;

(4) Have good moral and responsible character and reputation;

(5) Be literate and able to communicate in the English language, and assure that a person is on staff and available at the home who is capable of understanding and speaking English well enough to be able to respond appropriately to emergency situations and be able to read, understand and implement resident negotiated care plans;

(6) Have the ability to communicate with residents in their primary language, including through a qualified person on-site or readily available at all times, or other reasonable accommodations, such as a language line;

(7) Be able to carry out the management and administrative requirements of chapters 70.128, 70.129 and 74.34 RCW, this chapter and other applicable laws and regulations;

(8) Have completed at least one thousand hours of successful direct care experience in the previous sixty months obtained after age eighteen to vulnerable adults in a licensed or contracted setting before operating or managing a home. Individuals holding one of the following professional licenses are exempt from this requirement:

(a) Physician licensed under chapter 18.71 RCW;

(b) Osteopathic physician licensed under chapter 18.57 RCW;

(d) Physician assistant licensed under chapter 18.71A RCW; or

(e) Registered nurse, advanced registered nurse practitioner, or licensed practical nurse licensed under chapter 18.79 RCW;

(9) Have no disqualifying criminal convictions or pending criminal charges under chapter 388-113 WAC;

(10) Have none of the negative actions listed in WAC 388-76-10180;

(11) Obtain and keep valid cardiopulmonary resuscitation (CPR) and first-aid card or certificate as required in chapter 388-112A WAC; and

(12) Have tuberculosis screening to establish tuberculosis status per this chapter.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 20-05-016, § 388-76-10130, filed 2/6/20, effective 3/8/20. Statutory Authority: Chapter 70.128 RCW. WSR 18-20-015, § 388-76-10130, filed 9/21/18, effective 10/22/18
WSR 15-03-037, § 388-76-10130, filed 1/12/15, effective 2/12/15. Statutory Authority: RCW 74.39A.056 and chapters 74.34, 18.20 RCW. WSR 14-14-028, § 388-76-10130, filed 6/24/14, effective 7/25/14. Statutory Authority: Chapter 70.128 RCW. WSR 12-01-004, § 388-76-10130, filed 12/7/11, effective 1/7/12. Statutory Authority: RCW 70.128.040, chapter 74.39A RCW. WSR 10-16-082, § 388-76-10130, filed 7/30/10, effective 1/1/11. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10130, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10135 Qualifications—Caregiver.

The adult family home must ensure each caregiver has the following minimum qualifications:

(1) Be eighteen years of age or older;

(2) Has a clear understanding of the caregiver job responsibilities and knowledge of each resident's negotiated care plan to provide care specific to the needs of each resident;

(3) Has basic communication skills to:

(a) Be able to communicate or make provisions to communicate with the resident in his or her primary language; and

(b) Understand and speak English well enough to:

(i) Respond appropriately to emergency situations; and

(ii) Read, understand, and implement resident negotiated care plans;

(4) Has completed the training requirements in effect on the date the caregiver was hired, including the requirements applicable to the caregiver under chapter 388-112A WAC;

(5) Has no disqualifying criminal convictions or pending criminal charges under chapter 388-113 WAC;

(6) Has none of the negative actions listed in WAC 388-76-10180;

(7) Has a current valid first-aid card or certificate as required in chapter 388-112A WAC, except nurses, who are exempt from this requirement;

(8) Has a valid cardiopulmonary resuscitation (CPR) card or certificate as required in chapter 388-112A WAC; and

(9) Meets the tuberculosis screening requirements of this chapter.

History

Statutory Authority: Chapter 70.128 RCW. WSR 18-20-015, § 388-76-10135, filed 9/21/18, effective 10/22/18
WSR 17-01-002, § 388-76-10135, filed 12/7/16, effective 1/7/17. Statutory Authority: RCW 74.39A.056 and chapters 74.34, 18.20 RCW. WSR 14-14-028, § 388-76-10135, filed 6/24/14, effective 7/25/14. Statutory Authority: RCW 70.128.040, chapter 74.39A RCW. WSR 10-16-082, § 388-76-10135, filed 7/30/10, effective 1/1/11. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10135, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10140 Qualifications—Students—Volunteers.

The adult family home must ensure that students and volunteers meet the following minimum qualifications:

(1) Be eighteen years old or older;

(2) Meet the department's training requirements of chapter 388-112A WAC;

(3) Have no criminal convictions listed in RCW 43.43.830 and 43.43.842 or state or federal findings of abandonment, abuse, neglect or financial exploitation; and

(4) Tuberculosis screening to establish tuberculosis status per this chapter.

History

Statutory Authority: Chapter 70.128 RCW. WSR 18-20-015, § 388-76-10140, filed 9/21/18, effective 10/22/18. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10140, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10145 Qualifications—Licensed nurse as provider, entity representative, or resident manager.

The adult family home must ensure that a licensed nurse who is a provider, entity representative, or resident manager:

(1) Meets the relevant qualifications for their role listed in WAC 388-76-10130; and

(2) Has a current valid cardiopulmonary resuscitation (CPR) card or certificate as required in chapter 388-112A WAC.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 20-05-016, § 388-76-10145, filed 2/6/20, effective 3/8/20. Statutory Authority: Chapter 70.128 RCW. WSR 18-20-015, § 388-76-10145, filed 9/21/18, effective 10/22/18
WSR 16-20-095, § 388-76-10145, filed 10/4/16, effective 11/4/16. Statutory Authority: RCW 74.39A.056 and chapters 74.34, 18.20 RCW. WSR 14-14-028, § 388-76-10145, filed 6/24/14, effective 7/25/14. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10145, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10146 Qualifications—Training and home care aide certification.

(1) The adult family home must ensure staff persons hired before January 7, 2012 meet training requirements in effect on the date hired, including requirements in chapter 388-112A WAC.

(2) The adult family home must ensure all adult family home caregivers, entity representatives, and resident managers hired on or after January 7, 2012, meet the long-term care worker training requirements of chapter 388-112A WAC, including but not limited to:

(a) Orientation and safety;

(b) Basic;

(c) Specialty for dementia, mental illness and/or developmental disabilities when serving residents with any of those primary special needs;

(d) Cardiopulmonary resuscitation and first aid; and

(e) Continuing education.

(3) All persons listed in subsection (2) of this section, must obtain the home-care aide certification if required by this section or chapters 246-980 or 388-112A WAC.

(a) Until March 1, 2016, a provisional home-care aide certification may be issued by the department of health to a long-term care worker who is limited English proficient.

(4) Even if an adult family home applicant does not intend to provide direct personal care, the applicant must meet the long-term care worker training and home-care aide certification requirements under chapter 388-112A WAC to the same extent that the requirements would apply if the applicant was a long-term care worker.

(5) Under RCW 18.88B.041 and chapter 246-980 WAC, certain individuals, including registered nurses, licensed practical nurses, certified nursing assistants or persons who are in an approved certified nursing assistant program, are exempt from home-care aide certification and long-term care worker training requirements. This exemption does not apply to continuing education; these individuals must comply with continuing education requirements under chapter 388-112A WAC.

(6) The adult family home must ensure that all staff receive the orientation and training necessary to perform their job duties.

History

Statutory Authority: Chapter 70.128 RCW. WSR 18-20-015, § 388-76-10146, filed 9/21/18, effective 10/22/18
WSR 15-03-037, § 388-76-10146, filed 1/12/15, effective 2/12/15. Statutory Authority: RCW 70.128.040. WSR 12-16-087, § 388-76-10146, filed 7/31/12, effective 8/31/12. Statutory Authority: Chapter 70.128 RCW. WSR 12-01-004, § 388-76-10146, filed 12/7/11, effective 1/7/12. Statutory Authority: RCW 70.128.040, chapter 74.39A RCW. WSR 10-16-082, § 388-76-10146, filed 7/30/10, effective 1/1/11.

Wash. Admin. Code § 388-76-10150 Qualifications—Assessor.

(1) The adult family home must ensure that an assessor, except for an authorized department case manager, performing an assessment for any resident meets the following qualifications:

(a) A master's degree in social services, human services, behavioral sciences or an allied field and two years social service experience working with adults who have functional or cognitive disabilities; or

(b) A bachelor's degree in social services, human services, behavioral sciences or an allied field and three years social service experience working with adults who have functional or cognitive disabilities; or

(c) Have a valid Washington state license to practice as a nurse under chapter 18.79 RCW and three years of clinical nursing experience; or

(d) Is currently a licensed physician, including an osteopathic physician, in Washington state.

(2) The home must ensure than an assessor who meets the requirements of subsections (1)(a), (b), or (c) of this section does not have unsupervised access to any resident unless the assessor has:

(a) A current criminal history background check; and

(b) Has no disqualifying criminal convictions or pending criminal charges under chapter 388-113 WAC; and

History

Statutory Authority: RCW 74.39A.056 and chapters 74.34, 18.20 RCW. WSR 14-14-028, § 388-76-10150, filed 6/24/14, effective 7/25/14. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10150, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10160 Background checks—General.

(1) Background checks conducted by the department and required in this chapter include but are not limited to:

(a) Washington state name and date of birth background checks; and

(b) After January 7, 2012, a national fingerprint background check in accordance with RCW 74.39A.056.

(2) Nothing in this chapter should be interpreted as requiring the employment of any person against the better judgment of the adult family home.

(3) In addition to chapter 70.128 RCW, these rules are authorized by RCW 43.20A.710, 43.43.830 through 43.43.842 and RCW 74.39A.051.

History

Statutory Authority: RCW 70.128.040. WSR 12-16-087, § 388-76-10160, filed 7/31/12, effective 8/31/12. Statutory Authority: RCW 70.128.040, chapter 74.39A RCW. WSR 10-16-082, § 388-76-10160, filed 7/30/10, effective 1/1/11. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10160, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10161 Background checks—Who is required to have.

(1) An adult family home applicant and anyone affiliated with an applicant must have the following background checks before licensure:

(a) A Washington state name and date of birth background check; and

(b) If applying after January 7, 2012, a national fingerprint background check.

(2) The adult family home must ensure that all caregivers, entity representatives, and resident managers who are employed directly or by contract after January 7, 2012, have the following background checks:

(a) A Washington state name and date of birth background check; and

(b) A national fingerprint background check.

(3) All household members over the age of eleven, volunteers, students, and noncaregiving staff who may have unsupervised access to residents must have a Washington state name and date of birth background check. They are not required to have a national fingerprint background check.

History

Statutory Authority: RCW 70.128.040. WSR 12-16-087, § 388-76-10161, filed 7/31/12, effective 8/31/12. Statutory Authority: RCW 70.128.040, chapter 74.39A RCW. WSR 10-16-082, § 388-76-10161, filed 7/30/10, effective 1/1/11.

Wash. Admin. Code § 388-76-10163 Background checks—Process—Background authorization form.

Before the adult family home employs, directly or by contract, a resident manager, entity representative, caregiver, or noncaregiving staff, or accepts as a caregiver any volunteer or student, or allows a household member over the age of eleven unsupervised access to residents, the home must:

(1) Require the person to complete a DSHS background authorization form; and

(2) Submit form to the department's background check central unit, including any additional documentation and information requested by the department.

History

Statutory Authority: RCW 74.39A.056 and chapters 74.34, 18.20 RCW. WSR 14-14-028, § 388-76-10163, filed 6/24/14, effective 7/25/14. Statutory Authority: RCW 70.128.040. WSR 12-16-087, § 388-76-10163, filed 7/31/12, effective 8/31/12. Statutory Authority: RCW 70.128.040, chapter 74.39A RCW. WSR 10-16-082, § 388-76-10163, filed 7/30/10, effective 1/1/11.

Wash. Admin. Code § 388-76-101631 Background checks—Washington state name and date of birth background check.

If the results of the Washington state name and date of birth background check indicate an individual has a disqualifying criminal conviction or a pending charge for a disqualifying crime under chapter 388-113 WAC, or a disqualifying negative action listed in WAC 388-76-10180 then:

(1) If the individual is a caregiver, entity representative or resident manager, the adult family home must not employ the individual, either directly or by contract; and

(2) If the individual is a household member over the age of eleven, volunteer, student or noncaregiving staff then the adult family home must not allow the individual to have unsupervised access to residents.

History

Statutory Authority: RCW 74.39A.056 and chapters 74.34, 18.20 RCW. WSR 14-14-028, § 388-76-101631, filed 6/24/14, effective 7/25/14. Statutory Authority: RCW 70.128.040. WSR 12-16-087, § 388-76-101631, filed 7/31/12, effective 8/31/12.

Wash. Admin. Code § 388-76-101632 Background checks—National fingerprint background check.

(1) Individuals specified in WAC 388-76-10161(2) who are hired after January 7, 2012 and are not disqualified by the Washington state name and date of birth background check, must complete a national fingerprint background check and follow department procedures.

(2) After receiving the results letter of the national fingerprint background check the adult family home must not employ, directly or by contract, a caregiver, entity representative or resident manager who has been convicted of a disqualifying crime or who:

(i) Has a disqualifying conviction or pending charge under chapter 388-113 WAC; or

(ii) Has a disqualifying negative action listed in WAC 388-76-10180.

(3) The provider may accept a copy of a national fingerprint background check result letter and any additional information from the department's background check central unit from an individual who previously completed a national fingerprint background check through the background check central unit, provided the national fingerprint background check was completed after January 7, 2012.

History

Statutory Authority: RCW 74.39A.056 and chapters 74.34, 18.20 RCW. WSR 14-14-028, § 388-76-101632, filed 6/24/14, effective 7/25/14. Statutory Authority: RCW 70.128.040. WSR 12-16-087, § 388-76-101632, filed 7/31/12, effective 8/31/12.

Wash. Admin. Code § 388-76-10164 Background checks—Results—Duty to inform.

(1) After receiving the results of the Washington state name and date of birth background check, the adult family home must:

(a) Inform the person of the results of the background checks;

(b) Inform the person that they may request a copy of the results of the background check. If requested, a copy of the background check results must be provided within ten days of the request; and

(c) Notify the department and the other appropriate licensing or certification agency of any person resigning or terminated as a result of having a disqualifying criminal conviction or pending charge for a disqualifying crime under chapter 388-113 WAC, or a negative action that is disqualifying under WAC 388-76-10180.

(2) After receiving a copy of the results letter of the national fingerprint background check, the adult family home must inform the person:

(a) Of the background check result letter; and

(b) Inform the person that they may request a copy of the results of the national fingerprint background check result letter; and

History

Statutory Authority: RCW 74.39A.056 and chapters 74.34, 18.20 RCW. WSR 14-14-028, § 388-76-10164, filed 6/24/14, effective 7/25/14. Statutory Authority: RCW 70.128.040. WSR 12-16-087, § 388-76-10164, filed 7/31/12, effective 8/31/12. Statutory Authority: RCW 70.128.040, chapter 74.39A RCW. WSR 10-16-082, § 388-76-10164, filed 7/30/10, effective 1/1/11.

Wash. Admin. Code § 388-76-10165 Background checks—Washington state name and date of birth background check—Valid for two years—National fingerprint background check—Valid indefinitely.

(1) A Washington state name and date of birth background check is valid for two years from the initial date it is conducted. The adult family home must ensure:

(a) A new DSHS background authorization form is submitted to the department's background check central unit every two years for each individual listed in WAC 388-76-10161;

(b) There is a valid Washington state background check for all individuals listed in WAC 388-76-10161.

(2) A national fingerprint background check is valid for an indefinite period of time. The adult family home must ensure there is a valid national fingerprint background check for individuals hired after January 7, 2012 as caregivers, entity representatives or resident managers. To be considered valid, the individual must have completed the national fingerprint background check through the background check central unit after January 7, 2012.

History

Statutory Authority: RCW 70.128.040. WSR 12-16-087, § 388-76-10165, filed 7/31/12, effective 8/31/12. Statutory Authority: RCW 70.128.040, chapter 74.39A RCW. WSR 10-16-082, § 388-76-10165, filed 7/30/10, effective 1/1/11. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10165, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10166 Background checks—Household members, noncaregiving and unpaid staff—Unsupervised access.

(1) The adult family home must not allow individuals specified in WAC 388-76-10161(3) to have unsupervised access to residents until the home receives results of the Washington state name and date of birth background check from the department.

(2) If the background check results show that an individual specified in WAC 388-76-10161 has a criminal conviction or pending charge for a crime that is not automatically disqualifying under chapter 388-113 WAC, then the adult family home must:

(a) Determine whether or not the person has the character, competence and suitability to have unsupervised access to residents; and

(b) Document in writing the basis for making the decision.

(c) Nothing in this section should be interpreted as requiring the employment of any person against the better judgment of the adult family home.

History

Statutory Authority: RCW 74.39A.056 and chapters 74.34, 18.20 RCW. WSR 14-14-028, § 388-76-10166, filed 6/24/14, effective 7/25/14. Statutory Authority: RCW 70.128.040. WSR 12-16-087, § 388-76-10166, filed 7/31/12, effective 8/31/12.

Wash. Admin. Code § 388-76-10170 Background check—Confidentiality—Use restricted—Retention.

The adult family home must establish and implement procedures that ensure all background authorization forms, background check results, related information, and all copies are:

(1) Kept in a confidential and secure manner;

(2) Used for employment purposes only;

(3) Not disclosed to any person except:

(a) The person about whom the home made the disclosure or background check;

(b) Licensed facilities, an employer of an authorized program, or an in-home services agency employer identified in WAC 388-76-10174;

(d) The Washington state patrol auditor.

(4) Kept for two years after the date an employee either quits or is terminated.

History

Statutory Authority: RCW 70.128.040, chapter 74.39A RCW. WSR 10-16-082, § 388-76-10170, filed 7/30/10, effective 1/1/11. Statutory Authority: RCW 70.128.040. WSR 09-03-030, § 388-76-10170, filed 1/12/09, effective 2/12/09. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10170, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10174 Background check—Disclosure of information—Sharing of background information by health care facilities.

In accordance with RCW 43.43.832 a health care facility may share Washington state background check results with other health care facilities under certain circumstances. Results of the national fingerprint-based background check may not be shared. For the purposes of this section health care facility means a nursing home licensed under chapter 18.51 RCW, an assisted living facility licensed under chapter 18.20 RCW, or an adult family home licensed under chapter 70.128 RCW.

(1) A health care facility may, upon request from another health care facility, share completed Washington state background check results only if:

(a) The health care facility sharing the background check information is reasonably known to be the person's most recent employer;

(b) No more than twelve months has elapsed between the date the person was last employed at a licensed health care facility and the date of the person's current employment application; and

(d) The adult family home has no reason to believe the individual has a disqualifying criminal conviction or pending charge for a disqualifying crime under chapter 388-113 WAC, or a negative action listed in WAC 388-76-10180.

(2) If background check information is shared, the health care facility employing the subject of the check must require the applicant to sign a disclosure statement indicating that there has been no conviction or finding as described in WAC 388-76-10180 since the completion date of the most recent background check.

(3) Any health care facility that knows or has reason to believe that an applicant has or may have a disqualifying criminal conviction or pending charge for a disqualifying crime under chapter 388-113 WAC, or negative action listed in WAC 388-76-10180, after the completion date of their most recent background check:

(a) Cannot rely on the applicant's previous employer's background check information; and

(b) Must request a new background check as required by this chapter.

(4) Health care facilities that share background check information shall be immune from any claim of defamation, invasion of privacy, negligence, or any other claim in connection with any dissemination of this information in accordance with this section.

(5) Health care facilities must send and receive the background check information in a manner that reasonably protects the subject's rights to privacy and confidentiality.

(6) In accordance with RCW 74.39A.210, a home that discloses information about a former or current employee to certain types of prospective employers is presumed to act in good faith and is immune from civil and criminal liability for such disclosure or its consequences.

History

Statutory Authority: RCW 74.39A.056 and chapters 74.34, 18.20 RCW. WSR 14-14-028, § 388-76-10174, filed 6/24/14, effective 7/25/14. Statutory Authority: RCW 70.128.040, chapter 74.39A RCW. WSR 10-16-082, § 388-76-10174, filed 7/30/10, effective 1/1/11. Statutory Authority: RCW 70.128.040. WSR 09-03-030, § 388-76-10174, filed 1/12/09, effective 2/12/09.

Wash. Admin. Code § 388-76-10175 Background checks—Employment—Conditional hire—Pending results of Washington state name and date of birth background check.

An adult family home may conditionally employ a person directly or by contract, pending the result of a Washington state name and date of birth background check, provided the home:

(1) Submits the Washington state name and date of birth background check no later than one working day after conditional employment;

(2) Requires the individual to sign a disclosure statement and the individual denies having a disqualifying criminal conviction or pending charge for a disqualifying crime under chapter 388-113 WAC, or a negative action that is listed in WAC 388-76-10180;

(3) Does not allow the individual to have unsupervised access to any resident;

(4) Ensures direct supervision, as defined in WAC 388-76-10000, of the individual; and

(5) Ensures the individual is competent and receives the necessary training to perform assigned tasks and meets the staff training requirements under chapter 388-112A WAC.

History

Statutory Authority: RCW 70.128.040 and 70.128.066. WSR 23-12-075, § 388-76-10175, filed 6/6/23, effective 8/1/23. Statutory Authority: RCW 74.39A.056 and chapters 74.34, 18.20 RCW. WSR 14-14-028, § 388-76-10175, filed 6/24/14, effective 7/25/14. Statutory Authority: RCW 70.128.040. WSR 12-16-087, § 388-76-10175, filed 7/31/12, effective 8/31/12. Statutory Authority: RCW 70.128.040, chapter 74.39A RCW. WSR 10-16-082, § 388-76-10175, filed 7/30/10, effective 1/1/11. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10175, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10176 Background checks—Employment—Provisional hire—Pending results of national fingerprint background check.

The adult family home may provisionally employ individuals hired after January 7, 2012 and listed in WAC 388-76-10161(2) for one hundred twenty-days and allow those individuals to have unsupervised access to residents when:

(1) The individual is not disqualified based on the results of the Washington state name and date of birth background check; and

(2) The results of the national fingerprint background check are pending.

History

Statutory Authority: RCW 70.128.040. WSR 12-16-087, § 388-76-10176, filed 7/31/12, effective 8/31/12.

Wash. Admin. Code § 388-76-10180 Background checks—Employment—Disqualifying information. Disqualifying negative actions.

(1) The adult family home must not employ, directly or by contract, a caregiver, entity representative, or resident manager if:

(a) The caregiver, entity representative or resident manager will have unsupervised access to vulnerable adults, as defined in RCW 43.43.830; and either:

(b) The caregiver, entity representative or resident manager has a disqualifying criminal conviction or pending charge for a disqualifying crime under chapter 388-113 WAC; or

(ii) The individual is a registered sex offender;

(iii) The individual is on a registry based upon a final finding of abuse, neglect or financial exploitation of a vulnerable adult, unless the finding was made by adult protective services prior to October 2003;

(iv) A founded finding of abuse or neglect of a child was made against the person, unless the finding was made by child protective services prior to October 1, 1998;

(v) The individual was found in any dependency action to have sexually assaulted or exploited any child or to have physically abused any child;

(vii) The person has had a contract or license denied, terminated, revoked, or suspended due to abuse, neglect, financial exploitation, or mistreatment of a child or vulnerable adult; or

(viii) The person has relinquished a license or terminated a contract because an agency was taking an action against the individual related to alleged abuse, neglect, financial exploitation or mistreatment of a child or vulnerable adult.

Wash. Admin. Code § 388-76-10181 Background checks—Employment—Nondisqualifying information.

(1) If any background check results show that an employee or prospective employee has a criminal conviction or pending charge for a crime that is not disqualifying under chapter 388-113 WAC, then the adult family home must:

(a) Determine whether the person has the character, competence and suitability to work with vulnerable adults in long-term care; and

(b) Document in writing the basis for making the decision, and make it available to the department upon request.

(2) Nothing in this section should be interpreted as requiring the employment of any person against the better judgment of the adult family home.

History

Statutory Authority: RCW 74.39A.056 and chapters 74.34, 18.20 RCW. WSR 14-14-028, § 388-76-10181, filed 6/24/14, effective 7/25/14. Statutory Authority: RCW 70.128.040. WSR 12-16-087, § 388-76-10181, filed 7/31/12, effective 8/31/12.

Wash. Admin. Code § 388-76-10191 Liability insurance required.

The adult family home must:

(1) Obtain and maintain both:

(a) Commercial general liability insurance or business liability insurance covering the adult family home; and

(b) Professional liability insurance or errors and omissions insurance covering the adult family home.

(2) Obtain the liability insurance required in subsection (1) of this section before whichever of the following events happens first:

(a) Admitting the first resident after issuance of a new adult family home license; or

(b) 10 working days have passed since the issuance of the license.

(3) Have evidence of liability insurance coverage available if requested by the department.

(4) Notify the department's complaint resolution unit if there is any lapse in required liability insurance coverage.

History

Statutory Authority: RCW 70.128.040 and 70.128.066. WSR 23-12-075, § 388-76-10191, filed 6/6/23, effective 8/1/23. Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10191, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-76-10192 Liability insurance required—Coverage requirements.

(1) The liability insurance coverage required under WAC 388-76-10191 must include:

(a) Losses or allegations or both caused by errors and omissions of the adult family home or its employees or volunteers;

(b) Coverage for bodily injury, property damage, and contractual liability; and

(c) Coverage for premises, operations, products-completed operations, personal injury, advertising injury, and liability assumed under an insured contract.

(2) Each of the required liability insurance policies must cover a minimum limit of:

(a) Each occurrence at $500,000; and

(b) General aggregate at $1,000,000.

(3) The liability insurance policies must indemnify, hold harmless, and provide insurance coverage for the State of Washington, the department, its elected and appointed officials, agents, and employees of the state for any and all claims, losses, liability, damages, or fines arising out of the acts or omissions of the adult family home licensee, its staff, contractors, and residents. The State of Washington, the department, its elected and appointed officials, agents, and employees must be listed as additional insureds on all insurance policies relating to the operation or premises of the adult family home.

(4) If the home serves residents whose care is paid for by medicaid, the medicaid contract may require a higher minimum insurance limit.

History

Statutory Authority: RCW 70.128.040 and 70.128.066. WSR 23-12-075, § 388-76-10192, filed 6/6/23, effective 8/1/23. Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10192, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-76-10195 Adult family home—Staff—Generally.

The adult family home must ensure:

(1) When one or more residents are in the home, enough staff are available in the home to meet the needs of each resident, except as provided in WAC 388-76-10200;

(2) Staff are readily available to meet resident needs if the home takes the resident out to another location and the resident negotiated care plan does not indicate it is safe for the resident to be left unattended for a specific time period; and

(3) All staff are skilled and able to do the tasks assigned to meet the needs of each resident.

History

Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10195, filed 1/15/10, effective 2/15/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10195, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10198 Adult family home—Personnel records.

The adult family home must keep documents related to staff in a place readily accessible to authorized department staff. These documents must be available during the staff's employment, and for at least two years following employment. The documents must include but are not limited to:

(1) Staff information such as address and contact information.

(2) Staff orientation and training records pertinent to duties, including, but not limited to:

(a) Training required by chapter 388-112A WAC, including as appropriate for each staff person, orientation, basic training or modified basic training, specialty training, nurse delegation core training, and continuing education;

(b) Cardiopulmonary resuscitation;

(d) HIV/AIDS training.

(3) Tuberculosis testing results.

(4) Criminal history disclosure and background check results as required.

History

Statutory Authority: Chapter 70.128 RCW. WSR 18-20-015, § 388-76-10198, filed 9/21/18, effective 10/22/18. Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10198, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-76-10200 Adult family home—Staff—Availability—Contact information.

In addition to other licensing requirements for staff availability, the adult family home must:

(1) Ensure at least one qualified caregiver is present in the home whenever one or more residents are present in the home, except as provided in subsection (2). For purpose of this subsection, a qualified caregiver means someone who has completed orientation and basic training as required by chapter 388-112A WAC;

(2) Ensure that before the adult family home leaves a resident unattended:

(a) That the adult family home determines that the resident can be left unattended safely, based upon an assessment that identifies the resident's strengths and needs;

(b) The resident knows what to do in an emergency and is able to successfully act on that knowledge; such as leaving the home or calling 911, when necessary;

(c) The adult family home individualizes each resident's negotiated care plan to the resident's identified strengths and needs and includes a limited and specific amount of time the resident is safe to be left unattended;

(d) The resident consents to the plan to be left unattended; and

(e) The resident is able to contact a responsible staff person at all times.

(3) Designate an experienced, staff member who is capable of responding on behalf of the adult family home by phone or pager at all times.

(4) Give residents the telephone or pager number for the contact required in subsection (2) of this section;

(5) Ensure the provider, entity representative or resident manager is readily available to:

(a) Each resident;

(b) Residents' representatives;

(d) Authorized state staff.

History

Statutory Authority: Chapter 70.128 RCW. WSR 18-20-015, § 388-76-10200, filed 9/21/18, effective 10/22/18. Statutory Authority: RCW 70.128.040. WSR 12-16-087, § 388-76-10200, filed 7/31/12, effective 8/31/12
WSR 10-04-008, § 388-76-10200, filed 1/22/10, effective 2/22/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10200, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10201 Succession plan.

(1) The adult family home must have a written plan addressing how they will continue to meet the requirements of this chapter and provide care and services to residents in the event that the provider or entity representative is unable to fulfill their duties in the home and make it available upon request of the department.

(2) If an emergency or other exceptional circumstance requires a change of ownership due to the inability of a provider to continue to operate the home, an applicant who meets the qualifications to be a provider may apply for a provisional license that would allow the home to continue to operate. The applicant must also apply for a change of ownership at the same time. The department will have the discretion to determine if the circumstances warrant a provisional license.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 20-05-016, § 388-76-10201, filed 2/6/20, effective 3/8/20.

Wash. Admin. Code § 388-76-10205 Medicaid or state funded residents.

When the adult family home accepts medicaid or state funded residents, the home must follow the terms and conditions of the department contract and chapter 388-105 WAC.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10205, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10210 Resident relocation due to closure.

When an adult family home chooses to voluntarily close, the home must:

(1) Notify the following in writing of the closure at least thirty days before the home closes:

(a) The department;

(b) Each resident; and

(2) Develop, organize, and carry out a discharge plan that meets the needs of each resident.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10210, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10215 Resident funds—Protection, liquidation or transfer.

(1) The adult family home must meet the requirements of RCW 70.129.040 to protect any funds the resident may have deposited with the adult family home.

(2) If a deceased resident had some of his or her adult family home care paid for by the department, then the home must:

(a) Send the final accounting and funds payable to:

Secretary, Department of Social and Health Services

Office of Financial Recovery

Estate Recovery Unit

(b) Include with the final accounting required in subsection (2)(a) of this section:

(i) The deceased resident's name; and

(ii) The deceased resident's Social Security number.

(3) When a resident is missing from the home, in addition to other licensing requirements, the home must make a reasonable effort to find the missing resident before transferring resident funds to the department of revenue as per subsection (4) of this section.

(4) The adult family home must notify the department of revenue of abandoned property when:

(a) A resident is missing from the home for more than ninety days; and

(b) The missing resident:

(i) Gave money to the home to manage or for safekeeping;

(ii) Does not have a legal guardian;

(iii) Did not appoint a power of attorney to handle his or her financial affairs;

(iv) Did not name a family member to act on the resident's behalf; and

(v) Did not have his or her care paid for by the department.

(5) The home must send any money received from the missing resident, to the department of revenue:

(a) According to chapter 63.29 RCW;

(b) Within twenty days of notifying the department of revenue per subsection (2) of this section.

(6) Before the adult family home changes its owner, the home must:

(a) Give each resident a written statement that accounts for any personal funds held by the home;

(b) Give the prospective adult family home owner a written statement that accounts for all of the residents' funds that home will transfer to the new adult family home owner; and

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10215, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10220 Incident log.

The adult family home must keep a log of:

(1) Alleged or suspected instances of abandonment, neglect, abuse or financial exploitation;

(2) Accidents or incidents affecting a resident's welfare; and

(3) Any injury to a resident.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10220, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10221 Resident roster—Requirements.

(1) The adult family home must create, maintain, and regularly update a resident roster. The roster must include:

(a) The list of current resident names; and

(b) Room identifier assigned to each resident.

(2) The adult family home will provide a written copy immediately upon an in-person request from any long-term care ombud or department staff.

(3) The adult family home must comply with RCW 70.128.155(1), and all related statutory requirements.

History

Statutory Authority: RCW 18.20.090, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 25-16-099, s 388-76-10221, filed 8/6/25, effective 9/6/25.

Wash. Admin. Code § 388-76-10225 Reporting requirement.

(1) The adult family home must ensure all staff:

(a) Report suspected abuse, neglect, exploitation, or abandonment of a resident:

(i) As required by chapter 74.34 RCW;

(ii) To the department by calling the complaint toll-free hotline number or completing an online report; and

(iii) To the local law enforcement agency when required by RCW 74.34.035.

(b) Report the following to the department by calling the complaint toll-free hotline number or completing an online report:

(i) Any actual or potential event requiring any resident to be evacuated;

(ii) Conditions that threaten the provider's or entity representative's ability to continue to provide care or services to each resident; and

(iii) A missing resident.

(2) When there is a significant change in a resident's condition, or a serious injury, trauma, or death of a resident, the adult family home must immediately notify:

(a) The resident's family;

(b) The resident's representative, if one exists;

(d) Other appropriate professionals working with the resident;

(e) Persons identified in the negotiated care plan; and

(f) The resident's case manager if the resident is a department client.

(3) Whenever an outbreak of suspected food poisoning or communicable disease occurs, the adult family home must notify:

(a) The local public health officer; and

(b) The department's complaint toll-free hotline number or online reporting system.

(4) The adult family home must notify the department's case management office within 24 hours whenever a resident, whose stay is paid for by the department is discharged for more than 24 hours on medical leave to a nursing home or hospital.

(5) The adult family home licensed for seven or eight beds that does not have an automatic fire sprinkler system must notify the department's complaint toll-free hotline number or complete an online report when any resident in the home requires assistance with evacuation as defined in WAC 388-76-10870.

History

Statutory Authority: RCW 70.128.040 and 70.128.066. WSR 25-04-035, s 388-76-10225, filed 1/28/25, effective 3/4/25. Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10225, filed 1/15/10, effective 2/15/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10225, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10230 Pets.

The adult family home must ensure any animal visiting or living on the premises:

(1) Does not compromise any resident rights, preferences or medical needs;

(2) Has a suitable temperament, is clean and healthy, and otherwise poses no significant health or safety risks to any resident, staff, or visitors; and

(3) Has proof of up-to-date rabies vaccinations.

History

Statutory Authority: RCW 70.128.040. WSR 09-03-029, § 388-76-10230, filed 1/12/09, effective 2/12/09. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10230, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10231 Resident roster and complete contact information.

(1) The adult family home must:

(a) Create and regularly maintain a current resident roster containing the name and room number of each resident; and

(b) Provide a written copy of the resident roster upon an in-person request from any long-term care ombuds at the time of the visit and not later than the conclusion of the visit.

(2) The adult family home must:

(a) Create and regularly maintain current, accurate, and complete contact information for all residents, including the following resident information:

(i) Name;

(ii) Room number or room identifier, including letter and number combination identifiers;

(iii) Phone number, if available;

(iv) Email address, if available; and

(v) If a resident has a representative, the representative's:

(A) Name;

(B) Relationship to the resident;

(D) Email address, if available; and

(E) Mailing address, if available.

(b) Record and update the complete contact information required by this section upon receiving new or updated contact information from the resident or resident representative;

(c) Upon the written request of any long-term care ombuds that includes reference to RCW 70.128.155 and the relevant legal functions and duties of long-term care ombuds, provide a copy of the complete contact information required by RCW 70.128.155 within 48 hours, or within a reasonable time if agreed to by the requesting long-term care ombuds, by electronic copy to the secure email address or facsimile (fax) number provided in the written request.

History

Statutory Authority: RCW 18.20.090, 18.51.070, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 26-05-046, s 388-76-10231, filed 2/12/26, effective 3/15/26.

Wash. Admin. Code § 388-76-10235 Guardianship.

(1) Effective February 1, 2009, the adult family home must ensure that no provider, entity representative, resident manager, or staff becomes any resident's guardian.

(2) Provider, entity representative, resident manager or staff who is a resident's guardian before February 1, 2009 may continue to be that resident's guardian.

History

Statutory Authority: RCW 70.128.040. WSR 09-03-029, § 388-76-10235, filed 1/12/09, effective 2/12/09. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10235, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10240 Durable power of attorney for health care or financial decisions.

The adult family home must not allow a provider, entity representative, owner, administrator, or employees of the home to act as a resident's attorney in fact, according to chapter 11.94 RCW, unless the provider, entity representative, owner, administrator, or employee is the resident's:

(1) Spouse;

(2) Adult child; or

(3) Brother or sister.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10240, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10245 Resident self-determination—Health care decision making.

The adult family home must provide care and services consistent with the federal patient self-determination act and other statutes related to a resident legal representative and health care decision making, including but not limited to:

(1) Chapter 7.70 RCW;

(2) Chapter 70.122 RCW;

(3) Chapter 11.88 RCW;

(4) Chapter 11.92 RCW; and

(5) Chapter 11.94 RCW.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10245, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10250 Medical emergencies—Contacting emergency medical services—Required.

(1) The adult family home must develop and implement policies and procedures which require immediate contact of the local emergency medical services when a resident has a medical emergency. This requirement applies:

(a) Unless the caregiver, present at the time of the emergency, is a licensed physician or registered nurse acting within his or her scope of practice;

(b) Whether or not:

(i) Any order exists directing medical care for the resident;

(ii) The resident has provided an advance directive for medical care; or

(iii) The resident has expressed any wishes involving medical care.

(2) If available, the home must immediately give arriving emergency medical services personnel a copy of:

(a) Any order that exists directing medical care for the resident; and

(b) The resident's advance directive for medical care.

(3) The home must inform the resident of the requirements in this section.

(4) The home is not required to contact emergency medical services when a resident is receiving hospice care by a licensed hospice agency and the:

(a) Emergency relates to the expected hospice death; and

(b) Situation is monitored by the hospice agency.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10250, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10255 Infection control.

The adult family home must develop and implement an infection control system that:

(1) Uses nationally recognized infection control standards;

(2) Emphasizes frequent hand washing and other means of limiting the spread of infection;

(3) Follows the requirements of chapter 49.17 RCW, Washington Industrial Safety and Health Act to protect the health and safety of each resident and employees; and

(4) Directs all staff to:

(a) Dispose of razor blades, syringes, and other sharp items in a manner that will not risk the health and safety of residents, staff, other persons residing in the home or the public; and

(b) Use all disposable and single-service supplies and equipment only one time as specified by the manufacturer.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10255, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10260 Communicable disease—Preventing spread.

If the adult family home suspects anyone working or living in the home has or may have a communicable disease, the home must implement nationally recognized infection control measures.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10260, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10265 Tuberculosis—Testing—Required.

(1) The adult family home must develop and implement a system to ensure the following persons have tuberculosis testing within three days of employment:

(a) Provider;

(b) Entity representative;

(d) Caregiver;

(e) Staff; and

(f) Any student or volunteer providing any resident care and services.

(2) For the purposes of the tuberculosis sections "person" means the people listed in this section as required to have tuberculosis testing.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10265, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10270 Tuberculosis—Testing method—Required.

The adult family home must ensure that all tuberculosis testing is done through either:

(1) Intradermal (Mantoux) administration with test results read:

(a) Within forty-eight to seventy-two hours of the test; and

(b) By a trained professional; or

(2) A blood test for tuberculosis called interferon-gamma release assay (IGRA).

History

Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10270, filed 1/15/10, effective 2/15/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10270, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10275 Tuberculosis—No testing.

The adult family home is not required to have a person tested for tuberculosis if the person has:

(1) A documented history of a previous positive skin test, with ten or more millimeters induration;

(2) A documented history of a previous positive blood test; or

(3) Documented evidence of:

(a) Adequate therapy for active disease; or

(b) Completion of treatment for latent tuberculosis infection preventive therapy.

History

Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10275, filed 1/15/10, effective 2/15/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10275, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10280 Tuberculosis—One test.

The adult family home is only required to have a person take one test if the person has any of the following:

(1) A documented history of a negative result from a previous two step test done no more than one to three weeks apart; or

(2) A documented negative result from one skin or blood test in the previous twelve months.

History

Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10280, filed 1/15/10, effective 2/15/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10280, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10285 Tuberculosis—Two step skin testing.

Unless the person meets the requirement for having no skin testing or only one test, the adult family home, choosing to do skin testing, must ensure that each person has the following two-step skin testing:

(1) An initial skin test within three days of employment; and

(2) A second test done one to three weeks after the first test.

History

Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10285, filed 1/15/10, effective 2/15/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10285, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10290 Tuberculosis—Positive test result.

When there is a positive result to tuberculosis skin or blood testing the adult family home must:

(1) Ensure that the person has a chest X-ray within seven days;

(2) Ensure each resident or employee with a positive test result is evaluated for signs and symptoms of tuberculosis; and

(3) Follow the recommendation of the person's health care provider.

History

Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10290, filed 1/15/10, effective 2/15/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10290, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10295 Tuberculosis—Negative test result.

The adult family home may be required by the public health provider or licensing authority to ensure that persons with negative test results have follow-up testing in certain circumstances, such as:

(1) After exposure to active tuberculosis;

(2) When tuberculosis symptoms are present; or

(3) For periodic testing as determined by the health provider.

History

Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10295, filed 1/15/10, effective 2/15/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10295, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10300 Tuberculosis—Declining a skin test.

The adult family home must ensure that a person take the blood test for tuberculosis if they decline the skin test.

History

Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10300, filed 1/15/10, effective 2/15/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10300, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10305 Tuberculosis—Reporting required.

The adult family home must:

(1) Report any person or resident with tuberculosis symptoms or a positive chest X-ray to the appropriate health care provider or public health provider;

(2) Follow the infection control and safety measures ordered by the person's health care provider, including a public health provider; and

(3) Institute appropriate infection control measures.

History

Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10305, filed 1/15/10, effective 2/15/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10305, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10310 Tuberculosis—Test records.

The adult family home must:

(1) Keep the records of tuberculin test results, reports of X-ray findings, and any physician or public health provider orders in the adult family home;

(2) Make the records readily available to the appropriate health authority and licensing agency;

(3) Provide the employee a copy of his/her testing results; and

(4) Retain the records for eighteen months after the date an employee either quits or is terminated.

History

Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10310, filed 1/15/10, effective 2/15/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10310, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10315 Resident record—Required.

WAC 388-76-10315

The adult family home must:

(1) Create, maintain, and keep records for residents in the home where the resident lives and ensure that the records:

(a) Contain enough information so the home can provide the needed care and services to each resident;

(b) Be in a format useful to the home;

(d) Are only released to the following persons:

(i) A health care institution;

(ii) When requested by the law;

(iii) To department representatives; and

(iv) To the resident;

(e) Be protected to prevent loss, alteration, or destruction, and unauthorized use;

(f) Be kept for three years after the resident leaves the home or death of the resident;

(g) Be available so that department staff may review them when requested; and

(h) Provide access to the resident to review their record and obtain copies of their record at a reasonable cost.

(2) Ensure staff has access to the parts of residents' records needed by staff to provide care and services; and

(3) Allow representatives of the long-term care ombuds access to a resident's records in accordance with RCW 70.129.090.

History

Statutory Authority: RCW 70.128.040, 70.128.065, and 45 C.F.R. § 1324.11 (e)(2). WSR 26-17-004, s 388-76-10315, filed 8/5/26, effective 9/20/26. Statutory Authority: Chapter 70.128 RCW. WSR 15-03-037, § 388-76-10315, filed 1/12/15, effective 2/12/15. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10315, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10320 Resident record—Content.

WAC 388-76-10320

The adult family home must ensure that each resident record contains, at a minimum, the following information:

(1) Identifying information about the resident, including, but not limited to:

(a) Name;

(b) Bedroom they reside in;

(d) Email address, if available.

(2) The name, address, and telephone number of the resident's:

(a) Representative and the representative's;

(i) Relationship to the resident; and

(ii) Email address, if available.

(b) Health care providers;

(d) Other individuals the resident wants involved or notified.

(3) Current medical history;

(4) The resident assessment information;

(5) The preliminary service plan;

(6) The negotiated care plan;

(7) List of resident medications;

(8) A copy of:

(a) The notice of rights and services required by this chapter; and

(b) The acknowledgement required by this chapter that the resident received a copy of the notice, signed and dated by:

(i) The resident; and

(ii) The home;

(9) When the resident was:

(a) Admitted to the home;

(b) Absent from the home; and

(10) A current inventory of the resident's personal belongings dated and signed by:

(a) The resident; and

(b) The adult family home.

(11) Financial records.

(12) The residency agreement for residents with medicaid as a payor.

History

Statutory Authority: RCW 70.128.040, 70.128.065, and 45 C.F.R. § 1324.11 (e)(2). WSR 26-17-004, s 388-76-10320, filed 8/5/26, effective 9/20/26. Statutory Authority: RCW 18.20.090, 18.51.070, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 26-05-046, s 388-76-10320, filed 2/12/26, effective 3/15/26. Statutory Authority: RCW 18.20.090, 70.97.230, 70.128.040, 74.09.520(2), 74.39A.007, 42 C.F.R. 441.530 (a)(1)(vi)(A), and 441.301 (c)(4)(vi)(A). WSR 25-18-037, s 388-76-10320, filed 8/25/25, effective 1/1/26. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10320, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10325 Resident record—Legal documents—If available.

When available, the adult family home must obtain copies of the following legal documents for the resident's records:

(1) Any powers of attorney granted by the resident, including for health care decision making and financial; and

(2) Court order of guardianship for the resident.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10325, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10330 Resident assessment.

The adult family home must:

(1) Obtain a written assessment that contains accurate information about the prospective resident's current needs and preferences before admitting a resident to the home;

(2) Not admit a resident without an assessment except in cases of a genuine emergency;

(3) Ensure the assessment contains all of the information required in WAC 388-76-10335 unless the assessor can not:

(a) Obtain an element of the required assessment information; and

(b) The assessor documents the attempt to obtain the information in the assessment.

(4) Be knowledgeable about the needs and preferences of each resident documented in the assessment.

History

Statutory Authority: RCW 70.128.040. WSR 09-03-029, § 388-76-10330, filed 1/12/09, effective 2/12/09. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10330, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10335 Resident assessment topics.

The adult family home must ensure that each resident's assessment includes the following minimum information:

(1) Recent medical history;

(2) Current prescribed medications, and contraindicated medications, including but not limited to, medications known to cause adverse reactions or allergies;

(3) Medical diagnosis reported by the resident, the resident representative, family member, or by a licensed medical professional;

(4) Medication management:

(a) The ability of the resident to be independent in managing medications;

(b) The amount of medication assistance needed;

(d) If a combination of the elements in (a) through (c) above is required.

(5) Food allergies or sensitivities;

(6) Significant known behaviors or symptoms that may cause concern or require special care, including:

(a) The need for and use of medical devices;

(b) The refusal of care or treatment; and

(7) Cognitive status, including an evaluation of disorientation, memory impairment, and impaired judgment;

(8) History of depression and anxiety;

(9) History of mental illness, if applicable;

(10) Social, physical, and emotional strengths and needs;

(11) Functional abilities in relationship to activities of daily living including:

(a) Eating;

(b) Toileting;

(d) Transferring;

(e) Positioning;

(f) Personal hygiene;

(g) Dressing; and

(h) Bathing.

(12) Preferences and choices about daily life that are important to the resident, including but not limited to:

(a) The food that the resident enjoys;

(b) Meal times; and

(13) Activities.

History

Statutory Authority: RCW 70.128.040. WSR 09-03-030, § 388-76-10335, filed 1/12/09, effective 2/12/09. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10335, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10340 Preliminary service plan.

The adult family home must ensure that each resident has a preliminary service plan that includes:

(1) The resident's specific problems and needs identified in the assessment;

(2) The needs for which the resident chooses not to accept or refuses care or services;

(3) What the home will do to ensure the resident's health and safety related to the refusal of any care or service;

(4) Resident defined goals and preferences; and

(5) How the home will meet the resident's needs.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10340, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10345 Assessment—Qualified assessor—Required.

The adult family home must ensure the person performing resident assessments is:

(1) A qualified assessor; or

(2) For a resident who receives care and services paid for by the department, an authorized department case manager.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10345, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10350 Assessment—Updates required.

(1) The department amended portions of this rule from January 18, 2022, through June 8, 2023, in response to the state of emergency related to the COVID-19 pandemic. For requirements in place during that time, see WAC 388-76-10351.

(2) The adult family home must ensure each resident's assessment is reviewed and updated to document the resident's ongoing needs and preferences as follows:

(a) When there is a significant change in the resident's physical or mental condition;

(b) When the resident's negotiated care plan no longer reflects the resident's current status, needs, and preferences;

(d) At least every 12 months.

History

Statutory Authority: Chapter 18.51 RCW. WSR 23-14-029, § 388-76-10350, filed 6/26/23, effective 7/27/23. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10350, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10351 Assessment—Updates required—Requirements in effect from January 18, 2022, through June 8, 2023, in response to the state of emergency related to COVID-19.

(1) In response to the state of emergency related to the COVID-19 pandemic, the department adopted emergency rules under RCW 34.05.320 on January 18, 2022, to amend a portion of WAC 388-76-10350. The emergency rules remained in effect until June 8, 2023. The amended rules in place at that time were:

(2) The adult family home must ensure each resident's assessment is reviewed and updated to document the resident's ongoing needs and preferences as follows:

(a) When there is a significant change in the resident's physical or mental condition;

(b) When the resident's negotiated care plan no longer reflects the resident's current status, needs, and preferences;

(d) At least every 12 months, except beginning January 18, 2022, assessments for residents whose care is state funded may be extended an additional 12 months during the COVID-19 public health emergency.

History

Statutory Authority: Chapter 18.51 RCW. WSR 23-14-029, § 388-76-10351, filed 6/26/23, effective 7/27/23.

Wash. Admin. Code § 388-76-10355 Negotiated care plan.

The adult family home must use the resident assessment and preliminary care plan to develop a written negotiated care plan. The home must ensure each resident's negotiated care plan includes:

(1) A list of the care and services to be provided;

(2) Identification of who will provide the care and services;

(3) When and how the care and services will be provided;

(4) How medications will be managed, including how the resident will get their medications when the resident is not in the home;

(5) The resident's activities preferences and how the preferences will be met;

(6) Other preferences and choices about issues important to the resident, including, but not limited to:

(a) Food;

(b) Daily routine;

(d) How the home will accommodate the preferences and choices.

(7) If needed, a plan to:

(a) Follow in case of a foreseeable crisis due to a resident's assessed needs;

(b) Reduce tension, agitation and problem behaviors;

(d) Respond to a resident's refusal of care or treatment, including when the resident's physician or practitioner should be notified of the refusal;

(8) Identification of any communication barriers the resident may have and how the home will use behaviors and nonverbal gestures to communicate with the resident;

(9) A statement of the ability for resident to be left unattended for a specific length of time; and

(10) A hospice care plan if the resident is receiving services for hospice care delivered by a licensed hospice agency.

History

Statutory Authority: RCW 70.128.040. WSR 09-03-029, § 388-76-10355, filed 1/12/09, effective 2/12/09. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10355, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10360 Negotiated care plan—Timing of development—Required.

The adult family home must ensure the negotiated care plan is developed and completed within thirty days of the resident's admission.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10360, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10365 Negotiated care plan—Implementation—Required.

The adult family home must implement each resident's negotiated care plan.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10365, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10370 Negotiated care plan—Persons involved in development.

The adult family home must involve the following people in developing the negotiated care plan:

(1) The resident, to the greatest extent he or she can participate;

(2) The resident's family, if approved by the resident;

(3) The resident's representative, if the resident has a representative;

(4) Professionals involved in the care of the resident;

(5) Other individuals the resident wants included; and

(6) The department case manager, if the resident is receiving care and services paid for by the department.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10370, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10375 Negotiated care plan—Signatures—Required.

The adult family home must ensure that the negotiated care plan is agreed to and signed and dated by the:

(1) Resident; and

(2) Adult family home.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10375, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10380 Negotiated care plan—Timing of reviews and revisions.

The adult family home must ensure that each resident's negotiated care plan is reviewed and revised as follows:

(1) After an assessment for a significant change in the resident's physical or mental condition;

(2) When the plan, or parts of the plan, no longer address the resident's needs and preferences;

(3) At the request of the resident or the resident representative; or

(4) At least every twelve months.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10380, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10385 Negotiated care plan—Copy to department case manager—Required.

When the resident's services are paid for by the department, the adult family home must give the department case manager a copy of the negotiated care plan each time the plan is completed or updated, and after it has been signed and dated.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10385, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10390 Admission and continuation of services.

The adult family home must only admit or continue to provide services to a person when:

(1) The home can safely and appropriately meet the assessed needs and preferences of the person:

(a) With available staff; and

(b) Through reasonable accommodation.

(2) Admitting the resident does not negatively affect the ability of the home to:

(a) Meet the needs and does not endanger the safety of other residents; or

(b) Safely evacuate all people in the home during an emergency.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10390, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10395 Emergency admissions.

(1) The adult family home may only admit a resident to the home without an assessment or a preliminary service plan if a true emergency exists.

(2) To establish that a true emergency exists, the home must verify that the resident's life, health or safety is at serious risk due to circumstances in the resident's current place of residence or harm to the resident has occurred.

(3) After establishing that a true emergency exists, the home must:

(a) Ensure the assessment and preliminary service plan are completed within five working days after admitting the resident, if the resident pays for services with private funds; or

(b) Obtain approval from an authorized department case manager before admission if the resident's care and services are paid by the department or health care authority; and

History

Statutory Authority: Chapter 70.128 RCW. WSR 12-01-004, § 388-76-10395, filed 12/7/11, effective 1/7/12. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10395, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10400 Care and services.

The adult family home must ensure each resident receives:

(1) The care and services identified in the negotiated care plan.

(2) The necessary care and services to help the resident reach the highest level of physical, mental, and psychosocial well-being consistent with resident choice, current functional status and potential for improvement or decline.

(3) The care and services in a manner and in an environment that:

(a) Actively supports, maintains or improves each resident's quality of life;

(b) Actively supports the safety of each resident; and

(c) Reasonably accommodates each resident's individual needs and preferences except when the accommodation endangers the health or safety of the individual or another resident.

(4) Services by the appropriate professionals based upon the resident's assessment and negotiated care plan, including nurse delegation if needed.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10400, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10401 Home and community-based setting requirements.

(1) The home must ensure that the following conditions are present for each resident:

(a) Privacy in each resident's bedroom, including lockable doors when chosen, with only the resident or residents who live in the room and appropriate staff having the key;

(b) Choice of roommates;

(d) Freedom and support to control their own schedule;

(e) Access to food and water at any time; and

(f) Having visitors at any time, although nothing in this section requires an adult family home to provide a visitor with food or a place to sleep.

(2) When conditions under subsection (1) of this section cannot be met, the home must ensure the following elements are in place before implementing a modification:

(a) The specific assessed need for the modification is identified in the resident's assessment and negotiated care plan;

(b) The resident's negotiated care plan documents less intrusive methods and interventions that were tried prior to the modification but did not work;

(c) The details of the modification are clearly described in the resident's assessment and negotiated care plan, including how the modification addresses the resident's specific assessed need;

(d) The modification is agreed to by the resident or the resident's legal representative; and

(e) The modification must not cause the resident harm.

(3) All modifications must be reviewed annually with the assessment and negotiated care plan, and evidence of its effectiveness or lack thereof must be documented in both.

(4) Any modification must be discontinued if there is no longer a need for it or it is no longer effective.

History

Statutory Authority: RCW 70.128.040. WSR 20-03-097, § 388-76-10401, filed 1/14/20, effective 2/14/20.

Wash. Admin. Code § 388-76-10405 Nursing care.

If the adult family home identifies that a resident has a need for nursing care and the home is not able to provide the care per chapter 18.79 RCW, the home must:

(1) Contract with a nurse currently licensed in the state of Washington to provide the nursing care and service; or

(2) Hire or contract with a nurse to provide nurse delegation.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10405, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10410 Laundry services.

The adult family home must:

(1) Provide laundry services as needed; and

(2) Launder sheets and pillowcases weekly or more often if soiled.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10410, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10415 Food services.

The adult family home must:

(1) Ensure that the safe food handling training requirements of chapter 388-112A WAC are met; and

(2) Serve meals:

(a) In the home where each resident lives; and

(b) That accommodate each resident's:

(i) Preferences;

(ii) Food allergies and sensitivities;

(iii) Caloric needs;

(iv) Cultural and ethnic background; and

(v) Physical condition that may make food intake difficult such as being hard for the resident to chew or swallow.

History

Statutory Authority: Chapter 70.128 RCW. WSR 18-20-015, § 388-76-10415, filed 9/21/18, effective 10/22/18. Statutory Authority: RCW 70.128.040. WSR 10-04-008, § 388-76-10415, filed 1/22/10, effective 2/22/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10415, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10420 Meals and snacks.

The adult family home must:

(1) Serve at least three meals:

(a) In each twenty-four hour period;

(b) At regular times comparable to normal meal times in the community; and

(2) Make nutritious snacks available to residents:

(a) Between meals; and

(b) In the evening.

(3) Get input from residents in meal planning and scheduling;

(4) Serve nutrient concentrates, supplements, and modified diets only with written approval of the resident's physician;

(5) Only serve pasteurized milk;

(6) Process any home-canned foods served in the home, according to the latest guidelines of the county cooperative extension service; and

(7) Ensure food is:

(a) In sufficient supply; and

(b) Safe, sanitary, and uncontaminated.

History

Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10420, filed 1/15/10, effective 2/15/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10420, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10425 Offsite food preparation.

The adult family home must ensure:

(1) Persons preparing food, at a location separate from the home, have a current food handler's permit issued by the department of health;

(2) Prepared food transported to the home is in airtight containers; and

(3) Food stays at the appropriate and safe temperature:

(a) During transportation; and

(b) When served.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10425, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10430 Medication system.

(1) If the adult family home admits residents who need medication assistance or medication administration services by a legally authorized person, the home must have systems in place to ensure the services provided meet the medication needs of each resident and meet all laws and rules relating to medications.

(2) When providing medication assistance or medication administration for any resident, the home must ensure each resident:

(a) Assessment indicates the amount of medication assistance needed by the resident;

(b) Negotiated care plan identifies the medication service that will be provided to the resident;

(d) Receives medications as required.

(3) Records are kept which include a current list of prescribed and over-the-counter medications including name, dosage, frequency and the name and phone number of the practitioner as needed.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10430, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10435 Medication refusal.

(1) Each resident has the right to refuse to take medications.

(2) If the adult family home is assisting with or administering a resident's medications and the resident refuses to take or does not receive a prescribed medication:

(a) The home must notify the resident's practitioner; unless

(b) The provider, entity representative, resident manager or caregiver is a nurse or other health professional, acting within their scope of practice, is able to make a judgment about the impact of the resident's refusal.

(3) If the home becomes aware that a resident who self-administers, or takes their own medications, refuses to take a prescribed medication:

(a) The home must notify the practitioner; unless

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10435, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10440 Medication—Assessment—Identification of amount of assistance needed when taking medications.

(1) The adult family home must:

(a) Ensure each resident assessment identifies the amount of assistance the resident needs when taking medications; and

(b) Let the practitioner know when the following may affect the resident's ability to take their medications:

(i) Resident's physical or mental limitations; and

(ii) The setting or environment where the resident lives.

(2) The amount of assistance needed by a resident when taking their medications is as follows:

(a) Independent self-administration is when the resident does not need help taking medications and is able to directly take medications by eating or drinking, inhaling, by shot, through the skin or other means;

(b) Self-administration with assistance, as described in chapter 246-888 WAC, is when a resident is assisted in taking their medication by a nonpractitioner; and

(c) Medication administration is when medications are administered to the resident by a person legally authorized to do so, such as but not limited to a physician, nurse or pharmacist or through nurse delegation.

(3) The home must contact the resident's practitioner who will decide if a reassessment is necessary when:

(a) The resident has a change in the health status, medications, physical or mental limitations, or environment that might change the resident's need for medication assistance; or

(b) There is a need for a resident to have more than one type of medication assistance.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10440, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10445 Medication—Independent—Self-administration.

The adult family home must ensure residents who have medication assistance assessed as independent self-administration:

(1) Administer their own medications; and

(2) Are allowed to keep their prescribed and over-the-counter medications securely locked in either their room or another agreed upon area if documented in the resident negotiated care plan.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10445, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10450 Medication—Self-administration with assistance.

(1) For the purposes of this section "enabler" means a physical device used to facilitate a resident's self-administration of a prescribed or over-the-counter medication. Physical devices include, but are not limited to a medicine cup, glass, cup, spoons, bowl, prefilled syringes, syringes used to measure oral liquids, specially adapted table surfaces, drinking straw, piece of cloth, and the resident's hand.

(2) The adult family home must ensure that the resident can:

(a) Put the medication into their own mouth; or

(b) Apply, inject, or instill the medications.

(3) The home must:

(a) Provide set-up assistance just before the resident takes or applies the medication; or

(b) Only give oral medications through a gastrostomy or "g-tube" when ordered by the practitioner; and

(c) Ensure the resident is aware they are taking a medication, however the resident does not have to name the medication, effects or side effects.

(4) Self-administration with assistance:

(a) Does not include shots or intravenous medications as defined in WAC 246-888-020, except for a prefilled insulin syringe;

(b) May include steadying or guiding a resident's hand while applying or instilling medications such as ointments, eye, ear and nasal preparations, but does not include the practice of "hand-over-hand" (total physical assistance) administration;

(c) May include transferring the medications from one container to another to make a single dose such as pouring a liquid from the medication container to a calibrated spoon or measuring cup;

(d) May include reminding or coaching the resident to take their medication;

(e) Does not include direct assistance with intravenous and injectable medications except the home may carry a prefilled insulin syringe which the resident can administer;

(f) May include using an enabler; and

(g) Could include delivering a prefilled insulin syringe to the resident if the resident independently self-administers the injection per WAC 246-888-020.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10450, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10455 Medication—Administration.

For residents assessed with requiring the administration of medications, the adult family home must ensure medication administration is:

(1) Performed by a practitioner as defined in chapter 69.41 RCW; or

(2) By nurse delegation per WAC 246-840-910 through 246-840-970; unless

(3) Done by a family member or legally appointed resident representative.

History

Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10455, filed 1/15/10, effective 2/15/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10455, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10460 Medication—Negotiated care plan.

The adult family home must ensure that each resident's negotiated care plan addresses:

(1) The amount of medication assistance needed by each resident, including but not limited to:

(a) The reasons why a resident needs that amount of medication assistance; and

(b) When there is a need for the resident to have more than one type of medication assistance.

(2) How the resident will get their medications when the resident is away from the home or when a family member or resident representative is assisting with medications is not available.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10460, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10463 Medication—Psychopharmacologic.

For residents who are given psychopharmacologic medications, the adult family home must ensure:

(1) The resident assessment indicates that a psychopharmacologic medication is necessary to treat the resident's medical symptoms;

(2) The drug is prescribed by a physician or health care professional with prescriptive authority;

(3) The resident's negotiated care plan includes strategies and modifications of the environment and staff behavior to address the symptoms for which the medication is prescribed;

(4) Changes in medication only occur when the prescriber decides it is medically necessary; and

(5) The resident or resident representative is aware the resident is taking the psychopharmacologic medication and its purpose.

History

Statutory Authority: Chapter 70.128 RCW. WSR 16-20-095, § 388-76-10463, filed 10/4/16, effective 11/4/16
WSR 16-06-004, § 388-76-10463, filed 2/17/16, effective 4/1/16.

Wash. Admin. Code § 388-76-10465 Medication—Altering—Requirements.

(1) For the purposes of this section "altering a medication" means the alteration of prescribed or over the counter medications and includes, but is not limited to crushing tablets, cutting tablets in half; opening capsules and mixing powdered medications with food or liquids.

(2) The adult family home must consult with the practitioner or pharmacist before altering a medication and if the practitioner or pharmacist agrees with altering a medication, record the:

(a) Time;

(b) Date; and

(3) The home must ensure the resident is aware that a medication is:

(a) Altered; and/or

(b) Put in the resident's food or drink.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10465, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10470 Medication—Timing—Special directions.

(1) The adult family home must ensure medications are given:

(a) At the specific time(s) ordered by the practitioner; and

(b) As follows, when the practitioner does not order a medication to be given at a specific time:

(i) One time per day, approximately every twenty four hours;

(ii) Two times a day, approximately twelve hours apart;

(iii) Three times a day, approximately six hours apart; and

(iv) Four times a day, approximately four hours apart.

(2) The home must ensure all directions given by the practitioner are followed when assisting or giving each resident medication. This includes but is not limited to:

(a) Before meals;

(b) After meals;

(d) At bed time.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10470, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10475 Medication—Log.

The adult family home must:

(1) Keep an up-to-date daily medication log for each resident except for residents assessed as medication independent with self-administration.

(2) Include in each medication log the:

(a) Name of the resident;

(b) Name of all prescribed and over-the-counter medications;

(d) Frequency which the medications are taken; and

(e) Approximate time the resident must take each medication.

(3) Ensure the medication log includes:

(a) Initials of the staff who assisted or gave each resident medication(s);

(b) If the medication was refused and the reason for the refusal; and

(i) The change;

(ii) The date of the change;

(iii) A logged call requesting written verification of the change; and

(iv) A copy of written verification of the change from the practitioner received by the home by mail, facsimile, or other electronic means, or on new original labeled container from the pharmacy.

(4) Ensure that the changed or new medication is received from the pharmacy.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10475, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10480 Medication organizers.

The adult family home must ensure:

(1) A licensed nurse, pharmacist, the resident or the resident's family member fills a resident's medication organizer;

(2) Prescribed and over-the-counter medications placed in a medication organizer come from the original container labeled for the resident by the pharmacist or pharmacy service;

(3) Each resident and anyone giving care to a resident can readily identify medications in the medication organizer;

(4) Medication organizer labels clearly show the following:

(a) The name of the resident;

(b) A list of all prescribed and over-the-counter medications;

(d) The frequency which the medications are given.

(5) The person filling the medication organizer updates the labels on the medication organizer when the practitioner changes a medication.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10480, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10485 Medication storage.

The adult family home must ensure all prescribed and over-the-counter medications are stored:

(1) In locked storage;

(2) In the original container with legible and original labels; and

(3) Appropriately for each medication, such as if refrigeration is required for a medication and the medication is kept in refrigerator in locked storage.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10485, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10490 Medication disposal—Written policy—Required.

(1) For the purposes of this section, "discontinued" means medication that is no longer prescribed or being used to treat a condition, as directed by the resident's physician or health care professional with prescriptive authority.

(2) The adult family home must develop and implement a written policy addressing the safe disposal of resident medications that have been discontinued, have expired, or were refused by the resident. The policy must:

(a) Comply with all federal and state laws and regulations regarding medication disposal;

(b) Address the safe disposal of medications for current residents, deceased residents, and residents who have discharged from the facility; and

(i) For current residents the facility must safely dispose of discontinued medications, expired medications, and refused medications within 30 calendar days of discontinuation, expiration, or resident refusal;

(ii) For deceased residents the facility must safely dispose of all medications within 30 calendar days of the resident's death; and

(iii) For discharged residents the facility must:

(A) Assist with the transfer of the resident's medications to the resident's new setting, when needed;

(B) End fulfillment, delivery, and receipt of prescription medications within 10 calendar days; and

(i) Name of resident;

(ii) Name of medication;

(iii) Amount of medication;

(iv) Date of disposal or transfer; and

(v) Name of individual completing the task.

History

Statutory Authority: RCW 70.128.007 and 70.128.040. WSR 25-05-021, s 388-76-10490, filed 2/7/25, effective 3/10/25. Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10490, filed 1/15/10, effective 2/15/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10490, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10495 Specialty care—Designations.

The department may designate an adult family home to provide specialty care in one or more of the following areas:

(1) Developmental disability;

(2) Mental illness; and

(3) Dementia.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10495, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10500 Granting specialty care designation—Requirements.

The department will grant a specialty designation when:

(1) The provider, entity representative and resident manager has successfully completed training in one or more of the specialty care designated areas;

(2) The home provides the department with written documentation:

(a) Of successful completion of the required specialty care training or challenge test for each person in subsection (1) of this section; and

(b) For the specialty care training for all caregivers in the adult family home provided by a person knowledgeable in specialty care.

(3) The home ensures the specialty care need of each resident is met.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10500, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10505 Specialty care—Admitting and retaining residents.

The adult family home must not admit or keep a resident with specialty care needs, such as developmental disability, mental illness, or dementia as defined in WAC 388-76-10000, if the provider, entity representative, resident manager and staff have not completed the specialty care training required by chapter 388-112A WAC.

History

Statutory Authority: Chapter 70.128 RCW. WSR 18-20-015, § 388-76-10505, filed 9/21/18, effective 10/22/18. Statutory Authority: RCW 70.128.040. WSR 10-04-008, § 388-76-10505, filed 1/22/10, effective 2/22/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10505, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10506 Written residency agreement—Residents with medicaid as a payor.

(1) For the purposes of this section "residency agreement" means a legally enforceable written document prepared by the adult family home that contains the rights and responsibilities of the facility and the resident specific to transfer and discharge and is signed by both parties.

(2) For residents with medicaid as a payor the facility must complete a signed written residency agreement with each resident that:

(a) Is signed by the resident or their legal representative and the facility upon admission of the resident to the facility;

(b) Requires the facility to agree to comply with the long-term care residents rights statute transfer and discharge requirements pursuant to RCW 70.129; and

(c) Requires the facility to provide notice to residents before transfer and discharge that includes information about available legal resources and notice that, subject to legislative appropriation, residents have the right to legal counsel at public expense upon notice of transfer or discharge.

(3) For residents whose payor status changes from medicaid to private pay, a new residency agreement is required if the resident's payor status returns to medicaid.

(4) A copy of the residency agreement that is signed and dated by both parties must be:

(a) Kept in the resident record; and

(b) Provided to the resident or their representative.

(5) The residency agreement must be in substantially the following form:

Residency agreement—residents with medicaid as a payor.

(a) [facility name] agrees to comply with the long-term care residents rights statute transfer and discharge requirements pursuant to RCW 70.129.

(b) Subject to legislative appropriation [resident name] has a right to a free lawyer to help them in response to a notice of transfer or discharge. If they want a free lawyer to help them, they must call the long-term care discharge defense screening line at (888) 437-0017.

(d) [Signature of facility and date].

Reviser's note: The brackets and enclosed material in the text of the above section occurred in the copy filed by the agency.

Wash. Admin. Code § 388-76-10510 Resident rights—Basic rights.

The adult family home must ensure that each resident:

(1) Receives appropriate necessary services, as identified in the assessment and negotiated care plan;

(2) Is treated with courtesy, dignity, and respect;

(3) Continues to enjoy basic civil and legal rights;

(4) Has the opportunity to exercise control over life decisions, such as making the resident's own choices about daily life, participation in services or activities, care, and privacy;

(5) Has the opportunity to engage in religious, political, civic, recreational, and other social activities of their choice;

(6) Is cared for in a manner that enhances or maintains the resident's quality of life;

(7) Is cared for in an environment that is safe, clean, comfortable, and homelike; and

(8) Has the freedom to have and use their personal belongings to the extent possible.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10510, filed 5/17/21, effective 8/1/21. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10510, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10515 Resident rights—Exercise of rights.

The adult family home must:

(1) Protect each resident's right to a dignified existence, self-determination, and communication with and access to persons and services inside and outside the home;

(2) Protect and promote the rights of each resident and assist the resident to exercise the rights of a resident of the home and the state of Washington.

(3) Be free of interference, coercion, discrimination, and retaliation from the home in exercising the resident's rights; and

(4) Ensure the resident's right to choose a representative who may exercise the resident's rights to the extent provided by law.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10515, filed 5/17/21, effective 8/1/21. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10515, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10522 Resident rights—Notice—Policy on accepting medicaid as a payment source.

The adult family home must fully disclose the home's policy on accepting medicaid or other public funds as a payment source. The policy must:

(1) Clearly state the circumstances under which the adult family home provides care for medicaid eligible residents and for residents who become eligible for medicaid after admission;

(2) Be provided both orally and in writing in a language the resident understands;

(3) Be provided to all prospective residents, before admission to the home;

(4) Be provided to any current residents who were admitted before this requirement took effect or who did not receive copies prior to admission;

(5) Be a written document that is separate from other documents and use a type font that is at least fourteen point; and

(6) Be signed and dated by the resident and kept in the resident record after signature.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10522, filed 5/17/21, effective 8/1/21. Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10522, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-76-10525 Resident rights—Postings.

The adult family home must post the following in a common use area where they can be easily viewed by anyone in the home, including residents, resident representatives, the department, and visitors:

(1) The name, address, and telephone number for the home's regional residential care services licensing office;

(2) The department's poster that includes the complaint resolution unit hotline and the telephone number for the state ombuds program; and

(3) The poster from the agency designated as the protection and advocacy system for residents with disabilities.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10525, filed 5/17/21, effective 8/1/21. Statutory Authority: Chapter 70.128 RCW. WSR 15-03-037, § 388-76-10525, filed 1/12/15, effective 2/12/15. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10525, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10530 Resident rights—Notice of rights and services.

(1) The adult family home must provide each resident written notice of the resident's rights and services provided in the home in a language the resident understands and before the resident is admitted to the home. The notice must be reviewed at least once every 24 months from the date of the resident's admission and must include the following:

(a) Information regarding resident rights, including rights under chapter 70.129 RCW;

(b) A complete description of the services, items, and activities customarily available in the home or arranged for by the home as permitted by the license;

(c) A complete description of the charges for those services, items, and activities, including charges for services, items, and activities not covered by the home's per diem rate or applicable public benefit programs;

(d) The monthly or per diem rate charged to private pay residents to live in the home;

(e) Rules of the home, which must not violate resident rights in chapter 70.129 RCW;

(f) How the resident can file a complaint concerning alleged abandonment, abuse, neglect, or financial exploitation with the state hotline;

(g) If the home will be managing the resident's funds, a description of how the home will protect the resident's funds; and

(h) If the home does not serve residents who require assistance with evacuation due to a limit on their license, notice that residents living in the home whose status changes to require assistance will be discharged from the facility.

(2) Upon receiving the notice of rights and services at admission and at least every 24 months, the home must ensure the resident and a representative of the home sign and date an acknowledgement stating that the resident has received the notice of rights and services as outlined in this section. The home must retain a signed and dated copy of both the notice of rights and services and the acknowledgement in the resident's record.

History

Statutory Authority: RCW 70.128.040 and 70.128.066. WSR 25-04-035, s 388-76-10530, filed 1/28/25, effective 3/4/25. Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10530, filed 5/17/21, effective 8/1/21. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10530, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10532 Resident rights—Department standardized disclosure forms.

(1) The adult family home must complete the department's standardized disclosure of services form.

The home must:

(a) List on the form the scope of care and services available in the home;

(b) Send the completed form to the department when applying for a license; and

(c) Provide an updated form to the department thirty days prior to changing services, except in emergencies, when the scope of care and services is changing.

(2) The adult family home must complete the disclosure of charges form as provided by the department. The home must:

(a) Provide a copy to each resident prior to or upon admission to the home;

(b) Provide a copy upon resident request; and

(3) These forms do not replace the notice of rights and services required when a resident is admitted to the adult family home as directed in WAC 388-76-10530.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10532, filed 5/17/21, effective 8/1/21. Statutory Authority: Chapter 70.128 RCW. WSR 15-03-037, § 388-76-10532, filed 1/12/15, effective 2/12/15.

Wash. Admin. Code § 388-76-10535 Resident rights—Notice of change to services.

(1) The adult family home must inform each resident in advance of changes to services, items, activities, scope of care, or home rules as follows:

(a) In writing;

(b) At least fourteen days before the effective date of a change due to a substantial and continuing change in the resident's condition that necessitates substantially greater or lesser services, items, or activities;

(c) At least thirty days before the effective date of a change that decreases the scope of care, services, or activities due to circumstances beyond the home's control; and

(d) At least ninety days before the effective date the home voluntarily decreases the scope of care, services, or activities the home provides, if the change will result in the discharge of at least one resident.

(2) The home is not required to notify the resident if the home provides him or her different or additional services, items, or activities that do not result in an additional cost to the resident.

History

Statutory Authority: Chapter 70.128 RCW. WSR 16-20-095, § 388-76-10535, filed 10/4/16, effective 11/4/16
WSR 16-01-171, § 388-76-10535, filed 12/22/15, effective 1/22/16
WSR 15-03-037, § 388-76-10535, filed 1/12/15, effective 2/12/15. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10535, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10540 Resident rights—Disclosure of charges—Notice requirements—Deposits.

(1) If the adult family home requires an admission fee, deposit, prepaid charges, or any other fees or charges, by or on behalf of a person seeking admission, the home must include this information on the disclosure of charges form in writing in a language the resident understands prior to its receipt of any funds.

(2) The disclosure must include:

(a) A statement of the amount of any admissions fees, security deposits, prepaid charges, minimum stay fees, or any other fees or charges specifying what the funds are paid for and the basis for retaining any portion of the funds if the resident dies, is hospitalized, transferred, or discharged from the home;

(b) The home's advance notice or transfer requirements; and

(c) The amount of the security deposits, admission fees, prepaid charges, minimum stay fees, or any other fees or charges that the home will refund to the resident if the resident leaves the home.

(3) If the home does not provide the disclosures in subsection (1) of this section to the resident, the home must not keep the resident's security deposits, admission fees, prepaid charges, minimum stay fees, or any other fees or charges.

(4) If a resident dies, is hospitalized, or is transferred to another facility for more appropriate care and does not return to the home, the adult family home:

(a) Must refund any deposit or charges paid by the resident less the home's per diem rate for the days the resident actually resided, reserved, or retained a bed in the home regardless of any minimum stay policy or discharge notice requirements;

(b) May keep an additional amount to cover its reasonable and actual expenses incurred as a result of a private-pay resident's move, not to exceed five days per diem charges, unless the resident has given advance notice in compliance with the home's admission agreement; and

(5) The adult family home must not retain funds for reasonable wear and tear by the resident or for any basis that would violate RCW 70.129.150.

(6) The adult family home must provide the resident with any and all refunds due within thirty days from the resident's date of discharge from the home.

(7) Nothing in this section applies to provisions in contracts negotiated between a home and a certified health plan, health or disability insurer, health maintenance organization, managed care organization, or similar entities.

(8) The home must ensure that the notice of rights and services is consistent with the requirements of this section, chapters 70.128, 70.129, and 74.34 RCW, and other applicable state and federal laws.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10540, filed 5/17/21, effective 8/1/21. Statutory Authority: Chapter 70.128 RCW. WSR 16-20-095, § 388-76-10540, filed 10/4/16, effective 11/4/16
WSR 15-03-037, § 388-76-10540, filed 1/12/15, effective 2/12/15
WSR 12-01-004, § 388-76-10540, filed 12/7/11, effective 1/7/12. Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10540, filed 1/15/10, effective 2/15/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10540, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10545 Resident rights—Admitting and keeping residents.

The adult family home must:

(1) Only admit or keep individuals whose needs the home can safely meet:

(a) With qualified available staff; and

(b) Through the provision of reasonable accommodations required by state and federal law;

(2) Not admit an individual before obtaining a complete assessment of the individual's needs and preferences, except in cases of a genuine emergency;

(3) Ensure that the admission of the individual does not negatively affect the ability of the home to meet the needs of or endangers the safety of other residents; and

(4) Comply with all applicable federal and state requirements regarding nondiscrimination.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10545, filed 5/17/21, effective 8/1/21. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10545, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10550 Resident rights—Adult family home staffing—Notification required.

The adult family home must provide the following information in writing to prospective residents before admission and current residents who were admitted before this requirement took effect:

(1) Information about the provider, entity representative, and resident manager, including:

(a) Availability in the home, including a general statement about how often they each are in the home;

(b) Education and training relevant to resident caregiving;

(d) Primary responsibilities, including which general care management decisions they will make and which will be made by the resident or their representative; and

(e) How to contact the provider, entity representative, and resident manager when not in the home.

(2) Information about a licensed practical nurse or registered nurse, if there is one, who is in any way involved in the care of residents, including:

(a) Who the licensed practical nurse or registered nurse is employed by;

(b) The specific routine hours that the licensed practical nurse or registered nurse is on-site, if they are on-site routinely;

(d) The nonroutine times when the licensed practical nurse or registered nurse will be available, such as on-call; and

(e) A description of what the provider or entity representative will do to make the services of a licensed nurse available in an emergency or change in a resident's condition.

(3) A statement indicating whether the provider, caregiver or staff is qualified or willing to become qualified to perform nurse delegation as allowed under state law.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10550, filed 5/17/21, effective 8/1/21. Statutory Authority: RCW 70.128.040. WSR 10-04-008, § 388-76-10550, filed 1/22/10, effective 2/22/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10550, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10560 Resident rights—Adult family home management of resident financial affairs.

(1) Each resident has the right to manage their own financial affairs. The adult family home must not require any resident to deposit their personal funds with the home.

(2) If the adult family home agrees to manage a resident's personal funds, the home must:

(a) Have a written authorization from the resident;

(b) Develop and maintain a system that assures a full, complete, and separate accounting of each resident's personal funds given to the home on the resident's behalf;

(c) Ensure the resident's funds are not mixed with the home's funds or with the funds of any person other than another resident. If funds are pooled accounts, there must be a separate accounting for each resident's share;

(d) Deposit a resident's personal funds in excess of one hundred dollars in an interest-bearing account(s) separate from any of the home's operating accounts and that credits all interest earned on residents' funds to that account;

(e) Ensure that the account or accounts are held in a financial institution as defined in RCW 30A.22.040, and notify each resident in writing of the name, address, and location of the depository.

(f) Keep a resident's personal funds that do not exceed one hundred dollars in a noninterest-bearing account, interest-bearing account, or petty cash fund; and

(g) Provide an individual financial record when requested by the resident or the resident's legal representative.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10560, filed 5/17/21, effective 8/1/21. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10560, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10561 Resident rights—Resident security deposit account.

(1) Funds in excess of one hundred dollars that are paid to an adult family home as a security deposit or as prepayment for charges beyond the first month's residency must be deposited by the adult family home in an interest bearing account that is separate from any of the home's operating accounts and that credits all interest earned on the resident's funds to that account.

(2) The adult family home must:

(a) Provide a record of the account when requested by the resident, the resident's representative, or the department;

(b) Ensure the resident's funds are not mixed with the home's funds or with the funds of any person other than another resident. If an account pools resident funds, there must be a separate accounting for each resident's share;

(c) Ensure that the account(s) are held, and remain until a resident refund occurs, in a financial institution as defined in RCW 30A.22.040; and

(d) Notify the resident in writing of the name, address, and location of the depository.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10561, filed 5/17/21, effective 8/1/21. Statutory Authority: Chapter 70.128 RCW. WSR 12-01-004, § 388-76-10561, filed 12/7/11, effective 1/7/12.

Wash. Admin. Code § 388-76-10570 Resident rights—Financial affairs related to resident death.

If a resident's personal funds are deposited with the adult family home, the home must give the resident's funds and a final accounting of the funds within thirty days after the resident's death to the individual or probate jurisdiction administering the resident's estate; except for a resident who received long-term care services paid by the state, the home must send funds and accounting to the state of Washington, department of social and health services, office of financial recovery.

History

Statutory Authority: Chapter 70.128 RCW. WSR 12-01-004, § 388-76-10570, filed 12/7/11, effective 1/7/12. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10570, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10575 Resident rights—Privacy.

(1) The adult family home must ensure the right of each resident to personal privacy that includes:

(a) The home;

(b) Medical treatment;

(d) Personal care; and

(e) Visits and meetings of family and resident groups; however

(2) The resident right to personal privacy does not require the home to provide a private room for each resident.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10575, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10580 Resident rights—Grievances.

The adult family home must:

(1) Ensure each resident's right to voice grievances, including those about care and treatment given or not given that has been furnished as well as that which has not been furnished; and

(2) Make prompt efforts to resolve grievances the resident may have, including those about the behavior of other residents.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10580, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10584 Resident rights—Examination of license.

The adult family home must place its license to operate and any conditions on the license, in a visible location in a common use area where it can be examined by residents, resident representatives, the department and anyone interested without having to ask for them.

History

Statutory Authority: RCW 70.128.040. WSR 10-14-058, § 388-76-10584, filed 6/30/10, effective 7/31/10.

Wash. Admin. Code § 388-76-10585 Resident rights—Examination of inspection results.

(1) The adult family home must place a copy of the following documents in a common use area where they can be easily viewed by residents, resident representatives, the department, and anyone interested without having to ask for them:

(a) The most recent inspection report, any related follow-up reports, and related cover letters; and

(b) All complaint investigation reports, any related follow-up reports, and any related cover letters received since the most recent inspection or within the last twelve months, whichever is longer.

(2) The adult family home must post a notice that the following documents are available for review if requested by the residents, resident representatives, the department, and anyone interested:

(a) A copy of each inspection report and related cover letter received during the past three years; and

(b) A copy of any complaint investigation reports and related cover letters received during the past three years.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10585, filed 5/17/21, effective 8/1/21. Statutory Authority: RCW 70.128.040. WSR 10-14-058, § 388-76-10585, filed 6/30/10, effective 7/31/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10585, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10590 Resident rights—Contact with client advocates.

The adult family home must ensure that each resident:

(1) Receives information from client advocate agencies; and

(2) Has opportunities to contact client advocate agencies.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10590, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10595 Resident rights—Advocacy access and visitation rights.

The adult family home must not interfere with each resident's right to have access to and from:

(1) Any representative of the state;

(2) The resident's own physician;

(3) The state long-term care ombuds programs;

(4) The agency responsible for the protection and advocacy system for one or more of the following:

(a) Individuals with developmental disabilities as established under Part C of the Developmental Disabilities Assistance and Bill of Rights Act;

(b) Individuals with mental illness as established under the Protection and Advocacy for Individuals with Mental Illness Act;

(c) Individuals with disabilities as established under section 509 of the Rehabilitation Act of 1973, as amended, who are not served under the mandates of existing protection and advocacy systems created under federal law;

(5) Visitors who are visiting the resident with the resident's consent, which:

(a) The resident may withdraw at any time; and

(b) May only be limited when the limitation is to protect the rights or safety of the residents or others in the home and must be documented under WAC 388-76-10401; and

(6) The resident's representative or an entity or individual that provides health, social, legal, or other services to the resident, subject to the resident's right to deny or withdraw consent at any time.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10595, filed 5/17/21, effective 8/1/21. Statutory Authority: Chapter 70.128 RCW. WSR 15-03-037, § 388-76-10595, filed 1/12/15, effective 2/12/15. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10595, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10596 Essential support persons.

(1) In circumstances in which limitations must be placed on resident visitation due to a public health emergency or other threat to the health and safety of the residents and staff of a facility or nursing home, residents must still be allowed access to an essential support person, subject to reasonable limitations on such access tailored to protecting the health and safety of essential support persons, residents, and staff.

(2) The facility must comply with RCW 70.129.190, and all related statutory requirements.

History

Statutory Authority: RCW 18.20.090, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 25-16-099, s 388-76-10596, filed 8/6/25, effective 9/6/25.

Wash. Admin. Code § 388-76-10600 Resident rights—Mail and telephone privacy.

The adult family home must ensure each resident's right to privacy in communications, including the right to:

(1) Send and receive unopened mail without delay;

(2) Have writing paper, postage, and pens or pencils available that have been paid for by the resident; and

(3) Have twenty-four hour per day access to a telephone to make and receive confidential calls.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10600, filed 5/17/21, effective 8/1/21. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10600, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10605 Resident rights—Personal property and storage space.

The adult family home must ensure each resident's right to keep and use personal possessions, including furnishings, and appropriate clothing, as space permits, unless to do so would infringe upon the rights or health and safety of other residents.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10605, filed 5/17/21, effective 8/1/21. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10605, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10610 Resident rights—Waiver of liability.

The adult family home must not ask the resident for, or make the resident sign waivers of:

(1) Potential liability for losses of personal property or injury; and

(2) Residents' rights set forth in chapters 70.128, 70.129, 74.34 RCW, this chapter or in the applicable licensing laws.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10610, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10615 Resident rights—Transfer and discharge.

(1) The adult family home must allow each resident to stay in the home and not transfer or discharge the resident unless:

(a) The transfer or discharge is necessary for the resident's welfare and the resident's needs cannot be met in the home;

(b) The safety or health of individuals in the home is or would otherwise be endangered;

(d) The home ceases to operate.

(2) Before a home transfers or discharges a resident, the home must first attempt through reasonable accommodations to avoid the transfer or discharge, unless agreed to by the resident.

(3) The home must give residents enough preparation and orientation to ensure a safe and orderly transfer or discharge from the home.

(4) If the home discharges a resident in violation of this section or WAC 388-76-10616, the home must readmit the resident to the home as soon as a gender-appropriate bed becomes available.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10615, filed 5/17/21, effective 8/1/21. Statutory Authority: Chapter 70.128 RCW. WSR 15-03-037, § 388-76-10615, filed 1/12/15, effective 2/12/15. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10615, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10616 Resident rights—Transfer and discharge notice.

(1) Before a home transfers or discharges a resident, the home must give the resident and the resident's representative a written thirty day notification informing them of the transfer or discharge. The home must also make a reasonable effort to notify, if known, any interested family member. The written notification must be in a language and manner the resident understands and include the following:

(a) The reason for transfer or discharge;

(b) The effective date of transfer or discharge;

(c) The location where the resident is transferred or discharged if known at the time of the thirty-day discharge notice;

(d) The name, address, and telephone number of the state long-term care ombuds;

(e) For residents with developmental disabilities, the mailing address and telephone number of the agency responsible for the protection and advocacy of individuals with a developmental disability; and

(f) For residents with mental illness, the mailing address and telephone number of the agency responsible for the protection and advocacy of individuals with mental illness.

(2) The home may make the notice as soon as practicable before transfer or discharge when:

(a) The safety and health of the individuals in the home would be endangered;

(b) An immediate transfer or discharge is required by the resident's urgent medical needs; or

(3) A copy of the written notification must be in the resident's records.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10616, filed 5/17/21, effective 8/1/21.

Wash. Admin. Code § 388-76-10617 Resident rights—Transfer and discharge notice—Residents with medicaid as payor.

For residents with medicaid as a payor, in addition to the requirements in WAC 388-76-10616, the adult family home must do the following when issuing a written notice of transfer or discharge:

(1) Include in the notice contact information provided by the department for the legal services agencies assigned to provide legal counsel;

(2) Clearly state in the notice that, subject to legislative appropriation, legal counsel at public expense is available to represent the resident's interests in the transfer or discharge process. This language must be substantially in the following form: "Subject to legislative appropriation you have a right to a free lawyer to help you respond to a notice of transfer or discharge. If you want a free lawyer to help you, please call the long-term care discharge defense screening line at (888) 437-0017.";

(3) Within three calendar days of issuing the notice, provide a copy of the notice to the resident's assigned department case manager;

(4) Within three calendar days of issuing the notice, provide a copy of the notice to the Washington state long-term care ombudsman program; and

(5) Issue the transfer and discharge notice in substantially the following form:

Notice of transfer or discharge—residents with medicaid as a payor:

(a) Resident information;

(i) Resident name;

(ii) Resident address;

(b) Facility information;

(i) Facility name;

(ii) Facility address;

(iii) Contact person's name;

(d) Effective date: Effective date must be at least 30 days from the date notice is given unless an exception applies according to RCW 70.129.110;

(e) Location to where resident is transferred or discharged:

(i) Name;

(ii) Address;

(iii) Phone;

(f) Reason for transfer or discharge: The specific reason for the transfer or discharge must be one or more of the reasons in (i)-(v) of this subsection:

(i) Transfer or discharge is necessary for the resident's welfare and the residents' needs cannot be met in the facility;

(ii) The safety of individuals in the facility is endangered;

(iii) The health of individuals in the facility would otherwise be endangered;

(iv) The resident has failed to make the required payment for their stay;

(v) The facility ceases to operate.

(g) Copy of notice given within three days to:

(i) Department case manager;

(ii) Washington state long-term care ombudsman program;

(h) Your rights and resources.

(i) Legal counsel: Subject to legislative appropriation, you have a right to a free lawyer to help you respond to a notice of transfer or discharge. If you want a free lawyer to help you, please call the long-term care discharge defense screening line at (888) 437-0017.

(ii) Washington state ombuds: For assistance and information about this notice contact your long-term care ombuds toll free at 1- 800-562-6028 or by email at ltcop@mschelps.org. The Washington long-term care ombudsman program is located at 1200 South 336th St, Federal Way, WA 98003. You can find your local ombuds person on the Washington state long-term care ombudsman program website at www.waombudsman.org, under "Find an Ombuds".

(iii) Disability rights Washington: If you have a diagnosis of a mental illness or an intellectual disability, you may contact disability rights Washington 1-800-562-2702 or (206) 324-1521. You may also make your request in writing by fax at (206) 957-0729, email at info@dr-wa.org or mail at Disability rights Washington, 315 5th Ave S, Suite 850, Seattle WA, 98104.

(iv) DSHS home and community living administration (HCLA): You have the right to make a complaint to the complaint resolution unit (CRU/complaint hotline) 1-800-562-6078.

History

Statutory Authority: RCW 18.20.090, 70.97.230, and 70.128.040. WSR 26-08-074, s 388-76-10617, filed 3/30/26, effective 4/30/26. Statutory Authority: RCW 18.20.090, 70.97.230, 70.128.040, 74.09.520(2), 74.39A.007, 42 C.F.R. 441.530 (a)(1)(vi)(A), and 441.301 (c)(4)(vi)(A). WSR 25-18-037, s 388-76-10617, filed 8/25/25, effective 1/1/26.

Wash. Admin. Code § 388-76-10620 Resident rights—Quality of life—General.

(1) The adult family home must promote care for residents in a manner and in an environment that maintains or enhances each resident's dignity and respect in full recognition of his or her individuality.

(2) The home may design home rules that protect the rights and quality of life of residents. Within these rules, the home must ensure the resident's right to:

(a) Choose activities, schedules, and health care consistent with the resident's interests, assessments, and negotiated care plan;

(b) Interact with members of the community both inside and outside the home;

(d) Wear the resident's own clothing and decide their own dress, hair style, or other personal effects according to individual preference;

(e) Unless adjudged incompetent or otherwise found to be legally incapacitated to:

(i) Be informed in advance about recommended care and services and of any recommended changes in the care and services;

(ii) Participate in planning care and treatment or changes in care and treatment;

(iii) Direct the resident's own service plan and changes in the service plan; or

(iv) Refuse any particular service so long as such refusal is documented in the record of the resident.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10620, filed 5/17/21, effective 8/1/21. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10620, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10625 Resident rights—Quality of life—Meetings.

The adult family home must ensure:

(1) A resident's right to:

(a) Organize and take part in resident groups in the home;

(b) Have family meet in the home with the families of other residents; and

(2) The home must provide a resident or family group, if one exists, with meeting space.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10625, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10630 Resident rights—Quality of life—Adult family home response to issues.

When a resident or family group exists, the adult family home must listen to the views and act upon the grievances and recommendations of residents and families about proposed policy and operational decisions affecting resident care and life in the home.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10630, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10635 Resident rights—Quality of life—Work.

The adult family home must respect the resident's right to refuse to perform services for the home except as voluntarily agreed to by the resident and the home and documented in the resident's negotiated care plan.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10635, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10640 Resident rights—Quality of life—Resident participation.

The adult family home must ensure each resident's right to join in social, religious, and community activities that do not interfere with the rights of other residents in the home.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10640, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10645 Resident rights—Quality of life—Reasonable accommodation.

The adult family home must ensure each resident:

(1) Receives reasonable accommodation to meet the needs and preferences of the resident, except when the reasonable accommodation endangers the health or safety of the individual or other residents; and

(2) Has the ability to share a double room with his or her spouse or domestic partner when both spouses or domestic partners consent to the arrangement.

History

Statutory Authority: RCW 70.128.040. WSR 09-03-030, § 388-76-10645, filed 1/12/09, effective 2/12/09. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10645, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10650 Medical devices.

(1) The adult family home must not use a medical device with a known safety risk as a restraint or for staff convenience.

(2) Before a medical device with a known safety risk is used by a resident, the home must:

(a) Ensure an assessment has been completed that identifies the resident's need and ability to safely use the medical device;

(b) Provide the resident and his or her family or legal representative with information about the device's benefits and safety risks to enable them to make an informed decision about whether to use the device;

(d) Ensure the medical device is properly installed.

History

Statutory Authority: Chapter 70.128 RCW. WSR 16-20-095, § 388-76-10650, filed 10/4/16, effective 11/4/16. Statutory Authority: RCW 70.128.040. WSR 09-03-029, § 388-76-10650, filed 1/12/09, effective 2/12/09. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10650, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10655 Physical and mechanical restraints.

The adult family home must ensure:

(1) Each resident's right to be free from physical and mechanical restraints used for discipline or convenience;

(2) Prior to the use of physical or mechanical restraints, less restrictive alternatives have been tried and documented in the resident's negotiated care plan;

(3) The physical or mechanical restraints have been assessed as necessary to treat the resident's medical symptoms and addressed on the resident's negotiated care plan; and

(4) If physical or mechanical restraints are used to treat a resident's medical symptoms, the restraints are applied and immediately supervised on-site by a:

(a) Licensed registered nurse;

(b) Licensed practical nurse; or

(5) For the purposes of this section, "immediately supervised" means that the licensed person is in the home and quickly and easily available.

History

Statutory Authority: Chapter 70.128 RCW. WSR 16-20-095, § 388-76-10655, filed 10/4/16, effective 11/4/16
WSR 16-06-004, § 388-76-10655, filed 2/17/16, effective 4/1/16. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10655, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10660 Chemical restraints.

(1) "Chemical restraint(s)" cannot be used for discipline or convenience.

(2) Must only be used within the guidelines as "chemical restraint" is defined.

History

Statutory Authority: Chapter 70.128 RCW. WSR 17-01-002, § 388-76-10660, filed 12/7/16, effective 1/7/17
WSR 16-06-004, § 388-76-10660, filed 2/17/16, effective 4/1/16. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10660, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10665 Involuntary seclusion.

The adult family home must ensure a resident's right to be free from involuntary seclusion or isolation of the resident against his or her will.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10665, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10670 Prevention of abuse.

The adult family home must:

(1) Meet the requirements of chapter 74.34 RCW;

(2) Ensure each resident's right to be free from abandonment, verbal, sexual, physical and mental abuse, exploitation, financial exploitation, neglect, and involuntary seclusion;

(3) Protect each resident who is an alleged victim of abandonment, verbal, sexual, physical and mental abuse, exploitation, financial exploitation, neglect, and involuntary seclusion; and

(4) Prevent future potential abandonment, verbal, sexual, physical and mental abuse, exploitation, financial exploitation, neglect, and involuntary seclusion from occurring.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10670, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10673 Abuse and neglect reporting—Mandated reporting to department—Required.

(1) In accordance with chapter 74.34 RCW, all providers, entity representatives, resident managers, owners, caregivers, staff, and students that provide care and services to residents, are mandated reporters and must immediately report to the department when there is:

(a) A reasonable cause to believe that abandonment, abuse, exploitation, financial exploitation, or neglect of a vulnerable adult has occurred; or

(b) A reason to suspect that sexual assault of a vulnerable adult has occurred.

(2) Reports must be made to:

(a) The centralized toll free telephone number provided by the department; and

(b) The appropriate law enforcement agencies, as required under chapter 74.34 RCW.

History

Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10673, filed 1/15/10, effective 2/15/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 08-05-098, § 388-76-10673, filed 2/15/08, effective 3/17/08.

Wash. Admin. Code § 388-76-10675 Adult family home rules and policies related to abuse—Required.

The adult family home must develop and implement written rules and policies that:

(1) Do not allow abandonment, abuse, neglect of any resident, exploitation or financial exploitation of any resident;

(2) Require staff to report possible abuse, and other related incidents, as required in chapter 74.34 RCW; and

(3) Do not interfere with the requirement that employees and other mandated reporters file reports directly with the department, and with law enforcement, if they suspect sexual or physical assault to have occurred.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10675, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10680 Staff behavior related to abuse.

The adult family home must ensure that staff do not abandon, abuse, neglect, seclude, exploit, or financially exploit any resident.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10680, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10685 Bedrooms.

WAC 388-76-10685

The adult family home must meet all of the following requirements:

(1) Ensure each resident's bedroom is an outside room that allows entrance of natural light.

(2) Ensure window and door screens:

(a) Do not hinder emergency escape; and

(b) Prevent entrance of flies and other insects.

(3) Ensure each resident, including those using mobility aids such as wheelchairs and walkers has direct, unrestricted, and free access from the bedroom through doors, hallways, and corridors to common use areas and other rooms used for care and services including bathrooms.

(4) When a bedroom will be shared by two residents, the home must:

(a) Document through the notice of rights and services that the resident's bedroom is a shared bedroom; and

(b) Allow residents to express their preference of roommate and allow residents who mutually consent to share a bedroom to live in a double occupancy bedroom together, unless this will pose a health or safety risk for any resident in the home;

(5) Provide each bedroom with a minimum usable floor space as required in WAC 388-76-10690.

(6) Give each resident the opportunity to have a lock on their bedroom door if they choose to unless having a locked door would be unsafe for the resident and this is documented according to WAC 388-76-10401.

(7) Ensure each bedroom has a closet or a wardrobe, armoire, or reasonable storage space for clothes accessible to residents. Neither the closet nor wardrobe/armoire floor space will be considered a part of the room's usable square footage. The home must not remove a closet in order to provide additional floor space.

(8) Ensure there are no more than two residents to a bedroom.

(9) Unless the resident chooses to provide their own furniture and bedding, the home must provide each resident a bed 36 inches or wider with:

(a) A clean, comfortable mattress;

(b) A waterproof cover for use when needed or requested by the resident;

(d) Adequate clean blankets to meet the needs of each resident; and

(e) Clean pillows.

(10) Do not use the upper bunk of double-deck beds for a resident's bed.

(11) Provide each resident a call bell, or an alternative way of alerting staff in an emergency, that the resident can use, unless the bedroom of an AFH staff member is within hearing distance of the resident's bedroom and a staff member will be within hearing distance at all times.

(12) Ensure that members of the household and staff do not share bedrooms with residents.

(13) Ensure a resident does not share a bedroom with a person under 18 years of age, unless the person is the resident's own child.

(14) The adult family home must notify the department and receive an approved inspection from the department before allowing a resident to sleep in a bedroom not previously inspected and approved by the department.

History

Statutory Authority: RCW 70.128.040, 70.128.065, and 45 C.F.R. § 1324.11 (e)(2). WSR 26-17-004, s 388-76-10685, filed 8/5/26, effective 9/20/26. Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10685, filed 5/17/21, effective 8/1/21. Statutory Authority: Chapter 70.128 RCW. WSR 16-06-004, § 388-76-10685, filed 2/17/16, effective 4/1/16. Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10685, filed 1/15/10, effective 2/15/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10685, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10690 Bedroom usable floor space—In adult family homes after the effective date of this chapter.

(1) For the purposes of this section "vestibule" means a small room or hall between an outer door and the main part of the resident bedroom.

(2) The adult family home must ensure each resident bedroom has a minimum usable floor space as follows, excluding the floor space for toilet rooms, closets, lockers, wardrobes and vestibules:

(a) Single occupancy bedrooms with at least eighty square feet; and

(b) Double occupancy bedrooms with at least one-hundred twenty square feet.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10690, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10695 Building codes—Structural requirements.

(1) For single family dwellings used as an adult family home after July 1, 2007, the home must ensure the building meets the requirements of WAC 51-51-0330 if the building is:

(a) New; or

(b) An existing building converted for use as an adult family home.

(2) For buildings licensed as a home before July 1, 2007, the requirement of subsection (1) of this section does not apply if:

(a) The building sells or transfers to a new owner; and

(b) The new owner takes possession of the building before the issuance of the license.

(3) The home must ensure that every area used by residents:

(a) Has direct access to at least one exit which does not pass through other areas such as a room or garage subject to being locked or blocked from the opposite side; and

(b) Is not accessible only by or with the use of a:

(i) Ladder;

(ii) Folding stairs; or

(iii) Trap door.

History

Statutory Authority: RCW 70.128.040. WSR 21-04-131, § 388-76-10695, filed 2/2/21, effective 3/5/21. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10695, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10700 Building official—Inspection and approval.

The adult family home must have the building inspected and approved for use as an adult family home by the local building official:

(1) Before licensing; and

(2) After any construction changes that:

(a) Affect resident's ability to exit the home; or

(b) Change, add or modify a resident's bedroom.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10700, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10705 Common use areas.

(1) For the purposes of this section, common use areas:

(a) Are areas and rooms of the adult family home that residents use each day for tasks such as eating, visiting, and leisure activities; and

(b) Include but are not limited to dining and eating rooms, living and family rooms, and any entertainment and recreation areas.

(2) The adult family home must ensure common use areas are:

(a) Homelike, with furnishings that each resident may use;

(b) Large enough for all residents to use at the same time; and

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10705, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10710 Construction and remodeling—Relocation of residents.

Before moving all residents out of the adult family home for construction or remodeling, the home must:

(1) Notify the residents of the move date and the resident's options consistent with chapter 70.129 RCW;

(2) Notify the department at least thirty days before the anticipated move, including:

(a) The location to which the residents will be moved;

(b) The home's plans for providing and ensuring care and services during the relocation;

(d) The projected time frame for completing the construction or remodeling.

(3) Obtain the department's approval of the relocation plans before moving the residents.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10710, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10715 Doors—Ability to open.

WAC 388-76-10715

The adult family home must ensure:

(1) Every bedroom and bathroom door opens from the inside and outside;

(2) Every closet door opens from the inside and outside;

(3) At least one door leading to the outside is designated as an emergency exit. In homes licensed after January 1, 2016, this door must have a lever door handle on both sides and hardware that allows residents to exit when the door is locked and immediately reenter without a key, tool, or special knowledge or effort by residents;

(4) Other doors leading to the outside that are not designated as an emergency exit must open without any special skills or knowledge, and they must remain accessible to residents unless doing so poses a risk to the health or safety of at least one resident;

(5) All internal and external doors comply with local jurisdictional requirements as well as the building code requirements in chapter 51-51 WAC; and

(6) For homes licensed after September 20, 2026, all internal doors residents will pass through that are not designated as an emergency exit are at least 27 inches wide.

History

Statutory Authority: RCW 70.128.040, 70.128.065, and 45 C.F.R. § 1324.11 (e)(2). WSR 26-17-004, s 388-76-10715, filed 8/5/26, effective 9/20/26. Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10715, filed 5/17/21, effective 8/1/21. Statutory Authority: Chapter 70.128 RCW. WSR 16-20-095, § 388-76-10715, filed 10/4/16, effective 11/4/16
WSR 16-01-171, § 388-76-10715, filed 12/22/15, effective 1/22/16. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10715, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10720 Electronic monitoring equipment—Audio monitoring and video monitoring.

(1) Except as provided in this section or in WAC 388-76-10725, the adult family home must not use the following in the home or on the premises:

(a) Audio monitoring equipment; or

(b) Video monitoring equipment if it includes an audio component.

(2) The home may video monitor and video record activities in the home, without an audio component, only in the following areas:

(a) Entrances and exits if the cameras are:

(i) Focused only on the entrance or exit doorways; and

(ii) Not focused on areas where residents gather;

(b) Outdoor areas accessible to both residents and the public, such as, but not limited to, driveways or walkways, provided that the purpose of such monitoring is to prevent theft, property damage, or other crime on the premises;

(d) Designated smoking areas, subject to the following conditions:

(i) Residents are assessed as needing supervision for smoking;

(ii) A staff person watches the video monitor at any time the area is used by such residents;

(iii) The video camera must be clearly visible;

(iv) The video monitor must not be viewable by the general public; and

(3) The home must notify all residents in writing of the video monitoring equipment. The home must:

(a) Identify in the written notification each person or organization with access to electronic monitoring; and

(b) Retain an acknowledgment that has been signed and dated by both the resident and the home that states in writing that the resident has received this notification.

(4) The presence of cameras must not alter the obligation of the home to provide appropriate in-person assistance and monitoring due to individual physical or cognitive limitations.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10720, filed 5/17/21, effective 8/1/21. Statutory Authority: RCW 70.128.040. WSR 09-03-029, § 388-76-10720, filed 1/12/09, effective 2/12/09. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10720, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10725 Electronic monitoring equipment—Resident requested use.

(1) Audio or video monitoring equipment may not be installed in an adult family home to monitor any resident sleeping area unless the resident or the resident's representative has requested and consents to the monitoring;

(2) Electronic monitoring equipment must be installed in a manner that is safe for residents;

(3) An adult family home must not refuse to admit an individual, or discharge a resident, solely because of a request to conduct authorized electronic monitoring;

(4) A resident may limit consent for use of electronic monitoring devices in their bedrooms to specific times or situations, pointing the camera in a particular direction, or prohibiting the use of certain devices;

(5) The release of audio or video monitoring recordings by the facility is prohibited, except to authorized persons or as otherwise required by law;

(6) If the resident requests that the home conduct audio or video monitoring of their sleeping area, before any electronic monitoring occurs the home must ensure:

(a) That the electronic monitoring does not violate chapter 9.73 RCW;

(b) The resident's roommate has provided written consent to electronic monitoring, if the resident has a roommate; and

(c) The resident and the home have agreed upon a specific duration for the electronic monitoring and the agreement is documented in writing.

(7) The home must:

(a) Reevaluate the use of the electronic monitoring with the resident at least quarterly; and

(b) Have each reevaluation in writing signed and dated by the resident.

(8) The home must immediately stop electronic monitoring if the:

(a) Resident no longer wants electronic monitoring;

(b) Roommate objects or withdraws the consent to the electronic monitoring; or

(c) Resident becomes unable to give consent, unless consent has been provided by a resident's representative as described in this section.

(9) For the purposes of consenting to video electronic monitoring, without an audio component, the term "resident" includes the resident's representative.

(10) For the purposes of consenting to audio electronic monitoring, the term "resident" includes only:

(a) The resident residing in the home; or

(b) The resident's court-appointed guardian or attorney-in-fact who has obtained a court order specifically authorizing the court-appointed guardian or attorney-in-fact to consent to audio electronic monitoring of the resident.

(11) If the resident's decision maker consents to audio electronic monitoring as specified in subsection (10) of this section, the home must maintain a copy of the court order authorizing such consent in the resident's record.

(12) If the adult family home determines that a resident, resident's family, or other third party is electronically monitoring a resident's bedroom without complying with the requirements of this section, the home must disconnect or remove such equipment until the appropriate consent is obtained and notice given as required by this section.

(13) Nothing in this section prohibits or limits an adult family home from implementing electronic monitoring pursuant to a resident's negotiated care plan, including but not limited to motion sensor alerts, floor pressure sensors, or global positioning devices, where the monitoring does not entail the transmittal or recording of a human-viewable image, sound, or resident name.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10725, filed 5/17/21, effective 8/1/21. Statutory Authority: RCW 70.128.040. WSR 09-03-029, § 388-76-10725, filed 1/12/09, effective 2/12/09. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10725, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10730 Grab bars and hand rails.

(1) Homes licensed before November 1, 2016, must have at a minimum securely installed:

(a) Grab bars in bathing facilities such as tubs and showers;

(b) Grab bars next to toilets, if needed by any resident;

(d) Handrails on ramps if needed by any resident.

(2) Homes licensed and bathroom additions that occur after November 1, 2016, must install grab bars securely fastened in accordance with WAC 51-51-0330 at the following locations:

(a) Bathing facilities such as tubs and showers; and

(b) Each side of any toilet used by residents.

(3) Homes licensed after November 1, 2016, must install handrails on each side of the following:

(a) Step or steps; and

(b) Ramps used by residents.

History

Statutory Authority: RCW 70.128.040. WSR 21-04-131, § 388-76-10730, filed 2/2/21, effective 3/5/21. Statutory Authority: Chapter 70.128 RCW. WSR 16-20-095, § 388-76-10730, filed 10/4/16, effective 11/4/16. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10730, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10735 Kitchen facilities.

(1) The adult family home must ensure the kitchen facilities include adequate space for:

(a) Food handling;

(b) Preparation; and

(2) The home must keep the kitchen and equipment in a clean and sanitary manner.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10735, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10740 Lighting.

The adult family home must provide:

(1) Adequate light fixtures for each task a resident or staff does; and

(2) Emergency lighting, such as working flashlights for staff and residents that are readily accessible.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10740, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10745 Local codes and ordinances.

The adult family home must:

(1) Meet all applicable local licensing, zoning, building and housing codes as they pertain to a single family dwelling;

(2) Meet state and local fire safety regulations as they pertain to a single family dwelling; and

(3) Check with local authorities to ensure the home meets all local codes and ordinances.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10745, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10750 Safety and maintenance.

The adult family home must:

(1) Keep the home both internally and externally in good repair and condition with a safe, comfortable, sanitary, and homelike environment that is free of hazards;

(2) Ensure that there is existing outdoor space that is safe and usable for residents;

(3) Provide clean, functioning, safe, adequate household items and furnishings to meet the needs of each resident;

(4) Ensure items and furnishings brought into the home by the resident for their use are clean, functioning, and safe;

(5) Provide safe and functioning systems for:

(a) Heating;

(b) Cooling, which may include air circulating fans;

(d) Electricity;

(e) Plumbing;

(f) Garbage disposal;

(g) Sewage;

(h) Cooking;

(i) Laundry;

(j) Artificial and natural light;

(k) Ventilation; and

(l) Any other feature of the home;

(6) Ensure hot water temperature is at least one hundred five degrees and does not exceed one hundred twenty degrees Fahrenheit at all fixtures used by or accessible to residents, such as:

(a) Tubs;

(b) Showers; and

(7) Keep all toxic substances and hazardous materials in locked storage and in their original containers;

(8) Grant a resident access to and use of toxic substances and hazardous materials only with direct supervision, unless the resident has been assessed as safe to use the substance or material without direct supervision and if the use is documented in the negotiated care plan;

(9) Provide rapid access for all staff to any bedroom, toilet room, shower room, closet, other room occupied by each resident;

(10) Keep all firearms locked and accessible only to authorized persons; and

(11) Keep the home free from:

(a) Rodents;

(b) Flies;

(d) Other vermin.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10750, filed 5/17/21, effective 8/1/21. Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10750, filed 1/15/10, effective 2/15/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10750, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10755 Sewage and liquid wastes.

The adult family home must ensure sewage and liquid wastes are discharged into:

(1) A public sewer system; or

(2) An independent sewage system approved by the local health authority.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10755, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10760 Site.

The adult family home must ensure the home:

(1) Is on a well drained site free from:

(a) Hazardous conditions;

(b) Excessive noise;

(d) Smoke or odors.

(2) Has a road accessible at all times to emergency vehicles.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10760, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10765 Storage.

The adult family home must:

(1) Supply each resident with adequate and reasonable storage space for:

(a) Clothing;

(b) Personal possessions; and

(i) The resident has a single occupancy room with a lockable door; and

(ii) Only the resident and appropriate staff have a key to the door.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10765, filed 5/17/21, effective 8/1/21. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10765, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10770 Telephones.

The adult family home must:

(1) Have at least one working telephone in the home that does not cost residents money to use; and

(2) Allow residents privacy and reasonable access to the telephone to make and receive calls.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10770, filed 5/17/21, effective 8/1/21. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10770, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10775 Temperature and ventilation.

The adult family home must:

(1) Ensure that the maximum and minimum temperature of any room used by a resident is comfortable for the resident and does not compromise the resident's health and safety.

(2) At a minimum, keep room temperature at:

(a) Sixty-eight degrees Fahrenheit or more during waking hours; and

(b) Sixty degrees Fahrenheit or more during sleeping hours.

(3) Provide ventilation in the home to ensure the health and comfort of each resident is met.

History

Statutory Authority: RCW 70.128.040. WSR 09-03-029, § 388-76-10775, filed 1/12/09, effective 2/12/09. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10775, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10780 Toilets and bathing facilities.

(1) All adult family homes must ensure the home has toilets and bathing facilities that provide each resident with privacy and include at least:

(a) One accessible indoor flush toilet that meets WAC 51-51-0330 for each five persons including residents and household members who live in the home; and

(b) Sinks with hot and cold running water.

(2) For the purposes of this section, "accessible" means available and licensed for resident use.

(3) Homes licensed after July 1, 2007, must also ensure each resident has access to a toilet, and bathing facilities without going through another person's room.

(4) Homes licensed after August 1, 2023, must have a sufficient number of toilets to maintain a ratio of one accessible toilet to five persons, without having to go through another person's room to use a toilet.

(5) Toilets and bathing facilities not used by residents do not need to meet requirements of WAC 51-51-0330 and must not be accessible to residents.

History

Statutory Authority: RCW 70.128.040. WSR 25-04-069, s 388-76-10780, filed 1/31/25, effective 3/4/25. Statutory Authority: RCW 70.128.040 and 70.128.066. WSR 23-12-075, § 388-76-10780, filed 6/6/23, effective 8/1/23. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10780, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10783 Water hazards and bodies of water—Resident safety.

The adult family home must protect each resident:

(1) From risks associated with water hazards or bodies of water of any depth at the home; and

(2) When accompanying or escorting the resident at other locations where there are water hazards or bodies of water of any depth.

History

Statutory Authority: RCW 70.128.040. WSR 09-03-030, § 388-76-10783, filed 1/12/09, effective 2/12/09.

Wash. Admin. Code § 388-76-10784 Water hazards—Fences, gates, and alarms.

For any adult family home licensed after July 1, 2007 or any currently licensed adult family home that adds or modifies a new or existing water hazard after July 1, 2007 must ensure:

(1) Pools, spas, and hot tubs are installed according to the requirements of the International Residential Code (IRC) as adopted by the Washington state building code council.

(2) Water hazards over twenty-four inches deep are:

(a) Enclosed by fences and gates at least forty-eight inches high;

(b) Equipped with an audible alarm that sounds when any door, screen, or gate that directly leads to or surrounds the water hazard is opened; and

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10784, filed 5/17/21, effective 8/1/21. Statutory Authority: RCW 70.128.040. WSR 09-03-030, § 388-76-10784, filed 1/12/09, effective 2/12/09.

Wash. Admin. Code § 388-76-10790 Water supply.

The adult family home must:

(1) Obtain local health authority approval to use a private water supply;

(2) Provide a clean and healthy drinking water supply for the home; and

(3) Label any nonpotable water to avoid use as a drinking water source.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10790, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10795 Windows.

(1) The adult family home must ensure at least one window in each resident bedroom meets the following requirements:

(a) The sill height must not be more than forty-four inches above the finished floor.

For homes licensed after July 1, 2007, the department will not approve alternatives to the sill height requirement such as step(s), raised platform(s), or other devices placed by or under the window openings.

(b) The opening area must be a minimum of 5.7 square feet, except that the openings of windows in rooms at grade level as defined by the International Residential Code may have a minimum clear opening of 5.0 square feet. The window must also have:

(i) A minimum opening height of twenty-four inches;

(ii) A minimum opening width of twenty inches; and

(c) The home must ensure the bedroom window can be opened from inside the room without keys, tools, or special knowledge or effort to open.

(d) The window must be free from obstructions that might block or interfere with access for emergency escape or rescue.

(2) When resident bedroom windows are fitted with storm windows, the home must equip the storm windows with release mechanisms that:

(a) Easily open from the inside; and

(b) Do not require a key or special knowledge or effort to open.

(3) The home must ensure that each basement window is kept free from obstructions that might block or interfere with access for emergency escape or rescue.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10795, filed 5/17/21, effective 8/1/21. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10795, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10800 Adult family home located outside of public fire protection.

(1) If the adult family home is located in an area without public fire protection, the home must have written verification of adequate fire protection from the fire authority.

(2) If the local fire authority requires the home to have additional protective measures such as a fire extinguisher with a rating other than that required under WAC 388-76-10810(1), the home must meet this requirement.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10800, filed 5/17/21, effective 8/1/21. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10800, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10805 Automatic smoke alarms.

(1) The adult family home must ensure approved automatic smoke alarms are installed and maintained according to manufacturer instructions;

(2) At a minimum, smoke alarms must be located in the following areas:

(a) Every resident bedroom;

(b) In the immediate vicinity of resident bedroom(s), and if applicable, the sleeping areas used by the adult family home staff; and

(3) The home must ensure the smoke alarms in all parts of the home are active and interconnected in such a manner that the activation of one alarm will activate them all. Physical interconnection of smoke alarms shall not be required where listed wireless alarms are installed and all alarms sound upon activation of one alarm.

(4) Each smoke alarm must be kept in working condition at all times.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10805, filed 5/17/21, effective 8/1/21. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10805, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10810 Fire extinguishers.

(1) The adult family home must have an approved five pound 2A:10B-C rated fire extinguisher on each floor of the home.

(2) The home must ensure fire extinguishers are:

(a) Mounted or securely fastened in a stationary position at a minimum of four inches from the floor and a maximum of sixty inches from the floor;

(b) Inspected and serviced annually;

(d) Accessible at all times; and

(e) Not located behind a locked door.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10810, filed 5/17/21, effective 8/1/21. Statutory Authority: RCW 70.128.040. WSR 08-09-028, § 388-76-10810, filed 4/8/08, effective 5/9/08. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10810, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10815 Notice required—Compliance with building code and fire protection.

Before a resident is admitted, the adult family home must disclose in writing in a language understood by the prospective resident the following:

(1) Whether or not resident bedrooms comply with the current building code including evacuation standards; and

(2) If the home is located outside a public fire district, the source and plan for on-site fire protection.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10815, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10825 Space heaters, fireplaces, and stoves.

(1) The adult family home must not use oil, gas, kerosene, or electric space heaters that have not been certified by an organization listed as a nationally recognized testing laboratory.

(2) The adult family home must ensure that stoves and heaters do not block resident, staff, or household member escape routes.

(3) The adult family home must ensure that fireplaces, stoves, or heaters that get hot to the touch when in use have a stable, flame-resistant barrier that does not get hot to the touch and that prevents any contact by residents or any flammable materials.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10825, filed 5/17/21, effective 8/1/21. Statutory Authority: Chapter 70.128 RCW. WSR 16-20-095, § 388-76-10825, filed 10/4/16, effective 11/4/16. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10825, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10830 Emergency and disaster plan—Required.

The adult family home must have a written emergency and disaster plan to meet the needs of each resident during emergencies and disasters. The plan must include:

(1) Responding to natural and man-made emergencies and disasters that may reasonably occur at the home;

(2) Actions to be taken by staff and residents during and after an emergency or disaster; and

(3) The fire drill plan for evacuation of the home.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10830, filed 5/17/21, effective 8/1/21. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10830, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10840 Emergency food supply.

(1) The adult family home must have an on-site emergency food supply that:

(a) Will last for a minimum of seventy-two hours for each resident and each household member;

(b) Meets the dietary needs of each resident, including any specific dietary restrictions they may have;

(d) Is sufficient, safe, sanitary, and uncontaminated.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10840, filed 5/17/21, effective 8/1/21. Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10840, filed 1/15/10, effective 2/15/10
WSR 09-03-029, § 388-76-10840, filed 1/12/09, effective 2/12/09. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10840, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10845 Emergency drinking water supply.

The adult family home must have an on-site emergency supply of drinking water that:

(1) Will last for a minimum of seventy-two hours for the home's licensed capacity, every household member, and caregiving staff;

(2) Is at least three gallons for the home's licensed capacity, every household member, and caregiving staff;

(3) Is stored in well-sealed food grade or glass containers;

(4) Is chlorinated or commercially bottled;

(5) Is replaced every six months, unless it is sealed and commercially bottled; and

(6) Is stored in a cool, dry location away from direct sunlight.

History

Statutory Authority: Chapter 70.128 RCW. WSR 16-20-095, § 388-76-10845, filed 10/4/16, effective 11/4/16. Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10845, filed 1/15/10, effective 2/15/10
WSR 09-03-029, § 388-76-10845, filed 1/12/09, effective 2/12/09. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10845, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10850 Emergency medical supplies.

The adult family home must:

(1) Have emergency medical supplies on-hand for the application of basic first aid during an emergency or disaster in a sufficient amount for the number of residents living in the home;

(2) Replenish the emergency medical supplies as they are used; and

(3) Have a first aid manual.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10850, filed 5/17/21, effective 8/1/21. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10850, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10855 Emergency and disaster plan training—Required.

The adult family home must ensure all staff are trained on the emergency and disaster plan and procedures when they begin work in the home and all staff and residents review the emergency and disaster plan and procedures at least annually.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10855, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10860 Fire drill plan and procedures for emergency evacuation—Required.

The adult family home must:

(1) Have an emergency evacuation plan, including a fire drill plan and procedures for evacuating all residents from the adult family home; and

(2) Not admit or keep residents who cannot safely be evacuated.

History

Statutory Authority: RCW 70.128.040. WSR 10-04-008, § 388-76-10860, filed 1/22/10, effective 2/22/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10860, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10865 Resident evacuation from adult family home.

(1) The adult family home must be able to evacuate all residents from the home to a safe location outside the home in five minutes or less.

(2) The home must ensure that residents are able to evacuate the home as follows:

(a) Through a door designated as an emergency exit;

(b) Via a path from the resident's bedroom that does not go through other bedrooms; and

(i) Elevators;

(ii) Chairlifts; or

(iii) Platform lifts.

(3) Residents who require assistance with evacuation must have a path via an emergency exit to the designated safe location that does not require the use of stairs.

(4) Ramps for residents to enter, exit, or evacuate on homes licensed after November 1, 2016 must:

(a) Comply with chapter 51-51 WAC;

(b) Have a slope measuring no greater than eight and three-tenths percent in the direction of travel; and

(c) Have required landings at the top, bottom, and at any change of direction, with a slope measuring no greater than two percent in the direction of travel.

(5) Homes that serve residents who are not able to hear the fire alarm warning must install visual fire alarms.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10865, filed 5/17/21, effective 8/1/21. Statutory Authority: Chapter 70.128 RCW. WSR 16-20-095, § 388-76-10865, filed 10/4/16, effective 11/4/16. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10865, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10870 Resident evacuation capability levels—Identification required.

The adult family home must ensure that each resident's assessment, preliminary service plan, and negotiated care plan identifies and describes the resident's ability to evacuate the home according to the following descriptions:

(1) Independent: Resident is physically and mentally capable of independently evacuating the home without the assistance of another individual or the use of mobility aids. The department will consider a resident independent if capable of getting out of the home after one cue.

(2) Assistance required: Resident is not physically or mentally capable of evacuating the home without assistance from another individual, mobility aids, or multiple cues.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10870, filed 5/17/21, effective 8/1/21. Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10870, filed 1/15/10, effective 2/15/10
WSR 09-03-029, § 388-76-10870, filed 1/12/09, effective 2/12/09. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10870, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10885 Elements of emergency evacuation floor plan.

The adult family home must develop an emergency evacuation floor plan for each level of the home that:

(1) Is accurate and includes all rooms, hallways, and exits (such as doorways and windows) to the outside of the home;

(2) Illustrates the emergency evacuation route(s) to exit the home, with the route to the emergency exit door being easily identifiable; and

(3) Identifies the designated safe location for the residents to meet outside the home.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10885, filed 5/17/21, effective 8/1/21. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10885, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10890 Posting the emergency evacuation floor plan—Required.

The adult family home must display an emergency evacuation floor plan on each floor of the home and the plan must:

(1) Be posted in a visible location commonly used by residents, staff, and visitors alike; and

(2) Illustrate the evacuation route from the rooms on that floor to the designated safe location outside the home.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10890, filed 5/17/21, effective 8/1/21. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10890, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10895 Emergency evacuation drills—Frequency and participation.

WAC 388-76-10895

(1) There are two types of emergency evacuation drills:

(a) A full evacuation is evacuation from the home to the designated safe location; and

(b) A partial evacuation is evacuation to the designated emergency exit.

(2) The adult family home must conduct:

(a) Partial emergency evacuation drills which occur during random staffing shifts at least every two months, with each resident participating in at least one each calendar year;

(b) A full emergency evacuation drill at least once each calendar year, with all residents participating in the drill together and at the same time; and

(3) The home must respect the resident's right to refuse to participate in emergency evacuation drills. However, the home must still demonstrate the ability to safely evacuate all residents doing the following:

(a) Documenting the resident's wish to refuse to participate in the negotiated care plan;

(b) Providing an estimate of the amount of time it would take to evacuate the resident and how they calculated this estimate in the negotiated care plan;

(c) Adding the estimated time to the time recorded on the emergency evacuation drill log after each drill to ensure the length of time to evacuate does not exceed five minutes; and

(d) Continuing to offer the resident a chance to participate in every evacuation drill.

History

Statutory Authority: RCW 70.128.040, 70.128.065, and 45 C.F.R. § 1324.11 (e)(2). WSR 26-17-004, s 388-76-10895, filed 8/5/26, effective 9/20/26. Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10895, filed 5/17/21, effective 8/1/21. Statutory Authority: Chapter 70.128 RCW. WSR 16-20-095, § 388-76-10895, filed 10/4/16, effective 11/4/16. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10895, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10900 Documentation of emergency evacuation drills—Required.

The adult family home must document the following for all emergency evacuation drills:

(1) Names of each resident and staff involved in the drill;

(2) Name of the person conducting the drill;

(3) Date and time of the drill;

(4) Whether the drill was a full or partial emergency evacuation; and

(5) The length of time it took to complete the evacuation.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10900, filed 5/17/21, effective 8/1/21. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10900, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10905 Emergency evacuation—Notification of department required.

The adult family home must notify the department's complaint resolution unit as soon as possible after resident safety is secure when:

(1) The home is on emergent stand-by for evacuation;

(2) There is any fire; or

(3) Residents were evacuated from the home.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 21-11-074, § 388-76-10905, filed 5/17/21, effective 8/1/21. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10905, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10910 Inspections—Complaint investigations—Monitoring visits—General.

The department must conduct unannounced inspections, complaint investigations and monitoring visits to determine if the adult family home is in compliance with chapters 70.128, 70.129 and 74.34 RCW, this chapter and other applicable laws and regulations.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10910, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10911 Inspections—Multiple adult family home providers.

(1) In the event of serious noncompliance leading to the imposition of one or more actions listed in RCW 70.128.160(2) on a home operated by a provider with multiple adult family homes, all other homes operated by the provider must be inspected to determine if the same or related deficiencies are present in those homes.

(2) The department may issue fines under RCW 70.128.065(5) of up to three hundred dollars for each inspection when one or more actions listed in RCW 70.128.160(2) is imposed on a multiple home provider and inspections of the other homes are required to determine whether the same or related deficiencies are present in those homes.

History

Statutory Authority: Chapter 70.128 RCW. WSR 12-01-004, § 388-76-10911, filed 12/7/11, effective 1/7/12.

Wash. Admin. Code § 388-76-10912 Inspection timelines.

(1) In response to the COVID-19 pandemic, the governor suspended the requirement for the department to conduct full licensing inspections of adult family homes required by RCW 70.128.070 (2)(b).

(2) During the suspension of the full licensing inspection requirements, the department continued to conduct complaint investigations in adult family homes when it became aware of information that indicated an immediate threat to resident health and safety may exist.

(3) The department must prioritize and resume full licensing inspections of adult family homes affected by the suspension of the inspection requirements by applying the following criteria collectively:

(a) The department has identified an ongoing threat to the health and safety of residents through one or more reported complaints, previous inspections, or previous investigations;

(b) Whether the adult family home has had a remedy imposed in the last 24 months; and

(4) The department must conduct a full licensing inspection for adult family homes licensed after the reinstatement of RCW 70.128.070 (2)(b) in accordance with the schedule set by that section.

History

Statutory Authority: RCW 18.20.090, 70.97.100, 70.97.230, 70.128.040, and 74.42.620. WSR 22-17-051, § 388-76-10912, filed 8/11/22, effective 9/11/22.

Wash. Admin. Code § 388-76-10915 Department staff access—Willful interference prohibited.

The adult family home must ensure:

(1) Department staff have access to:

(a) The home, residents, including former residents;

(b) Resident records, includes former residents records;

(d) Financial records of the business if good cause to believe that a financial obligation related to resident care or services will not be met.

(2) The home and staff do not willfully interfere or fail to cooperate with department staff in the performance of official duties.

History

Statutory Authority: Chapter 70.128 RCW. WSR 12-01-004, § 388-76-10915, filed 12/7/11, effective 1/7/12. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10915, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10920 Inspection and investigation reports—Provided by department.

The department will mail or hand deliver the department's report to the adult family home:

(1) Within ten working days of completion of the inspection process; or

(2) Within ten calendar days of completion of the inspection if the home does not have a deficiency.

History

Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10920, filed 1/15/10, effective 2/15/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10920, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10925 Disclosure of inspection and complaint investigation reports.

(1) The department will make copies available to the public, subject to applicable public disclosure and confidentiality requirements, of:

(a) Inspection and complaint investigation reports as soon as they are completed; and

(b) Any final written decision by the department to take an enforcement action.

(2) Upon request, the department will provide the public with copies of the home's plan of correction if a copy is available at the time of the request.

History

Statutory Authority: Chapter 70.128 RCW. WSR 15-03-037, § 388-76-10925, filed 1/12/15, effective 2/12/15. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10925, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10930 Plan of correction (POC)—When required.

WAC 388-76-10930

(1) When the department finds the adult family home out of compliance with any licensing law or regulation, the department will send the home an inspection report for each cited deficiency.

(2) The adult family home must complete an attestation of correction for each cited deficiency as the department requires.

(3) For the purposes of this section an "attestation of correction statement" means a statement signed and dated by the home, that the home:

(a) Has or will correct each cited deficiency; and

(b) Will maintain correction of each cited deficiency.

(4) The home must be able to show to the department, upon request, that, for each deficiency cited, the home has:

(a) A plan of correction and maintaining correction;

(b) Corrected or is correcting each deficiency; and

(5) On each attestation of correction statement, the home must:

(a) Give a date, approved by the department, showing when the cited deficiency has been or will be corrected; and

(b) By signature and date show that the home has or will correct, and maintain correction, of each deficiency.

(6) The home must return the inspection report, with completed attestation of correction statements, to the department within 10 calendar days of receiving the report.

(7) This section does not apply where the department takes action to summarily suspend or revoke the adult family home license under its authority in RCW 70.128.100 or 70.128.160.

History

Statutory Authority: RCW 70.128.040, 70.128.065, and 45 C.F.R. § 1324.11 (e)(2). WSR 26-17-004, s 388-76-10930, filed 8/5/26, effective 9/20/26. Statutory Authority: RCW 70.128.040. WSR 09-03-029, § 388-76-10930, filed 1/12/09, effective 2/12/09. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10930, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10935 Washington protection and advocacy—Long-term care ombudsman—Official duties—Penalty for interference.

The adult family home must not willfully interfere with a representative of the following in the performance of official duties:

(1) Washington protection and advocacy system as defined under RCW 71A.10.080; or

(2) Long-term care ombuds as defined under chapter 43.190 RCW, the state regulations for the long-term care ombudsman and under federal law.

(3) The department must impose a civil penalty as per WAC 388-76-10975 for any such willful interference with a representative of the long-term care ombuds program.

History

Statutory Authority: Chapter 70.128 RCW. WSR 15-03-037, § 388-76-10935, filed 1/12/15, effective 2/12/15. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10935, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10940 Remedies—Generally.

The department may take one or more of the following actions in any case which the department finds that an adult family home failed or refused to comply with the applicable requirements of chapters 70.128, 70.129, or 74.34 RCW or this chapter:

(1) Denial of an application for a license;

(2) Impose reasonable conditions on a license;

(3) Impose civil penalties;

(4) Order stop placement; and/or

(5) Suspension or revocation of a license.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10940, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10945 Remedies—Imposition of remedies.

The department must impose a remedy or remedies listed in WAC 388-76-10940 when violations of chapter 70.128, 70.129 and 74.34 RCW and this chapter are:

(1) Repeated;

(2) Uncorrected;

(3) Pervasive; or

(4) Present a threat to the health, safety, or welfare of one or more residents.

History

Statutory Authority: Chapter 70.128 RCW. WSR 12-01-004, § 388-76-10945, filed 12/7/11, effective 1/7/12. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10945, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10950 Remedies—History and actions by individuals.

The department will consider the history and actions of the following individual or combination of individuals when imposing remedies:

(1) Applicant;

(2) Provider;

(3) Entity representative;

(4) Person affiliated with the applicant;

(5) Resident manager;

(6) A partner, officer, director or managerial employee of the entity;

(7) Spouse of the provider or entity representative;

(8) An owner:

(a) Of fifty-one percent or more of the entity; or

(b) Who exercises control over the daily operations of the home;

(9) A caregiver;

(10) Any person who:

(a) Has unsupervised access to residents in the home; or

(b) Lives in the home but who is not a resident; or

(11) Any affiliated entities.

History

Statutory Authority: RCW 70.128.040 and 70.128.060. WSR 20-05-016, § 388-76-10950, filed 2/6/20, effective 3/8/20. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10950, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10955 Remedies—Department must impose remedies.

(1) The department must impose a remedy or remedies if the department substantiates a complaint involving harm to a resident and violation of an applicable law or rule.

(2) The department must impose a remedy or remedies if the department substantiates, after licensure, that it has been less than twenty years since the adult family home voluntarily surrendered or relinquished an adult family home license in lieu of department initiated denial, suspension, nonrenewal, or revocation of a license.

(3) The department must impose a remedy or remedies if the department finds any person listed in WAC 388-76-10950:

(a) A court has issued a permanent restraining order or order of protection either active or expired, against the individual that was based upon abuse, neglect, financial exploitation, or mistreatment of a child or vulnerable adult;

(b) The individual is a registered sex offender;

(c) The individual is on a registry based upon a final finding of abuse, neglect or, financial exploitation of a vulnerable adult, unless the finding was made by adult protective services prior to October 2003;

(d) A founded finding of abuse or neglect of a child was made against the individual, unless the finding was made by child protective services prior to October 1, 1998;

(e) The individual has had a contract or license denied, terminated, revoked, or suspended due to abuse, neglect, financial exploitation, or mistreatment of a child or vulnerable adult; or

(f) The individual has relinquished a license or terminated a contract because an agency was taking an action against the individual related to alleged abuse, neglect, financial exploitation or mistreatment of a child or vulnerable adult.

History

Statutory Authority: RCW 74.39A.056 and chapters 74.34, 18.20 RCW. WSR 14-14-028, § 388-76-10955, filed 6/24/14, effective 7/25/14. Statutory Authority: RCW 70.128.040. WSR 12-16-087, § 388-76-10955, filed 7/31/12, effective 8/31/12
WSR 10-03-064, § 388-76-10955, filed 1/15/10, effective 2/15/10
WSR 09-03-028, § 388-76-10955, filed 1/12/09, effective 2/12/09. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10955, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10960 Remedies—Department may impose remedies.

The department may impose a remedy or remedies if the department finds any person listed in WAC 388-76-10950:

(1) Has been convicted of:

(a) Any felony that the department determines is reasonably related to the competency of the person to be involved in the ownership or operation of an adult family home; or

(b) A crime involving a firearm used in the commission of a felony or in any act of violence against a person.

(2) Has engaged in the illegal use, sale or distribution of drugs or excessive use of alcohol or drugs without the evidence of rehabilitation;

(3) Has committed an act of domestic violence toward a family or household member;

(5) Has had a license for the care of children or vulnerable adults denied, suspended, revoked, or not renewed;

(6) Has a history of violations of chapter 70.128 RCW, or any law regulating residential care facilities, that resulted in revocation, suspension, or nonrenewal of a license with the department;

(7) Has been enjoined from operating a facility for the care and services of children or adults;

(10) Has obtained or attempted to obtain a license by fraudulent means or misrepresentation;

(11) Knowingly, or with reason to know, made a false statement of material fact on his or her application for a license or any data attached to the application, or in any matter involving the department;

(12) Permitted, aided, or abetted the commission of any illegal act on the adult family home premises;

(13) Willfully prevented, interfered with, or failed to cooperate with any inspection, investigation, or monitoring visit made by the department, including refusal to permit authorized department representatives to interview residents or have access to their records;

(14) Failed or refused to comply with:

(a) A condition or limit imposed on a license or a stop placement order; or

(b) The requirements of chapters 70.128, 70.129, 74.34 RCW, this chapter or any other applicable laws.

(15) Misappropriated property of a resident, unless such action requires a remedy under WAC 388-76-10955;

(16) Exceeded licensed capacity in the operation of an adult family home;

(17) Operated a facility for the care of children or adults without a license or with a revoked license;

(18) In connection with the operation of any facility for the care of children or adults, relinquished or returned a license, or did not seek license renewal following written notification that the licensing agency intends to deny, suspend, cancel or revoke the license, unless such action requires imposition of a remedy under WAC 388-76-10955;

(19) When providing care to children or vulnerable adults, has had resident trust funds or assets seized by the Internal Revenue Service or a state entity for failure to pay income or payroll taxes;

(20) Failed to meet financial obligations as the obligations fell due in the normal course of owning or operating a business involved in the provision of care and services to children or vulnerable adults;

(21) Has failed to meet personal financial obligations and that failure has resulted in a failure to provide necessary care and services to the residents;

(22) Interfered with a long-term care ombuds or department staff in the performance of his or her duties; or

(23) Failed to relinquish or surrender the license as required.

History

Statutory Authority: Chapter 70.128 RCW. WSR 15-03-037, § 388-76-10960, filed 1/12/15, effective 2/12/15
WSR 12-01-004, § 388-76-10960, filed 12/7/11, effective 1/7/12. Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10960, filed 1/15/10, effective 2/15/10
WSR 09-03-028, § 388-76-10960, filed 1/12/09, effective 2/12/09. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10960, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10965 Remedies—Specific—Denial of application for license.

The department decision to deny an application for a license is specified in:

(1) WAC 388-76-10115;

(2) WAC 388-76-10120;

(3) WAC 388-76-10125; and

(4) WAC 388-76-10940.

History

Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10965, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10970 Remedies—Specific—Condition(s) on license.

(1) The department may impose reasonable conditions or limits on a new or current license.

(2) Conditions or limits the department may impose on a license include, but are not limited to, the following:

(a) Correction of deficiencies within a specified time;

(b) Training related to the deficiencies;

(d) Discharge of any resident when the department finds discharge is needed to meet that resident's needs or for the protection of other residents;

(e) Change in license capacity;

(f) Removal of the adult family home's designation as a specialized home;

(g) Prohibition of access to residents by a specified person; and

(h) Demonstration of ability to meet financial obligations necessary to continue operation.

History

Statutory Authority: RCW 70.128.040. WSR 10-04-008, § 388-76-10970, filed 1/22/10, effective 2/22/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10970, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10975 Remedies—Specific—Civil penalties.

(1) The department may impose civil penalties of at least one hundred dollars per day per violation:

(a) Fines up to one thousand dollars can be issued under RCW 70.128.150 for willful interference with a representative of the long-term care ombuds; and

(b) Fines up to three thousand dollars can be issued under RCW 74.39A.060 for retaliation against a resident, employee, or any other person making a complaint, providing information to, or cooperating with, the ombuds, the department, the attorney's general office, or a law enforcement agency; and

(c) Fines up to ten thousand dollars may be issued under RCW 70.128.065(2) for a current or former licensed provider who is operating an unlicensed home.

(2) When the adult family home fails to pay a fine under this chapter when due, the department may, in addition to other remedies, withhold an amount equal to the fine plus interest, if any, from any contract payment due to the provider from the department.

(3) Civil monetary penalties are due twenty-eight days after the adult family home or the owner or operator of an unlicensed adult family home is served with notice of the penalty unless the adult family home requests a hearing in compliance with chapter 34.05 RCW, RCW 43.20A.215, and this chapter. If the hearing is requested, the penalty becomes due ten days after a final decision in the department's favor is issued. Thirty days after the department serves the adult family home with notice of the penalty, interest begins to accrue at a rate of one percent per month as authorized by RCW 43.20B.695.

History

Statutory Authority: Chapter 70.128 RCW. WSR 15-03-037, § 388-76-10975, filed 1/12/15, effective 2/12/15
WSR 12-01-004, § 388-76-10975, filed 12/7/11, effective 1/7/12. Statutory Authority: RCW 70.128.040. WSR 10-04-008, § 388-76-10975, filed 1/22/10, effective 2/22/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10975, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10976 Remedies—Civil fine grid.

The department will consider the guidance in the tiered sanction grid below when imposing civil fine remedies:

| no harm | minimal or moderate harm | serious harm | imminent danger and/or immediate threat | | | | --- | --- | --- | --- | --- | --- | | Repeat / Uncorrected | Initial | Repeat / Uncorrected | Initial | Repeat / Uncorrected | Any Violation | | Civil fine of at least $100 per violation | Civil fine up to $500 per violation or a daily civil fine of at least $250 per day | Civil fine up to $1,000 per violation or a daily civil fine of at least $500 per day | Civil fine up to $2,000 per violation or a daily civil fine of at least $1,000 per day | Civil fine up to $3,000 per violation or a daily civil fine of at least $1,500 per day | Civil fine of $3,000 or daily civil fine of at least $1,000 per day |

History

Statutory Authority: Chapter 70.128 RCW. WSR 12-01-004, § 388-76-10976, filed 12/7/11, effective 1/7/12.

Wash. Admin. Code § 388-76-10980 Remedies—Specific—Stop placement—Admissions prohibited.

(1) The department may order stop placement and prohibit the admission of residents if the home does not meet the requirements of chapters 70.128, 70.129, 74.34 RCW or this chapter.

(2) Once imposed, the adult family home must:

(a) Publicly post the stop placement order or limited stop placement order in a location visible to residents, visitors, and staff within the adult family home, per requirements listed in RCW 70.128.306;

(b) Leave the notice in place until the department has terminated the stop placement order or limited stop placement order; and

(3) If the home requests, the department may approve readmission of a resident to the home from a hospital or nursing home during the stop placement.

(4) The department must end the stop placement only after the department finds the:

(a) Deficiencies necessitating the stop placement have been corrected; and

(b) Home can show it has the capacity to maintain adequate care and service.

History

Statutory Authority: RCW 18.20.090, 18.51.070, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 26-05-046, s 388-76-10980, filed 2/12/26, effective 3/15/26. Statutory Authority: RCW 18.20.090, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 25-16-099, s 388-76-10980, filed 8/6/25, effective 9/6/25. Statutory Authority: Chapter 70.128 RCW. WSR 15-03-037, § 388-76-10980, filed 1/12/15, effective 2/12/15. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10980, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10985 Remedies—May extend to multiple homes.

(1) If a licensed provider also operates an unlicensed adult family home, the department may impose a remedy or remedies listed in WAC 388-76-10940 on the licensed adult family home or homes.

(2) If violations in an adult family home are of such nature as to present a serious risk or harm to residents of other homes operated by the same provider, the department may impose remedies on those other homes.

History

Statutory Authority: RCW 70.128.040. WSR 10-04-008, § 388-76-10985, filed 1/22/10, effective 2/22/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10985, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10990 Informal dispute resolution (IDR).

(1) When an adult family home disagrees with the department's finding of a violation under this chapter, the adult family home has the right to have the violation reviewed by the department under the department's dispute resolution process.

(2) The purpose of the review is to give the adult family home an opportunity to present information that might warrant modification or deletion of a finding of a violation.

(3) The adult family home may submit a written statement for review.

(4) In addition to a written statement, the adult family home may ask to present the information in person to a department designee.

(5) Requests for review must be made in writing to the department at the address provided in the department's certified notice within ten working days of receipt of the written finding of a violation.

(6) Orders of the department imposing license suspension, stop placement, or conditions on a license are effective immediately upon notice and shall continue pending dispute resolution.

History

Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10990, filed 1/15/10, effective 2/15/10. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10990, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-10995 Notice, hearing rights, and effective dates relating to imposition of remedies.

(1) Chapter 34.05 RCW applies to department actions under this chapter and chapter 70.128 RCW, except that orders of the department imposing license suspension, stop placement, or conditions on license are effective immediately upon notice and must continue pending a final administrative decision.

(2) An adult family home contesting the imposition of any remedy by the department must within twenty-eight days of receipt of the decision:

(a) File a written application for an adjudicative proceeding by a method showing proof of receipt to the agency at the mailing address contained in the department's notice imposing the remedy; and

(b) Include in or with the application:

(i) The reasons for contesting the department decision; and

(ii) A copy of the contested department decision.

(3) Administrative proceedings are governed by chapter 34.05 RCW, RCW 43.20A.215, where applicable, this section, and chapter 388-02 WAC. If any provision in this chapter conflicts with chapter 388-02 WAC, the provision in this chapter applies.

History

Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-10995, filed 1/15/10, effective 2/15/10
WSR 09-03-029, § 388-76-10995, filed 1/12/09, effective 2/12/09. Statutory Authority: RCW 70.128.040 and chapters 70.128 and 74.34 RCW. WSR 07-21-080, § 388-76-10995, filed 10/16/07, effective 1/1/08.

Wash. Admin. Code § 388-76-11050 Management agreements—General.

(1) As used in WAC 388-76-11050 through 388-76-11070, the term "manager" means the individual or entity providing management services under a management agreement. It does not mean a resident manager.

(2) The requirements contained in WAC 388-76-11050 through 388-76-11070 apply to management agreements and not the temporary management program described in RCW 70.128.163.

(3) If the adult family home contracts with a manager, the adult family home must have a written management agreement that is consistent with chapter 388-76 WAC requirements.

(4) The adult family home must notify the department of its use of a manager when:

(a) Entering into a management agreement following initial licensure;

(b) Changing managers; or

(5) An applicant must notify the department of its use of a manager when:

(a) Applying for an adult family home license; or

(b) Entering into a management agreement prior to licensure.

(6) The adult family home must submit the written management agreement, including an organizational chart which shows the relationship between the adult family home, manager, and all related entities, including manager staff.

(7) The adult family home must submit a management agreement attestation form signed and dated by the home and the manager to demonstrate that both understand and agree to comply with the requirements of chapter 388-76 WAC.

(8) The written management agreement must be submitted to the department:

(a) With the initial license, change of ownership, or change of location applications; and

(b) 60 days prior to the proposed change of ownership date or the effective date of the management agreement.

(9) The adult family home must submit any amendment to an existing management agreement to the department 30 days before the amendment takes effect.

(10) The adult family home must notify current residents and their representatives 60 days before the effective date of the management agreement.

History

Statutory Authority: RCW 70.128.040 and 70.128.066. WSR 23-12-075, § 388-76-11050, filed 6/6/23, effective 8/1/23. Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-11050, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-76-11055 Management agreements—Adult family home.

(1) The adult family home is responsible for:

(a) The daily operations and provision of care and services to residents;

(b) Compliance with all applicable laws and rules;

(d) Ensuring the manager does not represent itself as, or give the appearance that it is the provider.

(2) The adult family home may not give the manager responsibilities that are so extensive the adult family home is relieved of responsibility for the daily operations and provision of care and services to residents. If the adult family home relinquishes responsibility for daily operation and provision of care and services to residents, the department will determine that a change of ownership has occurred. If the department determines a change of ownership has occurred, then the department may take licensing action.

(3) The adult family home and manager must act in accordance with the terms of the department approved management agreement. If the department determines they are not, then the department may take licensing action.

(4) The adult family home may enter into a management agreement only if the management agreement creates a principal/agent relationship between the adult family home and manager.

History

Statutory Authority: RCW 70.128.040 and 70.128.066. WSR 23-12-075, § 388-76-11055, filed 6/6/23, effective 8/1/23. Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-11055, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-76-11060 Terms of the management agreement.

Management agreements, at a minimum must:

(1) Describe the responsibilities of the adult family home and manager, including items, services, and activities to be provided;

(2) Maintain and retain all records in accordance with this chapter;

(3) Allow the department unlimited access to documentation and records according to applicable laws or regulations;

(4) Require the manager to immediately send copies of inspections and notices of noncompliance to the adult family home;

(5) Require the adult family home's governing body, board of directors or similar authority to appoint the entity representative;

(6) Require the adult family home to participate in monthly oversight meetings and at minimum, quarterly on-site visits to the home;

(7) State that the adult family home is responsible for reviewing, acknowledging and signing all initial, change of ownership, and change of location license applications;

(8) State that the adult family home and manager will review the management agreement annually and notify the department of change according to applicable regulations;

(9) Acknowledge that the adult family home is the party ultimately responsible for complying with all applicable laws and rules;

(10) Require the adult family home to oversee and maintain ultimate responsibility for:

(a) All personnel issues relating to the operation of the home;

(b) The care, services, and safety of all residents; and

(11) State the manager will not represent itself or give the appearance it is the provider;

(12) State that a duly authorized manager may execute resident leases or agreements on behalf of the adult family home, however all such resident leases or agreements must be between the adult family home and the resident or the resident's representative.

History

Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-11060, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-76-11065 Management agreements—Department review.

(1) Upon receipt of a proposed management agreement, the department may require:

(a) The adult family home to provide additional information or clarification;

(b) Changes necessary to:

(i) Bring the management agreement into compliance with this chapter; and

(ii) Ensure that the adult family home has continued to have ultimate responsibility for the daily operations of the home.

History

Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-11065, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-76-11070 Management agreements—Resident funds.

(1) If the management agreement delegates day-to-day management of resident personal funds to the manager, the adult family home must:

(a) Retain all fiduciary and custodial responsibility for funds that have been deposited with the adult family home by the resident;

(b) Remain directly accountable to the residents and resident representatives for such funds; and

(i) Is bonded or obtains insurance in sufficient amounts to specifically cover losses of resident funds;

(ii) Provides proof of bond or insurance; and

(iii) Provides proof of payment of the bond or insurance premium.

(2) If responsibilities for the day-to-day management of the resident funds are delegated to the manager, the manager must:

(a) Give the adult family home a monthly accounting of the residents' funds;

(b) Meet all legal requirements related to holding, and accounting for, resident funds; and

History

Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-11070, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-76-11080 Notice—Service complete.

Service of the department notices is complete when:

(1) Personal service is made;

(2) The notice is addressed to the home or the individual at his or her last known address, and deposited in the United States mail;

(3) The notice is faxed and the department receives evidence of transmission;

(4) Notice is delivered to a commercial delivery service with charges prepaid; or

(5) Notice is delivered to a legal messenger service with charges prepaid.

History

Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-11080, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-76-11085 Notice—Proof of service.

The department may establish proof of service by any of the following:

(1) A declaration of personal service;

(2) An affidavit or certificate of mailing to the adult family home or to the individual to whom the notice is directed;

(3) A signed receipt from the person who accepted the certified mail, the commercial delivery service, or the legal messenger service package; or

(4) Proof of fax transmission.

History

Statutory Authority: RCW 70.128.040. WSR 10-03-064, § 388-76-11085, filed 1/15/10, effective 2/15/10.

Chapter 388-78A Assisted living facility licensing rules.

Wash. Admin. Code § 388-78A-2010 Purpose.

This chapter is written to implement chapter 18.20 RCW, to promote the safety and well-being of assisted living facility residents, to specify standards for assisted living facility operators, and to further establish requirements for the operation of assisted living facilities.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2010, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2010, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2020 Definitions.

WAC 388-78A-2020

"Abuse" means intentional, willful, or reckless action or inaction that inflicts injury, unreasonable confinement, intimidation, or punishment on a vulnerable adult. In instances of abuse of a vulnerable adult who is unable to express or demonstrate physical harm, pain, or mental anguish, the abuse is presumed to cause physical harm, pain, or mental anguish. Abuse includes sexual abuse, mental abuse, physical abuse, and personal exploitation of a vulnerable adult, and improper use of restraint against a vulnerable adult, which have the following meanings:

(1) "Sexual abuse" means any form of nonconsensual sexual conduct, including, but not limited to, unwanted or inappropriate touching, rape, molestation, indecent liberties, sexual coercion, sexually explicit photographing or recording, voyeurism, indecent exposure, and sexual harassment. Sexual abuse also includes any sexual conduct between a staff person, who is not also a resident or a client, of a facility or a staff person of a program authorized under chapter 71A.12 RCW, and a vulnerable adult living in that facility or receiving service from a program authorized under chapter 71A.12 RCW, whether or not it is consensual.

(2) "Physical abuse" means the intentional, willful, or reckless action of inflicting bodily injury or physical mistreatment. Physical abuse includes, but is not limited to, striking with or without an object, slapping, pinching, choking, kicking, shoving, or prodding.

(3) "Mental abuse" means an intentional, willful, or reckless verbal or nonverbal action that threatens, humiliates, harasses, coerces, intimidates, isolates, unreasonably confines, or punishes a vulnerable adult. Mental abuse may include ridiculing, yelling, or swearing.

(4) "Personal exploitation" means an act of forcing, compelling, or exerting undue influence over a vulnerable adult causing the vulnerable adult to act in a way that is inconsistent with relevant past behavior, or causing the vulnerable adult to perform services for the benefit of another.

(5) "Improper use of restraint" means the inappropriate use of chemical, physical, or mechanical restraints for convenience or discipline or in a manner that:

(a) Is inconsistent with federal or state licensing or certification requirements for facilities, hospitals, or programs authorized under chapter 71A.12 RCW;

(b) Is not medically authorized; or

"Activities of daily living" means the following tasks related to basic personal care: Bathing; toileting; dressing; personal hygiene; mobility; transferring; and eating.

"Administrator" means an assisted living facility administrator who must be in active administrative charge of the assisted living facility as required in this chapter. Unless exempt under RCW 18.88B.041, the administrator must complete long-term care training and home care aide certification.

"Adult day services" means care and services provided to a nonresident individual by the assisted living facility on the assisted living facility premises, for a period of time not to exceed 10 continuous hours, and does not involve an overnight stay.

"Ambulatory" means capable of walking or traversing a normal path to safety without the physical assistance of another individual:

(1) "Nonambulatory" means unable to walk or traverse a normal path to safety without the physical assistance of another individual;

(2) "Semiambulatory" means physically and mentally capable of traversing a normal path to safety with the use of mobility aids, but unable to ascend or descend stairs without the physical assistance of another individual.

"Applicant" means a person, as defined in this section, that has submitted, or is in the process of submitting, an application for an assisted living facility license.

"Assisted living facility" means any home or other institution, however named, that is advertised, announced, or maintained for the express or implied purpose of providing housing, basic services, and assuming general responsibility for the safety and well-being of the residents, and may also provide domiciliary care, consistent with this chapter to seven or more residents after July 1, 2000. However, an assisted living facility that is licensed for three to six residents prior to or on July 1, 2000, may maintain its assisted living facility license as long as it is continually licensed as an assisted living facility. "Assisted living facility" may also include persons associated with the assisted living facility to carry out its duties under this chapter. "Assisted living facility" does not include facilities certified as group training homes under RCW 71A.22.040, nor any home, institution, or section that is otherwise licensed and regulated under state law that provides specifically for the licensing and regulation of that home, institution, or section. "Assisted living facility" also does not include independent senior housing, independent living units in continuing care retirement communities, or other similar living situations including those subsidized by the U.S. Department of Housing and Urban Development.

"Basic services" means housekeeping services, meals, nutritious snacks, laundry, and activities.

"Bathing fixture" means a bathtub, shower, or sit-down shower.

"Bathroom" means a room containing at least one bathing fixture.

"Building code" means the building codes and standards adopted by the Washington state building code council.

"Caregiver" means anyone providing direct personal care to another person including, but not limited to, cuing, reminding, or supervision of residents, on behalf of an assisted living facility, except volunteers who are directly supervised.

"Construction review services" means the office of construction review services within the Washington state department of health.

"Continuing care contract" means, as stated in RCW 70.38.025, a contract providing a person, for the duration of that person's life or for a term in excess of one year, shelter along with nursing, medical, health-related, or personal care services, which is conditioned upon the transfer of property, the payment of an entrance fee to the provider of such services, or the payment of periodic charges for the care and services involved. A continuing care contract is not excluded from this definition because the contract is mutually terminable or because shelter and services are not provided at the same location.

"Continuing care retirement community" means, as stated in RCW 70.38.025, an entity which provides shelter and services under continuing care contracts with its members and which sponsors or includes a health care facility or a health service.

"Contractor" means an agency or person who contracts with a licensee to provide resident care, services, or equipment.

"Crimes relating to financial exploitation" means the same as "crimes relating to financial exploitation" as defined in RCW 43.43.830 or 43.43.842.

"Dementia" means the irreversible loss of cognitive or intellectual function such as thinking, remembering, and reasoning so severe that it interferes with an individual's daily functioning and everyday life. "Dementia" is not a specific diagnosis, but rather a group of symptoms that accompany certain diseases or conditions including, but not limited to: Alzheimer's disease, vascular dementia, frontotemporal dementia, Lewy body dementia, alcohol-related dementia, and major neurocognitive disorder. "Dementia" does not include temporary or reversible destabilization due to delirium or behavioral or mental health disorders.

"Department" means the Washington state department of social and health services.

"Dietitian" means an individual certified under chapter 18.138 RCW.

"Direct supervision" means oversight by a person on behalf of the assisted living facility who has met training requirements, demonstrated competency in core areas, or has been fully exempted from the training requirements, is on the premises, and is quickly and easily available to the caregiver.

"Document" means to record, with signature, title, date, and time:

(1) Information about medication administration, medication assistance or disposal, a nursing care procedure, accident, occurrence, or change in resident condition that may affect the care or needs of a resident; and

(2) Processes, events, or activities that are required by law, rule, or policy.

"Domiciliary care" means:

(1) Assistance with activities of daily living provided by the assisted living facility either directly or indirectly;

(2) Health support services, if provided directly or indirectly by the assisted living facility; or

(3) Intermittent nursing services, if provided directly or indirectly by the assisted living facility.

"Enforcement remedy" means one or more of the department's responses to an assisted living facility's noncompliance with chapter 18.20 RCW and this chapter, as authorized by RCW 18.20.190.

"Essential Support Person" means an individual who is: at least 18 years of age; designated by the resident, or by the resident's representative, if the resident is determined to be incapacitated or otherwise legally incapacitated; and necessary for the resident's emotional, mental, or physical well-being during situations that include, but are not limited to, circumstances involving compassionate care of end-of-life care, circumstances where visitation from a familiar person will assist with important continuity of care or the reduction of confusion and anxiety for residents with cognitive impairments, or other circumstances where the presence of an essential support person will prevent or reduce significant emotional distress to the resident.

"Food service worker" means according to chapter 246-217 WAC, an individual who works (or intends to work) with or without pay in a food service establishment and handles unwrapped or unpackaged food or who may contribute to the transmission of infectious diseases through the nature of the individual's contact with food products or equipment and facilities. This does not include persons who simply assist residents with meals.

"General responsibility for the safety and well-being of the resident" means the provision of any one or more of the following:

(1) Prescribed general low sodium diets;

(2) Prescribed general diabetic diets;

(3) Prescribed mechanical soft foods;

(4) Emergency assistance;

(5) Monitoring of the resident;

(6) Arranging health care appointments with outside health care providers and reminding residents of such appointments as necessary;

(7) Coordinating health care services with outside health care providers consistent with WAC 388-78A-2350;

(8) Assisting the resident to obtain and maintain glasses, hearing aids, dentures, canes, crutches, walkers, wheelchairs, and assistive communication devices;

(9) Observation of the resident for changes in overall functioning;

(10) Blood pressure checks as scheduled;

(11) Responding appropriately when there are observable or reported changes in the resident's physical, mental, or emotional functioning;

(12) Medication assistance as permitted under RCW 69.41.085 and as described in RCW 69.41.010 and chapter 246-945 WAC.

"Harm" means a physical or mental or emotional injury or damage to a resident including those resulting from neglect or violations of a resident's rights.

"Health support services" means any of the following optional services:

(1) Blood glucose testing;

(2) Puree diets;

(3) Calorie controlled diabetic diets;

(4) Dementia care;

(5) Memory care provided only in an assisted living facility certified as a memory care facility or memory care unit;

(6) Mental health care; and

(7) Developmental disabilities care.

"Independent living unit" means:

(1) Independent senior housing;

(2) Independent living unit in a continuing care retirement community or other similar living environments;

(3) Assisted living facility unit where domiciliary services are not provided; or

(4) Assisted living facility unit where one or more items listed under "general responsibilities" are not provided.

"Independent senior housing" means an independent living unit occupied by an individual or individuals 60 or more years of age.

"Infectious" means capable of causing infection or disease by entrance of organisms into the body, which grow and multiply there, including, but not limited to, bacteria, viruses, protozoans, and fungi.

"Licensee" means a person, as defined in this section, to whom the department issues an assisted living facility license.

"Licensed resident bed capacity" means the resident occupancy level requested by a licensee and approved by the department. All residents receiving domiciliary care or the items or services listed under general responsibility for the safety and well-being of the resident as defined in this section count towards the licensed resident bed capacity. Adult day services clients do not count towards the licensed resident bed capacity.

"Long-term care worker" or "caregiver" means the same as "long-term care workers" is defined in RCW 74.39A.009.

"Majority owner" means any person that owns:

(1) More than 50 percent interest;

(2) If no one person owns more than 50 percent interest, the largest interest portion; or

(3) If more than one person owns equal largest interest portions, then all persons owning those equal largest interest portions.

"Manager" means a person, as defined in this section, that provides management services on behalf of a licensee.

"Management agreement" means a written, executed agreement between a licensee and manager regarding the provision of certain services on behalf of the licensee.

"Mandated reporter:"

(1) Is an employee of the department, law enforcement officer, social worker, professional school personnel, individual provider, employee of a facility, operator of a facility, employee of a social service, welfare, mental health, adult day health, adult day care, home health, home care, or hospice agency, county coroner or medical examiner, Christian Science practitioner, or health care provider subject to chapter 18.130 RCW; and

(2) For the purpose of the definition of mandated reporter, "facility" means a residence licensed or required to be licensed under chapter 18.20 RCW (assisted living facility), chapter 18.51 RCW (nursing homes), chapter 70.128 RCW (adult family homes), chapter 72.36 RCW (soldiers' homes), chapter 71A.20 RCW (residential habilitation centers), or any other facility licensed by the department.

"Maximum facility capacity" means the maximum number of individuals that the assisted living facility may serve at any one time, as determined by the department.

(1) The maximum facility capacity includes all residents, respite care residents, and adult day services clients.

(2) The maximum facility capacity is equal to the lesser of:

(a) The sum of the number of approved bed spaces for all resident rooms (total number of approved bed spaces), except as specified in subsection (3) of this section;

(b) Twice the seating capacity of the dining area(s) consistent with WAC 388-78A-2300;

(c) The number of residents permitted by calculating the ratios of toilets, sinks, and bathing fixtures to residents consistent with WAC 388-78A-3030;

(d) For assisted living facilities licensed on or before December 31, 1988, the total day room area in square feet divided by 10 square feet, consistent with WAC 388-78A-3050; or

(e) For assisted living facilities licensed after December 31, 1988, the total day room area in square feet divided by 20 square feet, consistent with WAC 388-78A-3050.

(3) For the purposes of providing adult day services consistent with WAC 388-78A-2360, one additional adult day services client may be served, beyond the total number of approved bed spaces, for each additional 60 square feet of day room area greater than the area produced by multiplying the total number of approved bed spaces by 20 square feet, provided that:

(a) There is at least one toilet and one hand washing sink accessible to adult day services clients for every eight adult day services clients or fraction thereof;

(b) The total number of residents and adult day services clients does not exceed twice the seating capacity of the dining area(s) consistent with WAC 388-78A-2300; and

(c) The adult day services program area(s) and building do not exceed the occupancy load as determined by the local building official or state fire marshal.

"Medication administration" means the direct application of a prescribed medication whether by injection, inhalation, ingestion, or other means, to the resident's body by an individual legally authorized to do so.

"Medication assistance" means assistance with self-administration of medication rendered by a nonpractitioner to a resident of an assisted living facility in accordance with chapter 246-945 WAC.

"Medication organizer" means a container with separate compartments for storing oral medications organized in daily doses.

"Medication service" means any service provided either directly or indirectly by an assisted living facility related to medication administration, medication administration provided through nurse delegation, medication assistance, or resident self-administration of medication.

"Memory care facility" or "memory care unit" means any assisted living facility which markets, or otherwise represents itself as providing memory care or specialized dementia care services, whether as a facility dedicated solely to serving residents with dementia or within a dedicated unit or wing within a larger facility. An assisted living facility does not need to specifically use the terms "memory care facility," "specialized dementia care," or similar terms in its name to be considered a memory care facility. If any part of an assisted living facility has restricted egress that prevents residents with cognitive impairment from leaving the facility without accompaniment by staff or another individual, it is sufficient to be considered as a memory care facility or memory care unit requiring certification.

"Memory care services" and "specialized dementia care services" means services offered and provided in addition to the domiciliary care services provided by the assisted living facility that are responsive to the typical needs of an individual with dementia.

"Neglect" means:

"Nonresident individual" means an individual who resides in independent senior housing, independent living units in continuing care retirement communities, other similar living environment, or an unlicensed room located within an assisted living facility. A nonresident individual must not receive from the assisted living facility:

(1) Domiciliary care directly or indirectly; or

(2) Items or services listed in the definition of "general responsibility for the safety and well-being of the resident," except as allowed under WAC 388-78A-2032 or when the person is receiving adult day services.

"Nonpractitioner" means any individual who is not a practitioner as defined in WAC 388-78A-2020 and chapter 69.41 RCW.

"Nurse" means an individual currently licensed under chapter 18.79 RCW as either a:

(1) Licensed practical nurse (LPN); or

(2) Registered nurse (RN).

"Over-the-counter (OTC) medication" means any medication that may be legally purchased without a prescriptive order, including, but not limited to, aspirin, antacids, vitamins, minerals, or herbal preparations.

"Person" means any individual, firm, partnership, corporation, company, association, joint stock association, or any other legal or commercial entity.

"Physician" means an individual licensed under chapter 18.57 or 18.71 RCW.

"Practitioner" means a licensed physician, osteopathic physician, podiatric physician, pharmacist, licensed practical nurse, registered nurse, advanced registered nurse practitioner, dentist, and physician assistant. Refer to chapter 69.41 RCW for a complete listing of practitioners.

"Prescribed medication" means any medication (legend drug, controlled substance, and over-the-counter) that is prescribed by an authorized practitioner.

"Prescriber" means a health care practitioner authorized by Washington state law to prescribe drugs.

"Problem" means a violation of any WAC or RCW applicable to the operation of an assisted living facility:

(1) "Recurring problem" means, for all purposes other than those described in RCW 18.20.400, that the department has cited the assisted living facility for a violation of WAC or RCW and the circumstances of either (a) or (b) of this subsection are present. If the previous violation in (a) or (b) of this subsection was pursuant to WAC or RCW that has changed at the time of the new violation, citation to the equivalent current WAC or RCW section is sufficient. When there is a change in licensees between the first and the second or third citations, the new licensee must accept, and the department will consider, the prior licensee's compliance and enforcement record as part of the new licensee's compliance record at that assisted living facility if any person affiliated with the new licensee was affiliated with the prior licensee at the same assisted living facility. A person is considered affiliated with the licensee if the person is an applicant for the assisted living facility license, or is listed on the license application as a partner, officer, director, or majority owner of the applicant.

(a) The department previously imposed an enforcement remedy for a violation of the same section of WAC or RCW for substantially the same problem following any type of inspection within the preceding 36 months.

(b) The department previously cited a violation under the same section of WAC or RCW for substantially the same problem following any type of inspection on two occasions within the preceding 36 months.

(2) "Serious problem" means that there has been a violation of a WAC or RCW and:

(a) The resident was significantly harmed; or

(b) It is likely that the resident will be significantly harmed or die.

(3) "Uncorrected problem" means the department has cited a violation of WAC or RCW following any type of inspection and the violation remains uncorrected at the time the department makes a subsequent inspection for the specific purpose of verifying whether such violation has been corrected. When there is a change in licensee, the new licensee is responsible for correcting any remaining violations that may exist, including complying with any plan of correction in effect immediately prior to the change in licensee.

"Prospective resident" means an individual who seeks admission to a licensed assisted living facility and has completed and signed an application for admission, or the individual's legal representative or designated representative, if any, completed and signed the application on their behalf.

"Reasonable accommodation" or "reasonably accommodate" have the meaning given in federal and state antidiscrimination laws and regulations which include, but are not limited to, the following:

(1) Reasonable accommodation means that the assisted living facility must:

(a) Not impose admission criteria that excludes individuals unless the criteria is necessary for the provision of assisted living facility services;

(b) Make reasonable modification to its policies, practices, or procedures if the modifications are necessary to accommodate the needs of the resident;

(2) Reasonable accommodations are not required if:

(a) The resident or individual applying for admission presents a significant risk to the health or safety of others that cannot be eliminated by the reasonable accommodation;

(b) The reasonable accommodations would fundamentally alter the nature of the services provided by the assisted living facility; or

"RCW" means Revised Code of Washington.

"Records" means:

(1) "Active records" means the current, relevant documentation regarding residents necessary to provide care and services to residents; or

(2) "Inactive records" means historical documentation regarding the provision of care and services to residents that is no longer relevant to the current delivery of services and has been thinned from the active record.

"Resident" means an individual who:

(1) Chooses to reside in an assisted living facility, including an individual receiving respite care;

(2) Is not related by blood or marriage to the operator of the assisted living facility;

(3) Receives basic services; and

(4) Receives one or more of the services listed in the definition of "general responsibility for the safety and well-being of the resident," and may receive domiciliary care or respite care provided directly, or indirectly, by the assisted living facility. Whereas, a nonresident individual may receive services that are permitted under WAC 388-78A-2032.

"Resident's representative" means one of the following:

(1) The legal representative who is the person or persons identified in RCW 7.70.065 and who may act on behalf of the resident pursuant to the scope of their legal authority. The legal representative must not be affiliated with the licensee, assisted living facility, or management company, unless the affiliated person is a family member of the resident.

(2) If there is no legal representative, a person designated voluntarily by a competent resident in writing, to act in the resident's behalf concerning the care and services provided by the assisted living facility, and to receive information from the assisted living facility if there is no legal representative. The resident's representative must not be affiliated with the licensee, assisted living facility, or management company, unless the affiliated person is a family member of the resident. The resident's representative under this subsection must not have authority to act on behalf of the resident once the resident is no longer competent. The resident's competence must be determined using the criteria in chapter 11.130 RCW.

"Respite care" means short-term care for any period in excess of 24 continuous hours for a resident to temporarily relieve the family or other caregiver of providing that care.

"Restraint" means any method or device used to prevent or limit free body movement, including, but not limited to:

(1) "Confinement" unless agreed to as provided in WAC 388-78A-2370;

(2) "Chemical restraint" means the administration of any drug to manage a vulnerable adult's behavior in a way that reduces the safety risk to the vulnerable adult or others, has the temporary effect of restricting the vulnerable adult's freedom of movement, and is not standard treatment for the vulnerable adult's medical or psychiatric condition.

(3) "Mechanical restraint" means any device attached or adjacent to the vulnerable adult's body that they cannot easily remove and restricts freedom of movement or normal access to the vulnerable adult's body. "Mechanical restraint" does not include the use of devices, materials, or equipment that are:

(a) Medically authorized, as required, and;

(b) Used in a manner that is consistent with federal or state licensing or certification requirements for facilities, hospitals, or programs authorized under chapter 71A.12 RCW.

(4) "Physical restraint" means the application of physical force without the use of any device, for the purpose of restraining the free movement of a vulnerable adult's body. "Physical restraint" does not include:

(a) Briefly holding without undue force a vulnerable adult in order to calm or comfort the vulnerable adult; or

(b) Holding a vulnerable adult's hand to safely escort the vulnerable adult from one area to another.

"Room" means a space set apart by floor to ceiling partitions on all sides with all openings provided with doors or windows.

(1) "Sleeping room" means a room where a resident is customarily expected to sleep and contains a resident's bed.

(2) "Resident living room" means the common space in a resident unit that is not a sleeping room, bathroom, or closet.

"Significant change" means a change in the resident's physical, mental, or psychosocial status that causes either life-threatening conditions or clinical complications.

"Special needs" means a developmental disability, mental illness, or dementia.

"Staff person" means any assisted living facility employee, temporary employee, or contractor, whether employed or retained by the licensee or any management company or volunteer.

"State fire marshal" means the director of fire protection under the direction of the chief of the Washington state patrol.

"Toilet" means a disposal apparatus used for urination and defecation fitted with a seat and flushing device.

"Volunteer" means an individual who interacts with residents without reimbursement.

"Vulnerable adult" means a person:

(1) Sixty years of age or older who has the functional, mental, or physical inability to care for themselves;

(2) Found incapacitated under RCW 74.34.020;

(3) Who has a developmental disability as defined under RCW 71A.10.020;

(4) Admitted to any facility, including any assisted living facility;

(5) Receiving services from home health, hospice, or home care agencies licensed or required to be licensed under chapter 70.127 RCW;

(6) Receiving services from an individual provider; or

(7) For the purposes of requesting and receiving background checks pursuant to RCW 43.43.832, includes a person who is an adult of any age who lacks the functional, mental, or physical ability to care for themselves.

"WAC" means Washington Administrative Code.

"Wellness program" means an educational program provided by the assisted living facility. It is a proactive and preventative approach to assist residents and nonresident individuals in achieving optimal levels of health, social, and emotional functioning. A wellness program does not include medical care or interventions.

"Willful" means the deliberate, or nonaccidental action or inaction by an alleged perpetrator that the alleged perpetrator knows, or reasonably should have known, could cause a negative outcome, including harm, injury, pain, or anguish.

"WISHA" means the Washington Industrial Safety and Health Act, chapter 49.17 RCW administered by the Washington state department of labor and industries.

History

Statutory Authority: RCW 18.20.090 and 18.20.550. WSR 26-15-066, s 388-78A-2020, filed 7/15/26, effective 8/15/26. Statutory Authority: RCW 18.20.090, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 25-16-099, s 388-78A-2020, filed 8/6/25, effective 9/6/25. Statutory Authority: Chapter 18.20 RCW. WSR 18-18-004, § 388-78A-2020, filed 8/23/18, effective 9/23/18
WSR 18-08-065, § 388-78A-2020, filed 4/2/18, effective 5/3/18
WSR 14-05-035, § 388-78A-2020, filed 2/12/14, effective 3/15/14
WSR 13-13-063, § 388-78A-2020, filed 6/18/13, effective 7/19/13
WSR 12-21-070, § 388-78A-2020, filed 10/18/12, effective 11/18/12
WSR 12-08-004, § 388-78A-2020, filed 3/22/12, effective 4/22/12. Statutory Authority: RCW 18.20.090 and chapters 18.20 and 74.34 RCW. WSR 08-05-099, § 388-78A-2020, filed 2/15/08, effective 3/17/08. Statutory Authority: RCW 18.20.090 and 2006 c 242. WSR 06-13-028, § 388-78A-2020, filed 6/13/06, effective 7/14/06. Statutory Authority: RCW 18.20.090. WSR 06-01-047, § 388-78A-2020, filed 12/15/05, effective 1/15/06. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2020, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2030 Assisted living facility license required.

(1) An assisted living facility license is required to operate or maintain an assisted living facility as defined in chapter 18.20 RCW and this chapter.

(2) An assisted living facility license is required when any person other than a family member provides housing, one or more basic services, and one or more of the following:

(a) Assumes general responsibility for the safety and well-being of the residents except as provided in WAC 388-78A-2032;

(b) Provides domiciliary care which includes:

(i) Providing assistance with activities of daily living, either directly or indirectly as defined in this chapter and described in WAC 388-78A-2190;

(ii) Providing health support services, either directly or indirectly as defined in this chapter and described in WAC 388-78A-2200; or

(iii) Providing intermittent nursing services, either directly or indirectly as described in WAC 388-78A-2310.

(3) An assisted living facility license is required if the provision of items and services to a nonresident individual requires ongoing evaluation or assessment, ongoing care and service planning, ongoing intervention or ongoing monitoring of a nonresident individual's well-being as specified in this chapter.

(4) The assisted living facility may provide adult day services as defined in WAC 388-78A-2020 and as specified in WAC 388-78A-2360 to nonresident individuals, including independent living residents, on the assisted living facility premises.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2030, filed 6/18/13, effective 7/19/13
WSR 12-08-004, § 388-78A-2030, filed 3/22/12, effective 4/22/12. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2030, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2032 Assisted living facility license not required.

(1) An assisted living facility license is not required for the housing, or services, customarily provided under landlord tenant agreements governed by the residential tenant act, chapter 59.18 RCW, or when housing nonresident individuals who chose to participate in the programs or services in subsection (2) of this section when offered by the assisted living facility licensee or the licensee's contractor.

(2) An assisted living facility license is not required for one or more of the following items and services that may, upon request of the nonresident individual, be provided to a nonresident individual:

(a) Emergency assistance provided on an intermittent or nonroutine basis;

(b) Systems including technology-based monitoring devices employed by independent senior housing, or independent living units in continuing care retirement communities, to respond to the potential need for emergency services;

(d) Nursing assessment services to determine whether referral to an outside health care provider is recommended;

(e) Making and reminding of health care appointments;

(f) Preadmission assessment, for the purposes of transitioning to a licensed care setting;

(g) Medication assistance which may include reminding or coaching the nonresident individual, opening the nonresident individual's medication container, using an enabler, and handing prefilled insulin syringes to the nonresident individual;

(h) Prefilling insulin syringes which must be performed by a nurse licensed under chapter 18.79 RCW;

(i) Assessment to determine cause of a fall;

(j) Nutrition management and education services;

(k) Dental services;

(l) Wellness programs as defined in WAC 388-78A-2020; or

(m) Services customarily provided under the landlord tenant agreements governed by the Residential Landlord-Tenant Act, chapter 59.18 RCW.

(3) This section does not prohibit an assisted living facility from furnishing written information concerning available community resources to nonresident individuals or the individual's family members or legal representatives. However, the assisted living facility may not require the use of any particular service provider.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2032, filed 6/18/13, effective 7/19/13
WSR 12-08-004, § 388-78A-2032, filed 3/22/12, effective 4/22/12.

Wash. Admin. Code § 388-78A-2035 Disclosure statement to nonresident individuals.

(1) An assisted living facility must provide each nonresident individual a disclosure statement upon admission and at the time that additional services are requested by the nonresident individual.

(2) The disclosure statement must notify the nonresident individual that:

(a) The resident rights of chapter 70.129 RCW do not apply to nonresident individuals;

(b) Licensing requirements for assisted living facilities under this chapter do not apply to nonresident units; and

History

Statutory Authority: Chapter 18.20 RCW. WSR 14-05-035, § 388-78A-2035, filed 2/12/14, effective 3/15/14
WSR 13-13-063, § 388-78A-2035, filed 6/18/13, effective 7/19/13
WSR 12-08-004, § 388-78A-2035, filed 3/22/12, effective 4/22/12.

Wash. Admin. Code § 388-78A-2040 Other requirements.

(1) The assisted living facility must comply with all other applicable federal, state, county and municipal statutes, rules, codes and ordinances, including without limitations those that prohibit discrimination.

(2) The assisted living facility must have its building approved by the Washington state fire marshal in order to be licensed.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2040, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2040, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2050 Resident characteristics.

WAC 388-78A-2050

(1) The assisted living facility may admit and retain an individual as a resident in an assisted living facility only if:

(a) The assisted living facility can safely and appropriately serve the individual with appropriate available staff providing:

(i) The scope of care and services described in the assisted living facility's disclosure information, except if the assisted living facility chooses to provide additional services consistent with RCW 18.20.300(4); and

(ii) The reasonable accommodations required by state or federal law, including providing any specialized training to caregivers that may be required according to WAC 388-78A-2490 through 388-78A-2510;

(b) The individual does not require the frequent presence and frequent evaluation of a registered nurse, excluding those individuals who are receiving hospice care or individuals who have a short-term illness that is expected to be resolved within fourteen days as long as the assisted living facility has the capacity to meet the individual's identified needs; and

(c) The individual is ambulatory, unless the assisted living facility is approved by the Washington state director of fire protection to care for semiambulatory or nonambulatory residents.

(2) The assisted living facility may admit and provide care for residents with dementia in a building without restricted egress when the facility does not represent themselves to the public, prospective residents, residents, and resident representatives as providing memory care services, as a memory care facility, or memory care unit without obtaining a certification.

History

Statutory Authority: RCW 18.20.090 and 18.20.550. WSR 26-15-066, s 388-78A-2050, filed 7/15/26, effective 8/15/26. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2050, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090. WSR 06-01-047, § 388-78A-2050, filed 12/15/05, effective 1/15/06. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2050, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2060 Preadmission assessment.

The assisted living facility must conduct a preadmission assessment for each prospective resident that includes the following information, unless unavailable despite the best efforts of the assisted living facility:

(1) Medical history;

(2) Necessary and contraindicated medications;

(3) A licensed medical or health professional's diagnosis, unless the prospective resident objects for religious reasons;

(4) Significant known behaviors or symptoms that may cause concern or require special care;

(5) Mental illness diagnosis, except where protected by confidentiality laws;

(6) Level of personal care needs;

(7) Activities and service preferences; and

(8) Preferences regarding other issues important to the prospective resident, such as food and daily routine.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2060, filed 6/18/13, effective 7/19/13
WSR 10-03-066, § 388-78A-2060, filed 1/15/10, effective 2/15/10. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2060, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2070 Timing of preadmission assessment.

(1) Unless there is an emergency, the assisted living facility must complete the preadmission assessment of the prospective resident before each prospective resident moves into the assisted living facility.

(2) The assisted living facility must ensure the preadmission assessment is completed within five calendar days of the resident moving into the assisted living facility when the resident moves in under emergency conditions.

(3) For the purposes of this section, "emergency" means any circumstances when the prospective resident would otherwise need to remain in an unsafe setting or be without adequate and safe housing.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2070, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2070, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2080 Qualified assessor.

The assisted living facility must ensure the person responsible for completing a preadmission assessment of a prospective resident:

(1) Has a master's degree in social services, human services, behavioral sciences or an allied field and two years social service experience working with adults who have functional or cognitive disabilities; or

(2) Has a bachelor's degree in social services, human services, behavioral sciences, or an allied field and three years social service experience working with adults who have functional or cognitive disabilities; or

(3) Has a valid Washington state license to practice nursing, in accordance with chapters 18.79 RCW and 246-840 WAC; or

(4) Is a physician with a valid state license to practice medicine; or

(5) Has three years of successful experience acquired prior to September 1, 2004, assessing prospective and current assisted living facility residents in a setting licensed by a state agency for the care of vulnerable adults, such as a nursing home, assisted living facility, or adult family home, or a setting having a contract with a recognized social service agency for the provision of care to vulnerable adults, such as supported living.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2080, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2080, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2090 Full assessment topics.

The assisted living facility must obtain sufficient information to be able to assess the capabilities, needs, and preferences for each resident, and must complete a full assessment addressing the following, within fourteen days of the resident's move-in date, unless extended by the department for good cause:

(1) Individual's recent medical history, including, but not limited to:

(a) A licensed medical or health professional's diagnosis, unless the resident objects for religious reasons;

(b) Chronic, current, and potential skin conditions; or

(2) Currently necessary and contraindicated medications and treatments for the individual, including:

(a) Any prescribed medications, and over-the-counter medications commonly taken by the individual, that the individual is able to independently self-administer, or safely and accurately direct others to administer to him/her;

(b) Any prescribed medications, and over-the-counter medications commonly taken by the individual, that the individual is able to self-administer when he/she has the assistance of a caregiver; and

(c) Any prescribed medications, and over-the-counter medications commonly taken by the individual, that the individual is not able to self-administer, and needs to have administered to him or her.

(3) The individual's nursing needs when the individual requires the services of a nurse on the assisted living facility premises.

(4) Individual's sensory abilities, including:

(a) Vision; and

(b) Hearing.

(5) Individual's communication abilities, including:

(a) Modes of expression;

(b) Ability to make self understood; and

(6) Significant known behaviors or symptoms of the individual causing concern or requiring special care, including:

(a) History of substance abuse;

(b) History of harming self, others, or property; or

(d) Individual's ability to leave the assisted living facility unsupervised; and

(e) Other safety considerations that may pose a danger to the individual or others, such as use of medical devices or the individual's ability to smoke unsupervised, if smoking is permitted in the assisted living facility.

(7) Individual's special needs, by evaluating available information, or if available information does not indicate the presence of special needs, selecting and using an appropriate tool, to determine the presence of symptoms consistent with, and implications for care and services of:

(a) Mental illness, or needs for psychological or mental health services, except where protected by confidentiality laws;

(b) Developmental disability;

(i) Base any determination that the resident has short-term memory loss upon objective evidence; and

(ii) Document the evidence in the resident's record.

(d) Other conditions affecting cognition, such as traumatic brain injury.

(8) Individual's level of personal care needs, including:

(a) Ability to perform activities of daily living;

(b) Medication management ability, including:

(i) The individual's ability to obtain and appropriately use over-the-counter medications; and

(ii) How the individual will obtain prescribed medications for use in the assisted living facility.

(9) Individual's activities, typical daily routines, habits and service preferences.

(10) Individual's personal identity and lifestyle, to the extent the individual is willing to share the information, and the manner in which they are expressed, including preferences regarding food, community contacts, hobbies, spiritual preferences, or other sources of pleasure and comfort.

(11) Who has decision-making authority for the individual, including:

(a) The presence of any advance directive, or other legal document that will establish a substitute decision maker in the future;

(b) The presence of any legal document that establishes a current substitute decision maker; and

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2090, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2090, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2100 Ongoing assessments.

WAC 388-78A-2100

(2) The assisted living facility must:

(a) Complete a full assessment addressing the elements set forth in WAC 388-78A-2090 for each resident at least annually;

(b) For residents with dementia living in an assisted living facility certified as a memory care facility or memory care unit, complete a full assessment addressing the elements set forth in 388-78A-2090 for each resident at least semi-annually.

(i) Consistent with the resident's change of condition as specified in WAC 388-78A-2120;

(ii) When the resident's negotiated service agreement no longer addresses the resident's current needs and preferences;

(iii) When the resident has an injury requiring the intervention of a practitioner.

(d) Ensure the staff person performing the ongoing assessments is qualified to perform them.

History

Statutory Authority: RCW 18.20.090 and 18.20.550. WSR 26-15-066, s 388-78A-2100, filed 7/15/26, effective 8/15/26. Statutory Authority: Chapter 18.51 RCW. WSR 23-14-029, § 388-78A-2100, filed 6/26/23, effective 7/27/23. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2100, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090. WSR 06-01-047, § 388-78A-2100, filed 12/15/05, effective 1/15/06. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2100, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2101 Ongoing assessments—Requirements in effect from January 18, 2022, through June 8, 2023, in response to the state of emergency related to COVID-19.

(1) In response to the state of emergency related to the COVID-19 pandemic, the department adopted emergency rules under RCW 34.05.320 on January 18, 2022, to amend a portion of WAC 388-78A-2100. The emergency rules remained in effect until June 8, 2023. The amended rules in place at that time were:

(2) The assisted living facility must:

(a) Complete a full assessment addressing the elements set forth in WAC 388-78A-2090 for each resident at least annually, except beginning January 18, 2022, assessments for residents whose care is state funded may be extended an additional 12 months during the COVID-19 public health emergency;

(b) Complete an assessment specifically focused on a resident's identified problems and related issues:

(i) Consistent with the resident's change of condition as specified in WAC 388-78A-2120;

(ii) When the resident's negotiated service agreement no longer addresses the resident's current needs and preferences;

(iii) When the resident has an injury requiring the intervention of a practitioner.

History

Statutory Authority: Chapter 18.51 RCW. WSR 23-14-029, § 388-78A-2101, filed 6/26/23, effective 7/27/23.

Wash. Admin. Code § 388-78A-2110 Resident participation in assessments.

The assisted living facility must directly involve each resident or prospective resident, to the extent possible, along with any appropriate resident representative to the extent he or she is willing and capable, in the preadmission assessment and on-going assessment process.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2110, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2110, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2120 Monitoring residents' well-being.

The assisted living facility must:

(1) Observe each resident consistent with his or her assessed needs and negotiated service agreement;

(2) Identify any changes in the resident's physical, emotional, and mental functioning that are a:

(a) Departure from the resident's customary range of functioning; or

(b) Recurring condition in a resident's physical, emotional, or mental functioning that has previously required intervention by others.

(3) Evaluate, in order to determine if there is a need for further action:

(a) The changes identified in the resident per subsection (2) of this section; and

(b) Each resident when an accident or incident that is likely to adversely affect the resident's well-being, is observed by or reported to staff persons.

(4) Take appropriate action in response to each resident's changing needs.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2120, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090. WSR 06-01-047, § 388-78A-2120, filed 12/15/05, effective 1/15/06. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2120, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2130 Service agreement planning.

The assisted living facility must:

(1) Develop an initial resident service plan, based upon discussions with the resident and the resident's representative if the resident has one, and the preadmission assessment of a qualified assessor, upon admitting a resident into an assisted living facility. The assisted living facility must ensure the initial resident service plan:

(a) Integrates the assessment information provided by the department's case manager for each resident whose care is partially or wholly funded by the department or the health care authority;

(b) Identifies the resident's immediate needs; and

(c) Provides direction to staff and caregivers relating to the resident's immediate needs, capabilities, and preferences.

(2) Complete the negotiated service agreement for each resident using the resident's preadmission assessment, initial resident service plan, and full assessment information, within thirty days of the resident moving in;

(3) Review and update each resident's negotiated service agreement consistent with WAC 388-78A-2120:

(a) Within a reasonable time consistent with the needs of the resident following any change in the resident's physical, mental, or emotional functioning; and

(b) Whenever the negotiated service agreement no longer adequately addresses the resident's current assessed needs and preferences.

(4) Review and update each resident's negotiated service agreement as necessary following an annual full assessment;

(5) Involve the following persons in the process of developing and updating a negotiated service agreement:

(a) The resident;

(b) The resident's representative to the extent he or she is willing and capable, if the resident has one;

(d) The department's case manager, if the resident is a recipient of medicaid assistance, or any private case manager, if available; and

(e) Staff designated by the assisted living facility.

(6) Ensure:

(a) Individuals participating in developing the resident's negotiated service agreement:

(i) Discuss the resident's assessed needs, capabilities, and preferences; and

(ii) Negotiate and agree upon the care and services to be provided to support the resident; and

(b) Staff persons document in the resident's record the agreed upon plan for services.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2130, filed 6/18/13, effective 7/19/13
WSR 12-01-003, § 388-78A-2130, filed 12/7/11, effective 1/7/12. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2130, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2140 Negotiated service agreement contents.

The assisted living facility must develop, and document in the resident's record, the agreed upon plan to address and support each resident's assessed capabilities, needs and preferences, including the following:

(1) The care and services necessary to meet the resident's needs, including:

(a) The plan to monitor the resident and address interventions for current risks to the resident's health and safety that were identified in one or more of the following:

(i) The resident's preadmission assessment;

(ii) The resident's full assessments;

(iii) On-going assessments of the resident;

(b) The plan to provide assistance with activities of daily living, if provided by the assisted living facility;

(d) The plan to provide necessary health support services, if provided by the assisted living facility;

(e) The resident's preferences for how services will be provided, supported and accommodated by the assisted living facility.

(2) Clearly defined respective roles and responsibilities of the resident, the assisted living facility staff, and resident's family or other significant persons in meeting the resident's needs and preferences. Except as specified in WAC 388-78A-2290 and 388-78A-2340(5), if a person other than a caregiver is to be responsible for providing care or services to the resident in the assisted living facility, the assisted living facility must specify in the negotiated service agreement an alternate plan for providing care or service to the resident in the event the necessary services are not provided. The assisted living facility may develop an alternate plan:

(a) Exclusively for the individual resident; or

(b) Based on standard policies and procedures in the assisted living facility provided that they are consistent with the reasonable accommodation requirements of state and federal law.

(3) The times services will be delivered, including frequency and approximate time of day, as appropriate;

(4) The resident's preferences for activities and how those preferences will be supported;

(5) Appropriate behavioral interventions, if needed;

(6) A communication plan, if special communication needs are present;

(7) The resident's ability to leave the assisted living facility premises unsupervised; and

(8) The assisted living facility must not require or ask the resident or the resident's representative to sign any negotiated service or risk agreement, that purports to waive any rights of the resident or that purports to place responsibility or liability for losses of personal property or injury on the resident.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2140, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2140, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2150 Signing negotiated service agreement.

The assisted living facility must ensure that the negotiated service agreement is agreed to and signed at least annually by:

(1) The resident, or the resident's representative if the resident has one and is unable to sign or chooses not to sign;

(2) A representative of the assisted living facility duly authorized by the assisted living facility to sign on its behalf; and

(3) Any public or private case manager for the resident, if available.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2150, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2150, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2160 Implementation of negotiated service agreement.

The assisted living facility must provide the care and services as agreed upon in the negotiated service agreement to each resident unless a deviation from the negotiated service agreement is mutually agreed upon between the assisted living facility and the resident or the resident's representative at the time the care or services are scheduled.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2160, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2160, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2170 Required assisted living facility services.

(1) The assisted living facility must provide housing and assume general responsibility for the safety and well-being of each resident, as defined in this chapter, consistent with the resident's assessed needs and negotiated service agreement.

(2) The assisted living facility must provide each resident with the following basic services, consistent with the resident's assessed needs and negotiated service agreement:

(a) Activities - Arranging for activities in accordance with WAC 388-78A-2180;

(b) Housekeeping - Providing a safe, clean and comfortable environment for each resident, including personal living quarters and all other resident accessible areas of the building;

(c) Laundry - Keeping the resident's clothing clean and in good repair, and laundering towels, washcloths, bed linens on a weekly basis or more often as necessary to maintain cleanliness;

(d) Meals - Providing meals in accordance with WAC 388-78A-2300; and

(e) Nutritious snacks - Providing nutritious snack items on a scheduled and nonscheduled basis, and providing nutritious snacks in accordance with WAC 388-78A-2300.

(3) The assisted living facility must:

(a) Provide care and services to each resident by staff persons who are able to communicate with the resident in a language the resident understands; or

(b) Make provisions for communications between staff persons and residents to ensure an accurate exchange of information.

(4) The assisted living facility must ensure each resident is able to obtain individually preferred personal care items when:

(a) The preferred personal care items are reasonably available; and

(b) The resident is willing and able to pay for obtaining the preferred items.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2170, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2170, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2180 Activities.

WAC 388-78A-2180

The assisted living facility must:

(1) Provide space and staff support necessary for:

(a) Each resident to engage in independent or self-directed activities that are appropriate to the setting, consistent with the resident's assessed interests, functional abilities, preferences, and negotiated service agreement; and

(b) Group activities at least three times per week that may be planned and facilitated by caregivers consistent with the collective interests of a group of residents.

(2) Make available routine supplies and equipment necessary for activities described in subsection (1) of this section.

(3) The assisted living facility certified as a memory care facility or memory care unit must provide daily activities consistent with functional abilities, interests, habits, and preferences of the individual residents. On a daily basis, except during the activation of the disaster preparedness plan, the facility or unit must provide residents access to:

(a) Opportunities for independent, self-directed activities;

(b) Individual activities, in which a staff person or volunteer engages the resident in a planned or spontaneous activity of interest. Activities may include personal care activities and provide opportunities for purposeful and positive interactions;

(d) Offer opportunities for activities that accommodate variations in a resident's mood, energy, and preferences. The facility or unit must make appropriate activities available based upon each resident's individual schedule and interests. For example, a resident up at night must have access to staff support, food, and appropriate activities.

History

Statutory Authority: RCW 18.20.090 and 18.20.550. WSR 26-15-066, s 388-78A-2180, filed 7/15/26, effective 8/15/26. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2180, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2180, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2190 Activities of daily living.

Assistance with activities of daily living is a service that the assisted living facility may provide.

(1) If an assisted living facility chooses not to provide assistance with activities of daily living:

(a) The assisted living facility must admit or retain only those residents who are independent in activities of daily living; except that

(b) A resident, or the resident's representative, may independently arrange for outside services to assist with activities of daily living.

(2) When an assisted living facility chooses to provide, either directly or indirectly, assistance with activities of daily living, the assisted living facility must provide that assistance consistent with the reasonable accommodation requirements in state and federal laws.

(3) When an assisted living facility chooses to provide, either directly or indirectly, assistance with activities of daily living, the assisted living facility must provide to each resident, consistent with the resident's assessed needs, minimal assistance with the following activities of daily living:

(a) Bathing: Minimal assistance with bathing means the assisted living facility must provide the resident with occasional:

(i) Reminding or cuing to wash and dry all areas of the body as needed;

(ii) Stand-by assistance getting into and out of the tub or shower; and

(iii) Physical assistance limited to steadying the resident during the activity.

(b) Dressing: Minimal assistance with dressing means the assisted living facility must provide the resident with occasional:

(i) Reminding or cuing to put on, take off, or lay out clothing, including prostheses when the assistance of a licensed nurse is not required;

(ii) Stand-by assistance during the activity; and

(iii) Physical assistance limited to steadying the resident during the activity.

(i) Reminding or cuing to eat and drink; and

(ii) Physical assistance limited to cutting food up, preparing food and beverages, and bringing food and fluids to the resident.

(d) Personal hygiene: Minimal assistance with personal hygiene means the assisted living facility must provide the resident with occasional:

(i) Reminding and cuing to comb hair, perform oral care and brush teeth, shave, apply makeup, and wash and dry face, hands and other areas of the body;

(ii) Stand-by assistance during the activity; and

(iii) Physical assistance limited to steadying the resident during the activity.

(e) Transferring: Minimal assistance in transferring means the assisted living facility must provide the resident with occasional:

(i) Reminders or cuing to move between surfaces, for example to and from the bed, chair and standing;

(ii) Stand-by assistance during the activity; and

(iii) Physical assistance limited to steadying the resident during self-transfers.

(f) Toileting: Minimal assistance in toileting means the assisted living facility must provide the resident with occasional:

(i) Reminders and cuing to toilet, including resident self-care of ostomy or catheter, to wipe and cleanse, and to change and adjust clothing, protective garments and pads;

(ii) Stand-by assistance during the activity; and

(iii) Physical assistance limited to steadying the resident during the activity.

(g) Mobility: Minimal assistance in mobility means the assisted living facility must provide the resident with occasional:

(i) Reminding or cuing to move between locations on the assisted living facility premises;

(ii) Stand-by assistance during the activity; and

(iii) Physical assistance limited to steadying the resident during the activity; and

(h) Medication assistance: As defined in RCW 69.41.010.

(4) The assisted living facility may choose to provide more than minimal assistance with activities of daily living consistent with state and federal law.

History

Statutory Authority: Chapter 18.20 RCW and RCW 18.20.310. WSR 19-07-033, § 388-78A-2190, filed 3/13/19, effective 4/13/19. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2190, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2190, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2200 Health support services.

WAC 388-78A-2200

Health support services are an optional service that the assisted living facility may provide. The assisted living facility may choose to provide any of the following health support services; however, an assisted living facility may or may not need to provide additional health support services to comply with the reasonable accommodation requirements in federal and state law. The assisted living facility may provide:

(1) Blood glucose testing;

(2) Puree diets;

(3) Calorie controlled diabetic diets;

(4) Dementia care;

(5) Memory care only in an assisted living facility certified as a memory care facility or memory care unit;

(6) Mental health care; and

(7) Developmental disabilities care.

History

Statutory Authority: RCW 18.20.090 and 18.20.550. WSR 26-15-066, s 388-78A-2200, filed 7/15/26, effective 8/15/26. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2200, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2200, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2202 Respite—General.

An assisted living facility:

(1) May provide short term respite care;

(2) Must limit the length of stay for an individual on respite to thirty calendar days or less; and

(3) Must not use respite as a placement pending the resident's admission to the assisted living facility.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2202, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090, 2008 c 146, and chapter 18.20 RCW. WSR 09-01-079, § 388-78A-2202, filed 12/15/08, effective 1/15/09.

Wash. Admin. Code § 388-78A-2204 Respite—Information.

When an assisting living facility provides respite care, before or at the time of admission, the assisted living facility must obtain sufficient information about the individual to meet the individual's anticipated needs. That information must include at a minimum:

(1) The resident's legal name;

(2) The name, phone number and address of the resident's representative, if applicable;

(3) The name and address of the adult family home, assisted living facility, or other location where the resident normally lives, with the name of a contact person and the contact person's phone number;

(4) The name, address, and telephone number of the resident's attending physician, and alternate physician if any;

(5) Medical and social history, which may be obtained from a respite care assessment and respite service plan performed by a case manager designated by an area agency on aging under contract with the department, and mental and physical assessment data; and

(6) Physician's orders for diet, medication, and routine care consistent with the resident's status on admission.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2204, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090, 2008 c 146, and chapter 18.20 RCW. WSR 09-01-079, § 388-78A-2204, filed 12/15/08, effective 1/15/09.

Wash. Admin. Code § 388-78A-2206 Respite—Assessment.

The assisted living facility must ensure that any individual on respite has assessments performed, where needed, and if the assessment of the individual shows symptoms of:

(1) Tuberculosis, follow required tuberculosis testing requirements; and

(2) Other infectious conditions or diseases, follow the appropriate infection control processes.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2206, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090, 2008 c 146, and chapter 18.20 RCW. WSR 09-01-079, § 388-78A-2206, filed 12/15/08, effective 1/15/09.

Wash. Admin. Code § 388-78A-2208 Respite—Negotiated service agreement.

With the participation of the individual, and where appropriate their representative, the assisted living facility must develop a negotiated service agreement, to maintain or improve the individual's health and functional status during their stay in the assisted living facility.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2208, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090, 2008 c 146, and chapter 18.20 RCW. WSR 09-01-079, § 388-78A-2208, filed 12/15/08, effective 1/15/09.

Wash. Admin. Code § 388-78A-2210 Medication services.

(1) An assisted living facility providing medication service, either directly or indirectly, must:

(a) Meet the requirements of chapter 69.41 RCW Legend drugs—Prescription drugs, and other applicable statutes and administrative rules; and

(b) Develop and implement systems that support and promote safe medication service for each resident.

(2) The assisted living facility must ensure the following residents receive their medications as prescribed, except as provided for in WAC 388-78A-2230 and 388-78A-2250:

(a) Each resident who requires medication assistance and his or her negotiated service agreement indicates the assisted living facility will provide medication assistance; and

(b) If the assisted living facility provides medication administration services, each resident who requires medication administration and his or her negotiated service agreement indicates the assisted living facility will provide medication administration.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2210, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2210, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2220 Prescribed medication authorizations.

(1) Before the assisted living facility may provide medication assistance or medication administration to a resident for prescribed medications, the assisted living facility must have one of the following:

(a) A prescription label completed by a licensed pharmacy;

(b) A written order from the prescriber;

(d) Written documentation by a nurse of a telephone order from the prescriber.

(2) The documentation required above in subsection (1) of this section must include the following information:

(a) The name of the resident;

(b) The name of the medication;

(d) The name of the prescriber.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2220, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2220, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2230 Medication refusal.

(1) When a resident who is receiving medication assistance or medication administration services from the assisted living facility chooses to not take his or her medications, the assisted living facility must:

(a) Respect the resident's right to choose not to take medication;

(b) Document the time, date and medication the resident did not take;

(c) Notify the physician of the refusal and follow any instructions provided, unless there is a staff person available who, acting within his or her scope of practice, is able to evaluate the significance of the resident not getting his or her medication, and such staff person;

(i) Conducts an evaluation; and

(ii) Takes the appropriate action, including notifying the prescriber or primary care practitioner when there is a consistent pattern of the resident choosing to not take his or her medications.

(2) The assisted living facility must comply with subsection (1) of this section, unless the prescriber or primary care practitioner has provided the assisted living facility with:

(a) Specific directions for addressing the refusal of the identified medication;

(b) The assisted living facility documents such directions; and

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2230, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2230, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2240 Nonavailability of medications.

When the assisted living facility has assumed responsibility for obtaining a resident's prescribed medications, the assisted living facility must obtain them in a correct and timely manner.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2240, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2240, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2250 Alteration of medications.

The assisted living facility must generally provide medications in the form they are prescribed when administering medications or providing medication assistance to a resident. The assisted living facility may provide medications in an altered form consistent with the following:

(1) Alteration includes, but is not limited to, crushing tablets, cutting tablets in half, opening capsules, mixing powdered medications with foods or liquids, or mixing tablets or capsules with foods or liquids.

(2) Residents must be aware that the medication is being altered or added to their food.

(3) A pharmacist or other practitioner practicing within their scope of practice must determine that it is safe to alter a medication.

(4) If the medication is altered, documentation of the appropriateness of the alteration must be on the prescription container, or in the resident's record.

(5) Alteration of medications for self-administration with assistance is provided in accordance with chapter 246-888 WAC.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2250, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2250, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2260 Storing, securing, and accounting for medications.

(1) The assisted living facility must secure medications for residents who are not capable of safely storing their own medications.

(2) The assisted living facility must ensure all medications under the assisted living facility's control are properly stored:

(a) In containers with pharmacist-prepared label or original manufacturer's label;

(b) Together for each resident and physically separated from other residents' medications;

(d) In a locked compartment that is accessible only to designated responsible staff persons; and

(e) In environments recommended on the medication label.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2260, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2260, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2270 Resident controlled medications.

(1) The assisted living facility must ensure all medications are stored in a manner that prevents each resident from gaining access to another resident's medications.

(2) The assisted living facility must allow a resident to control and secure the medications that he or she self-administers or self-administers with assistance if the assisted living facility assesses the resident to be capable of safely and appropriately storing his or her own medications and the resident desires to do so.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2270, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090. WSR 06-01-047, § 388-78A-2270, filed 12/15/05, effective 1/15/06. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2270, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2280 Medication organizers.

(1) The assisted living facility must ensure no staff person other than a nurse or licensed pharmacist fills medication organizers for residents.

(2) The assisted living facility must ensure that any nurse who fills a medication organizer for a resident labels the medication organizer with:

(a) The name of the resident;

(b) The name of the medications in the organizer; and

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2280, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090. WSR 06-01-047, § 388-78A-2280, filed 12/15/05, effective 1/15/06. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2280, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2290 Family assistance with medications and treatments.

(1) An assisted living facility may permit a resident's family member to administer medications or treatments or to provide medication or treatment assistance, including obtaining medications or treatment supplies, to the resident.

(2) The assisted living facility must disclose to the department, residents, the residents' legal representatives, if any, and if not the residents' representative if any, and to interested consumers upon request, information describing whether the assisted living facility permits such family administration or assistance and, if so, the extent of any limitations or conditions.

(3) If the assisted living facility allows family assistance with or administration of medications and treatments, and the resident and a family member(s) agree a family member will provide medication or treatment assistance, or medication or treatment administration to the resident, the assisted living facility must request that the family member submit to the assisted living facility a written plan for such assistance or administration that includes at a minimum:

(a) By name, the family member who will provide the medication or treatment assistance or administration;

(b) A description of the medication or treatment assistance or administration that the family member will provide, to be referred to as the primary plan;

(d) An emergency contact person and telephone number if the assisted living facility observes changes in the resident's overall functioning or condition that may relate to the medication or treatment plan; and

(e) Other information determined necessary by the assisted living facility.

(4) The plan for family assistance with medications or treatments must be signed and dated by:

(a) The resident, if able;

(b) The resident's representative, if any;

(d) A representative of the assisted living facility authorized by the assisted living facility to sign on its behalf.

(5) The assisted living facility may, through policy or procedure, require the resident's family member to immediately notify the assisted living facility of any changes in the medication or treatment plans for family assistance or administration.

(6) The assisted living facility must require that whenever a resident's family provides medication assistance or medication administration services, the resident's significant medications remain on the assisted living facility premises whenever the resident is on the assisted living facility premises.

(7) The assisted living facility's duty of care shall be limited to: Observation of the resident for changes in overall functioning consistent with RCW 18.20.280; notification to the person or persons identified in RCW 70.129.030 when there are observed changes in the resident's overall functioning or condition, or when the assisted living facility is aware that both the primary and alternate plan are not implemented; and appropriately responding to obtain needed assistance when there are observable or reported changes in the resident's physical or mental functioning.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2290, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2290, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2300 Food and nutrition services.

(1) The assisted living facility must:

(a) Provide a minimum of three meals a day:

(i) At regular intervals;

(ii) With no more than fourteen hours between the evening meal and breakfast, unless the assisted living facility provides a nutritious snack after the evening meal and before breakfast.

(b) Provide sufficient time and staff support for residents to consume meals;

(i) Are written at least one week in advance and delivered to residents' rooms or posted where residents can see them, except as specified in (f) of this subsection;

(ii) Indicate the date, day of week, month and year;

(iii) Include all food and snacks served that contribute to nutritional requirements;

(iv) Are kept at least six months;

(v) Provide a variety of foods; and

(vi) Are not repeated for at least three weeks, except that breakfast menus in assisted living facilities that provide a variety of daily choices of hot and cold foods are not required to have a minimum three-week cycle.

(d) Prepare food on-site, or provide food through a contract with a food service establishment located in the vicinity that meets the requirements of chapter 246-215 WAC Food service;

(e) Serve nourishing, palatable and attractively served meals adjusted for:

(i) Age, gender and activities, unless medically contraindicated; and

(ii) Individual preferences to the extent reasonably possible.

(f) Substitute foods of equal nutrient value, when changes in the current day's menu are necessary, and record changes on the original menu;

(g) Make available and give residents alternate choices in entrees for midday and evening meals that are of comparable quality and nutritional value. The assisted living facility is not required to post alternate choices in entrees on the menu one week in advance, but must record on the menus the alternate choices in entrees that are served;

(h) Develop, make known to residents, and implement a process for residents to express their views and comment on the food services; and

(i) Maintain a dining area or areas approved by the department with a seating capacity for fifty percent or more of the residents per meal setting, or ten square feet times the licensed resident bed capacity, whichever is greater.

(2) The assisted living facility must plan in writing, prepare on-site or provide through a contract with a food service establishment located in the vicinity that meets the requirements of chapter 246-215 WAC, and serve to each resident as ordered:

(a) Prescribed general low sodium, general diabetic, and mechanical soft food diets according to a diet manual. The assisted living facility must ensure the diet manual is:

(i) Available to and used by staff persons responsible for food preparation;

(ii) Approved by a dietitian; and

(iii) Reviewed and updated as necessary or at least every five years.

(b) Prescribed nutrient concentrates and supplements when prescribed in writing by a health care practitioner.

(3) The assisted living facility may provide to a resident at his or her request and as agreed upon in the resident's negotiated service agreement, nonprescribed:

(a) Modified or therapeutic diets;

(b) Nutritional concentrates or supplements.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2300, filed 6/18/13, effective 7/19/13
WSR 10-03-066, § 388-78A-2300, filed 1/15/10, effective 2/15/10. Statutory Authority: RCW 18.20.090. WSR 06-01-047, § 388-78A-2300, filed 12/15/05, effective 1/15/06. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2300, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2305 Food sanitation.

The assisted living facility must:

(1) Manage food, and maintain any on-site food service facilities in compliance with chapter 246-215 WAC, Food service;

(2) Ensure employees working as food service workers obtain a food worker card according to chapter 246-217 WAC; and

(3) Ensure a resident obtains a food worker card according to chapter 246-217 WAC whenever:

(a) The resident is routinely or regularly involved in the preparation of food to be served to other residents;

(b) The resident is paid for helping to prepare food; or

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2305, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090. WSR 06-01-047, § 388-78A-2305, filed 12/15/05, effective 1/15/06.

Wash. Admin. Code § 388-78A-2310 Intermittent nursing services.

(1) Intermittent nursing services are an optional service that the assisted living facility may provide.

(2) The assisted living facility may choose to provide any of the following intermittent nursing services through appropriately licensed and credentialed staff; however, the facility may or may not need to provide additional intermittent nursing services to comply with the reasonable accommodation requirements in federal or state law:

(a) Medication administration;

(b) Administration of health treatments;

(d) Nonroutine ostomy care;

(e) Tube feeding; and

(f) Nurse delegation consistent with chapter 18.79 RCW.

(3) The assisted living facility must clarify on the disclosure form any limitations, additional services, or conditions that may apply under this section.

(4) In providing intermittent nursing services, the assisted living facility must observe the resident for changes in overall functioning and respond appropriately when there are observable or reported changes in the resident's physical, mental or emotional functioning.

(5) The assisted living facility may provide intermittent nursing services to the extent permitted by RCW 18.20.160.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2310, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2310, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2320 Intermittent nursing services systems.

(1) When an assisted living facility provides intermittent nursing services to any resident, either directly or indirectly, the assisted living facility must:

(a) Develop and implement systems that support and promote the safe practice of nursing for each resident; and

(b) Ensure the requirements of chapters 18.79 RCW and 246-840 WAC are met.

(2) The assisted living facility providing nursing services, either directly or indirectly, must ensure that the nursing services systems include:

(a) Nursing services supervision;

(b) Nurse delegation, if provided;

(d) Development of, and necessary amendments to, the nursing component of the negotiated service agreement for each resident;

(e) Implementation of the nursing component of each resident's negotiated service agreement; and

(f) Availability of the supervisor, in person, by pager, or by telephone, to respond to residents' needs on the assisted living facility premises as necessary.

(3) The assisted living facility must ensure that all nursing services, including nursing supervision, assessments, and delegation, are provided in accordance with applicable statutes and rules, including, but not limited to:

(a) Chapter 18.79 RCW, Nursing care;

(b) Chapter 18.88A RCW, Nursing assistants;

(d) Chapter 246-841 WAC, Nursing assistants; and

(e) Chapter 246-888 WAC, Medication assistance.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2320, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2320, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2330 Tube feeding.

(1) Tube feeding services are an optional service that an assisted living facility may provide.

(2) The assisted living facility must provide intermittent nursing services to develop and implement the nursing component of the negotiated service agreement, administer feedings and necessary medications, and provide routine care of the tube insertion site whenever any resident requiring tube feeding is not able to:

(a) Independently and safely manage:

(i) Maintenance of the tube insertion site;

(ii) Necessary medication administration through the tube; and

(iii) Feeding administration through the tube.

(b) Arrange for an outside resource to provide:

(i) Maintenance of the tube insertion site;

(ii) Necessary medication administration through the tube; and

(iii) Feeding administration through the tube.

(3) The assisted living facility is not required to provide nursing services to a resident simply because the resident requires tube feeding if the resident can either independently manage or arrange for an outside resource to perform the tasks specified in subsection (2)(a) and (b) of this section.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2330, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2330, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2340 Resident-arranged services.

(1) The assisted living facility must allow a resident to arrange to receive on-site care and services from:

(a) A practitioner, licensed under Title 18 RCW regulating health care professions; and

(b) A home health, hospice, or home care agency licensed under chapter 70.127 RCW.

(2) The assisted living facility may permit the resident or the resident's legal representative, if any, to independently arrange for other persons to provide on-site care and services to the resident.

(3) The assisted living facility is not required to supervise the activities of a person providing care or services to a resident when the resident or resident's representative has independently arranged for or contracted with the person.

(4) The assisted living facility may establish policies and procedures that describe reasonable limitations, conditions, or requirements that must be met prior to an outside service provider being allowed on-site.

(5) When the resident or the resident's representative, if any, independently arranges for outside services under subsection (1) of this section, the assisted living facility's duty of care, and any negligence that may be attributed thereto, shall be limited to: The responsibilities described under subsection (3) of this section; observation of the resident for changes in overall functioning, consistent with RCW 18.20.280; notification to the person or persons identified in RCW 70.129.030 when there are observed changes in the resident's overall functioning or condition; and appropriately responding to obtain needed assistance when there are observable or reported changes in the resident's physical or mental functioning.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2340, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2340, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2350 Coordination of health care services.

(1) The assisted living facility must coordinate services with external health care providers to meet the residents' needs, consistent with the resident's negotiated service agreement.

(2) The assisted living facility must develop, implement and inform residents of the assisted living facility's policies regarding how the assisted living facility interacts with external health care providers, including:

(a) The conditions under which health care information regarding a resident will be shared with external health care providers, consistent with chapter 70.02 RCW; and

(b) How residents' rights to privacy will be protected, including provisions for residents to authorize the release of health care information.

(3) The assisted living facility may disclose health care information about a resident to external health care providers without the resident's authorization if the conditions in RCW 70.02.050 are met.

(4) If the conditions in RCW 70.02.050 are not met, the assisted living facility must request, but may not require, a resident to authorize the assisted living facility and the external health care provider to share the resident's health care information when:

(a) The assisted living facility becomes aware that a resident is receiving health care services from a source other than the assisted living facility; and

(b) The resident has not previously authorized the assisted living facility to release health care information to an external health care provider.

(5) When a resident authorizes the release of health care information or resident authorization is not required under RCW 70.02.050, the assisted living facility must contact the external health care provider and coordinate services.

(6) When authorizations to release health care information are not obtained, or when an external health care provider is unresponsive to the assisted living facility's efforts to coordinate services, the assisted living facility must:

(a) Document the assisted living facility's actions to coordinate services;

(b) Provide notice to the resident of the risks of not allowing the assisted living facility to coordinate care with the external provider; and

(7) When coordinating care or services, the assisted living facility must:

(a) Integrate relevant information from the external provider into the resident's preadmission assessment and reassessment, and when appropriate, negotiated service agreement; and

(b) Respond appropriately when there are observable or reported changes in the resident's physical, mental, or emotional functioning.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2350, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2350, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2360 Adult day services.

(1) The assisted living facility may, but is not required to, provide an adult day services program for nonresidents.

(2) If adult day services are provided, the assisted living facility must:

(a) Ensure each adult day services client receives appropriate supervision and agreed upon care and services during the time spent in the day services program;

(b) Ensure the care and services provided to adult day services clients do not compromise the care and services provided to assisted living facility residents;

(c) Ensure the total number of residents plus adult day services clients does not exceed the assisted living facility's maximum facility capacity;

(d) Only accept adult day services clients who are appropriate for assisted living facility care and services, consistent with WAC 388-78A-2050;

(e) Provide sufficient furniture for the comfort of day services clients, in addition to furniture provided for residents;

(f) Notify appropriate individuals specified in the client's record and consistent with WAC 388-78A-2640 when there is a significant change in the condition of an adult day services client;

(g) Investigate and document incidents and accidents involving adult day services clients consistent with WAC 388-78A-2371;

(h) Maintain a separate register of adult day services clients; and

(i) Maintain a record for each adult day services client.

History

Statutory Authority: RCW 18.20.090 and 74.34.068. WSR 21-12-065, § 388-78A-2360, filed 5/27/21, effective 6/27/21. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2360, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090. WSR 06-01-047, § 388-78A-2360, filed 12/15/05, effective 1/15/06. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2360, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2361 Project and operations functional program.

(1) The facility must develop and document their functional programing, under WAC 388-78A-2852, during the project development and planning process. This document must inform the design process and be provided to the department of health construction review services consistent with WAC 388-78A-2852 for use in review of the construction project documents and preoccupancy survey. This document must identify and describe, as applicable:

(a) Services offered, whether intermittent nursing services or contract care services under chapter 388-110 WAC;

(b) Number of residents served under contract care services, as applicable;

(c) The care needs of the population served, to include but not limited to dementia, cognitive and developmental disability, mental health, bariatric needs, safety risks, security, resident rights, and dignity of memory care residents;

(d) Circulation patterns;

(e) Special locking or other security measures;

(f) Room use, required resources, and systems to include intermittent nursing services that will take place in the resident unit;

(g) Consideration of and mitigation for risks associated with:

(i) Operational infection control;

(ii) Resident mobility and falls;

(iii) Elopement and security;

(iv) Medication services; and

(v) Staff injury.

(2) The facility may maintain an operational functional program to document considerations and decisions related to resident needs and the maintenance or modifications to the physical environment as necessary to demonstrate compliance with performance based expectations of this chapter. This document may be used to evaluate conditions of the built environment for appropriateness to the population served and must document circumstances where facility policy and procedure are implemented in lieu of, or in support of, changes to the built environment.

History

Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 20-02-104, § 388-78A-2361, filed 12/31/19, effective 1/31/20.

Wash. Admin. Code § 388-78A-2370 Dementia care.

(1) The assisted living facility must, to the fullest extent reasonably possible, obtain for each resident who has symptoms consistent with dementia as assessed per WAC 388-78A-2090(7):

(a) Information regarding the resident's significant life experiences, including:

(i) Family members or other significant relationships;

(ii) Education and training;

(iii) Employment and career experiences;

(iv) Religious or spiritual preferences;

(v) Familiar roles or sources of pride and pleasure.

(b) Information regarding the resident's ability or inability to:

(i) Articulate his or her personal needs; and

(ii) Initiate activity.

(c) Information regarding any patterns of resident behavior that express the resident's needs or concerns that the resident is not able to verbalize. Examples of such behaviors include, but are not limited to:

(i) Agitation;

(ii) Wandering;

(iii) Resistance to care;

(iv) Social isolation; and

(v) Aggression.

(2) The assisted living facility, in consultation with the resident's family or others familiar with the resident, must evaluate the significance and implications of the information obtained per subsection (1) of this section and integrate appropriate aspects into an individualized negotiated service agreement for the resident.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2370, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2370, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2371 Investigations.

The assisted living facility must:

(1) Investigate and document investigative actions and findings for any alleged or suspected abuse, neglect, or financial exploitation; or accident or incident jeopardizing or affecting a resident health or life;

(2) Determine the circumstances of the event;

(3) When necessary, institute and document appropriate measures to prevent similar future situations if the alleged incident is substantiated; and

(4) Protect residents during the course of the investigation.

History

Statutory Authority: RCW 18.20.090 and 74.34.068. WSR 21-12-065, § 388-78A-2371, filed 5/27/21, effective 6/27/21. Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 20-02-104, § 388-78A-2371, filed 12/31/19, effective 1/31/20.

Wash. Admin. Code § 388-78A-2380 Freedom of movement.

An assisted living facility must ensure all of the following conditions are present before moving residents into units or buildings with exits that may restrict a resident's egress:

(1) Each resident, or a person authorized under RCW 7.70.065 to provide consent on behalf of the resident, consents to living in such unit or building.

(2) Each resident assessed as being cognitively and physically able to safely leave the assisted living facility is able to do so independently without restriction consistent with the resident's negotiated service agreement.

(3) The assisted living facility must have a system in place to inform and permit visitors, staff persons and appropriate residents how they may exit without sounding the alarm.

(4) The installation of access and egress controls that does not restrict the movement of residents who are cognitively and physically able to safely leave the facility independently;

(5) In new construction, access and egress controlled doors that are installed as permitted by the building code adopted by the Washington state building code council;

(6) Existing access and egress controlled doors that meet and are maintained to the requirements of the building code at the time of construction; and

(7) Buildings from which egress is restricted have:

(a) A system in place to inform and permit visitors, staff persons, and appropriate residents freedom of movement; and

(b) A secured outdoor space per WAC 388-78A-2381.

History

Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 20-02-104, § 388-78A-2380, filed 12/31/19, effective 1/31/20. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2380, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090. WSR 06-01-047, § 388-78A-2380, filed 12/15/05, effective 1/15/06. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2380, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2381 General design requirements for memory care.

WAC 388-78A-2381

(1) When planning for new construction, renovations or change of service to include certified memory care services, the facility must document design considerations appropriate to residents with dementia, mental health issues, or cognitive and developmental disabilities within its functional program consistent with WAC 388-78A-2380.

(2) The facility must provide common areas, including at least one resident accessible common area outdoors. Such common areas should accommodate and offer the opportunity of social interaction, by using various sized furniture groupings that stimulate activity with environmental cues such as a garden area, resident kitchen, workshop, or contains areas with activity supplies and props to encourage engagement, and have safe outdoor paths to encourage exercise and movement.

(a) These areas must have a residential atmosphere and must accommodate and offer opportunities for individual or group activity including:

(i) Giving residents opportunities for privacy, socialization, and common spaces that account for wandering behaviors;

(ii) Ensuring any public address system in the area of specialized dementia care services is used only for emergencies;

(iii) Encouraging residents' individualized spaces to be furnished and decorated with personal items based on resident needs and preferences; and

(iv) Ensuring residents have access to their own rooms at all times without staff assistance.

(b) Unless an alternative viewing area is provided as described in (c) of this subsection and written policies and procedures are created as described in (d) of this subsection, the facility must provide an outdoor area for residents that:

(i) Is located on the floor on which the resident resides;

(ii) Is designed with a minimum of 25 square feet of space per resident served;

(iii) Has areas protected from direct sunshine and rain throughout the day;

(iv) Has walking surfaces that are firm, slip-resistant and free from abrupt changes, and suitable for individuals using wheelchairs and walkers;

(v) Has outdoor furniture;

(vi) Has plants that are not poisonous or toxic to humans;

(vii) Has areas appropriate for outdoor activities of interest to residents, such as walking paths, raised garden, flowerbeds, or bird feeders; and

(viii) Is surrounded by a wall or fence at least six feet high.

(c) If a facility does not provide an outdoor area located on the floor on which the resident resides in compliance with subsection (b)(i) of this subsection, then a facility must provide an alternative viewing area that:

(i) Is not obstructed by indoor furniture, storage areas, cleaning equipment, trash receptacles, snack food or drink tables, and other such encumbrances that would minimize access to the viewing area;

(ii) Must not serve as a hallway, or an additionally required community space such as a dining area, activity room, mobile healthcare services (such as home health, podiatrist, and dental services), or other purposes;

(iii) Must be a community space, not within the residents' room; and

(iv) Has windows that have an unobstructed and viewable height accessible by wheelchair.

(d) If a facility does not provide an outdoor area located on the floor on which the resident resides in compliance with subsection (b)(i) of this section, a facility must put in place and maintain a written policy and procedure that documents how the facility provides residents with access to an outdoor area on a floor other than the floor on which the resident resides. Upon request the facility shall present that plan to the department for review. Such a plan must include:

(i) The location of the outdoor space;

(ii) A description of any assistance necessary for the resident to reach the outdoor space at any time, and documented in the negotiated service agreement plan per WAC 388-78A-2140(2);

(iii) The facility's plan for providing any necessary staff assistance described in subsection (d)(ii) of this section; and

(iv) A plan to maintain safety and security to prevent wandering or exit seeking while the resident is using the outdoor space.

(e) The required outdoor area must be accessible to residents without staff assistance except where pursuant to a facility policy, and consistent with WAC 388-78A-2600, the facility administrator or other appropriate staff will monitor or temporarily restrict access if staff reasonably believe that the health, safety, or well-being of a resident or residents may be at risk, including, but not limited to, instances of:

(i) Inclement weather;

(ii) Dangerous construction or maintenance activities; or

(iii) Other temporary environmental factors that create an unsafe environment.

(f) Facilities licensed prior to date of implementation of this rule that have an outdoor area on each floor, may not eliminate the required outdoor space.

(g) The department may grant an exemption to an assisted living facility applying for certification of memory care when:

(i) The facility was licensed between February 1, 2020, and July 1, 2025:

(A) To the requirement of an outdoor area located on the floor on which the resident resides in compliance with subsection (b)(i) of this section; and

(B) If the exemption is granted the facility must maintain an alternative viewing area meeting subsection (c)(i) through (iv) of this section and must comply with subsection (d)(i) through (iv) of this section.

(ii) The facility was licensed prior to January 31, 2020:

(A) The requirement of an outdoor area located on the same floor which the resident resides in compliance with subsection (b)(i) and an alternative viewing area in compliance with subsection (c)(i) through (iv); and

(B) If the exemption is granted the facility must comply with subsection (d)(i) through (iv) of this section.

History

Statutory Authority: RCW 18.20.090 and 18.20.550. WSR 26-15-066, s 388-78A-2381, filed 7/15/26, effective 8/15/26. Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 20-02-104, § 388-78A-2381, filed 12/31/19, effective 1/31/20.

Wash. Admin. Code § 388-78A-2383 Certified memory care.

WAC 388-78A-2383

(1) After July 1, 2026, an assisted living facility may not operate as a memory care facility or maintain a memory care unit without becoming certified.

(2) To be certified by the department the assisted living facility must:

(a) Have a valid, current, license to operate an assisted living facility as required under RCW 18.20.030;

(b) Apply for certification and submit the initial certification fee as required by WAC 388-78A-2750;

(c) Not have a pattern of uncorrected or recurring significant enforcement remedies prior to the date of application. Evidence of significant enforcement may include:

(i) Citations issued in areas of resident harm or serious risk of harm, or actions or inactions resulting in serious disregard for resident health, safety, or deterioration of quality of care; or

(ii) Civil fines based on the department's determination of moderate to severe violations as defined in WAC 388-78A-3183;

(d) Not have a stop placement or conditions on a license related to resident care, or license revocation actions prior to the date of application for certification;

(e) Have permanent infrastructure considering the specialized needs of residents with dementia in WAC 388-78A-2381 including elements to restrict egress and meet daily activity requirements in WAC 388-78A-2180;

(f) Have a staffing plan that maintains 24-hour awake caregivers at a level adequate to respond to each resident's accessed needs, including waking and sleeping patterns and routine assistance with eating;

(g) Have a staffing plan, if applicable, when residents live in separate buildings or cottages that maintains at least one awake caregiver physically present in each building or cottage 24 hours per day; and

(h) Have policies and procedures outlining how staff respond to and manage residents who wander, actions to take when a resident is missing, and how and when consultive services will be obtained and utilized for residents experiencing behavioral challenges.

(3) The department at its sole discretion, on a case-by-case basis, after taking into consideration information on the certification application of the assisted living facility licensed before July 1, 2026, may grant conditional exemptions to prevent disruption of services or displacement of residents.

History

Statutory Authority: RCW 18.20.090 and 18.20.550. WSR 26-15-066, s 388-78A-2383, filed 7/15/26, effective 8/15/26.

Wash. Admin. Code § 388-78A-2384 Certification memory care—Implementation.

WAC 388-78A-2384

(1) For the purpose of certification implementation for an assisted living facility with a current license issued on or before July 1, 2026, and operating a memory care facility or memory care unit as defined in WAC 388-78A-2020 the department may:

(a) Grant certification, deeming the licensee compliant from the application submission date to the effective date of certification, while the department processes the application, when the application is submitted to the department by July 1, 2026: and

(b) Work with the licensee during the application process up to 120 calendar days to:

(i) Obtain information for an incomplete certification application from the licensee;

(ii) Complete the conditional exemption process, if applicable.

(2) If the department determines during the review process the licensee does not meet the certification requirements, the licensee may request a conditional exemption by submitting a written request to the department that includes:

(a) A description of the requested conditional exemption;

(b) The specific rule for which the exemption is sought;

(c) A description of what the assisted living facility has in place to meet the certification requirements at the time of application; and

(d) A detailed plan and timeline to meet the certification requirements, when applicable, to the exemption request.

(3) If the assisted living facility is granted a conditional exemption for certification a copy of the exemption must be retained in the facility.

(4) If the department determines a licensee will not be certified, or denies a request for conditional exemption, the assisted living facility may not appeal the department's denial.

(5) During the time of application review for certification and the department's decision to grant or deny a certification, the assisted living facility will not be subject to citations related to certified memory care requirements, provided the application was submitted by July 1, 2026.

(6) If during the application review the assisted living facility licensee withdraws from the certification process, or the department denies a certification, the assisted living facility must:

(a) Within 30 calendar days provide to residents, and their representatives, if applicable, notice of the withdrawal or denial of the certification application; and

(b) Assist all residents requiring memory care services to transition to a certified memory care facility or memory care unit within 180 calendar days of the date the facility withdrew their application or the department denied the certification.

(7) The assisted living facility will not be subject to citation related to memory care certification requirements for the period of application through resident transition after a withdrawal or denial of certification if the application was submitted by July 1, 2026.

(8) The department may consider an application for certification void when the applicant:

(a) Does not return information to the department within 60 days of the first request for additional information for an incomplete certification application; or

(b) Has not obtained certification within 120 days of the first submission of an application for certification to the department.

(9) When an assisted living facility with a current license, not meeting the definition of a memory care facility or memory care unit in WAC 388-78A-2020 on July 1, 2026, decides to transition to a certified memory care facility or add a memory care unit the facility must:

(a) Meet construction review requirements consistent with WAC 388-78A-2821, when applicable;

(b) Meet construction review requirements consistent with WAC 388-78A-2850, when applicable;

(d) Request a capacity increase consistent with WAC 388-78A-2800; and

(e) Meet criteria for increased licensed capacity consistent with WAC 388-78A-2810.

History

Statutory Authority: RCW 18.20.090 and 18.20.550. WSR 26-15-066, s 388-78A-2384, filed 7/15/26, effective 8/15/26.

Wash. Admin. Code § 388-78A-2385 Certified memory care—Disclosure.

WAC 388-78A-2385

(1) An assisted living facility certified as a memory care facility or memory care unit must post in a prominent location in the facility or unit and make available upon request a memory care disclosure to residents, resident representatives, if any, and interested consumers in substantially the following format:

Memory care disclosure required by RCW 18.20.300 (2)(a):

(a) Facility information, including:

(i) Facility name;

(ii) Facility address;

(iii) Facility phone number;

(b) Number of licensed beds in the memory care facility or memory care unit;

(i) Caregivers;

(ii) Other direct care staff;

(d) Number of regular direct care staff and caregivers per resident occupied bed during the day and evening hours;

(i) Caregivers;

(ii) Other direct care staff;

(2) The assisted living facility certified as a memory care facility or memory care unit must provide written notice informing the resident and their representative, if any, as defined in RCW 70.129.010, of a significant change in staffing within 30 days of the change and make the notification available for department review.

(3) For the purpose of this section "significant change in staffing" is defined as a reduction in the caregiver or direct care staff workforce in the memory care facility or memory care unit lasting more than five days where the facility or unit only meets basic essential needs such as eating, drinking, toileting, and medications for residents based on staffing. A significant change in staffing does not apply when an adjustment to the memory care facility or memory care unit staffing is based on a fluctuation in resident census.

History

Statutory Authority: RCW 18.20.090 and 18.20.550. WSR 26-15-066, s 388-78A-2385, filed 7/15/26, effective 8/15/26.

Wash. Admin. Code § 388-78A-2387 Certified memory care—Evaluation.

WAC 388-78A-2387

The department will conduct an on-site certification evaluation during regular licensing activities for an assisted living facility certified as a memory care facility or memory care unit.

History

Statutory Authority: RCW 18.20.090 and 18.20.550. WSR 26-15-066, s 388-78A-2387, filed 7/15/26, effective 8/15/26.

Wash. Admin. Code § 388-78A-2389 Certified memory care—Application of consumer protection act.

WAC 388-78A-2389

Operation of an assisted living facility memory care facility or memory care unit without a certification are matters vitally affecting the public interest for the purpose of applying the consumer protection act, chapter 19.86 RCW. A violation of this chapter is not reasonable in relation to the development and preservation of business and is unfair or deceptive acts in trade or commerce and an unfair method of competition for the purpose of applying the consumer protection act, chapter 19.86 RCW.

History

Statutory Authority: RCW 18.20.090 and 18.20.550. WSR 26-15-066, s 388-78A-2389, filed 7/15/26, effective 8/15/26.

Wash. Admin. Code § 388-78A-2390 Resident records.

The assisted living facility must maintain adequate records concerning residents to enable the assisted living facility:

(1) To effectively provide the care and services agreed upon with the resident;

(2) To allow the resident to communicate with family, medical providers, and others; and

(3) To respond appropriately in emergency situations, including, but not limited to, contacting the residents' emergency contact.

History

Statutory Authority: RCW 18.20.090, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 25-16-099, s 388-78A-2390, filed 8/6/25, effective 9/6/25. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2390, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2390, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2400 Protection of resident records.

The assisted living facility must:

(1) Maintain a systematic and secure method of identifying and filing resident records for easy access;

(2) Maintain resident records and preserve their confidentiality in accordance with applicable state and federal statutes and rules, including chapters 70.02 and 70.129 RCW;

(3) Allow authorized representatives of the department and other authorized regulatory agencies access to resident records;

(4) Provide any resident or other individual or organization access to resident records upon written consent of the resident or the resident's representative, unless state or federal law provide for broader access;

(5) Allow authorized agents, such as a management company, to use resident records solely for the purpose of providing care and services to residents and ensure that agents do not disclose such records except in a manner consistent with law; and

(6) Maintain ownership and control of resident records, except that resident records may be transferred to a subsequent person licensed by the department to operate the assisted living facility.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2400, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2400, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2410 Content of resident records.

Wash. Admin. Code § 388-78A-2420 Record retention.

(1) The assisted living facility must maintain on the assisted living facility premises in a resident's active record(s) all relevant information and documentation necessary for meeting a resident's current assessed needs.

(2) The assisted living facility may remove outdated information from the resident's active records that is no longer significant or relevant to the resident's current assessed service and care needs, and maintain it in an inactive record that must remain on the assisted living facility premises as long as the resident remains in the assisted living facility.

(3) The assisted living facility must maintain all documentation filed in a closed resident record, on the assisted living facility premises for six months after the date the resident leaves the assisted living facility and on the assisted living facility premises or another location for five years after the date the resident leaves the assisted living facility.

(4) All active, inactive, and closed resident records must be available for review by department staff and other authorized persons.

(5) If an assisted living facility ceases to operate as a licensed assisted living facility, the most recent licensee must make arrangements to ensure that the former residents' records are retained according to the times specified in this section and are available for review by department staff and other authorized individuals.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2420, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2420, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2430 Resident review of records.

(1) The assisted living facility must assemble all records pertaining to a resident and make them available to a resident within twenty-four hours of the resident's or the resident's representative's request to review the resident's records per RCW 70.129.030.

(2) The assisted living facility must provide to the resident or the resident's representative, photocopies of the records or any portions of the records pertaining to the resident, within two working days of the resident's or resident's representative's request for the records.

(a) For the purposes of this section, "working days" means Monday through Friday, except for legal holidays.

(b) The assisted living facility may charge the resident or the resident's representative a fee not to exceed twenty-five cents per page for the cost of photocopying the resident's record.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2430, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2430, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2440 Resident register, resident roster, and complete contact information.

(1) Resident register:

(a) The assisted living facility must regularly maintain in the assisted living facility a single current registry of all assisted living facility residents, their roommates, and identification of the rooms in which such persons reside or sleep, as required under the resident roster in RCW 18.20.095.

(b) The assisted living facility must maintain a readily available permanent, current book, computer file, or record with entries in ink or typewritten, of all individuals who resided in the assisted living facility within the past five years, including:

(i) Move-in date;

(ii) Full name;

(iii) Date of birth;

(iv) Resident room identifier;

(v) Resident phone number, if available;

(vi) Email address, if available;

(viii) Date of moving out;

(ix) Reason for moving out;

(x) Location and address to which the resident was discharged; and

(xi) If the resident has a representative, the resident representative's:

(A) Name;

(B) Relationship to the resident;

(D) Email address if available; and

(E) Mailing address, if available.

(c) Record and update the collection of contact information required by this section upon receipt of new or updated contact information for the resident or resident representative; and

(i) Upon the written request of any long-term care ombuds that includes reference to RCW 18.20.095 and the relevant legal functions and duties of long-term care ombuds; and

(ii) Provide a copy of the aggregated contact information required by this section within 48 hours, or within a reasonable time if agreed to by the requesting long-term care ombuds by electronic copy to the secure email address or facsimile number provided in the written request.

(2) Resident roster: The assisted living facility must:

(a) Create and regularly maintain a current resident roster of all residents in the assisted living facility. The roster must include the resident name and room number;

(b) Immediately provide a written copy of the roster upon an in-person request from any long-term care ombuds; and

(c) Make the current resident roster available to representatives of the Washington state fire marshal when conducting fire safety inspections.

(3) Complete contact information: The assisted living facility must:

(a) Create and regularly maintain current, accurate, and complete contact information for all residents including the following information:

(i) Resident name;

(ii) Resident room number;

(iii) Resident phone number, if available;

(iv) Email address, if available; and

(v) If the resident has a representative, the resident representative's:

(A) Name;

(B) Relationship to the resident;

(D) Email address, if available; and

(E) Mailing address, if available.

(b) Record and update the aggregated contact information required by this section upon receipt of new or updated contact information from the resident or resident representative; and

(c) Upon the written request of any long-term care ombuds that includes reference to RCW 18.20.095 and the relevant legal functions and duties of long-term care ombuds, provide a copy of the aggregated contact information required by this section within 48 hours, or within a reasonable time if agreed to by the requesting long-term care ombuds by electronic copy to the secure email address or facsimile number provided in the written request.

(4) The assisted living facility must make the information in this section immediately available to authorized department staff.

History

Statutory Authority: RCW 18.20.090, 18.51.070, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 26-05-046, s 388-78A-2440, filed 2/12/26, effective 3/15/26. Statutory Authority: RCW 18.20.090, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 25-16-099, s 388-78A-2440, filed 8/6/25, effective 9/6/25. Statutory Authority: Chapter 18.20 RCW. WSR 14-05-035, § 388-78A-2440, filed 2/12/14, effective 3/15/14
WSR 13-13-063, § 388-78A-2440, filed 6/18/13, effective 7/19/13
WSR 10-03-066, § 388-78A-2440, filed 1/15/10, effective 2/15/10. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2440, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2450 Staff.

WAC 388-78A-2450

(1) Each assisted living facility must provide sufficient, trained staff persons to:

(a) Furnish the services and care needed by each resident consistent with their negotiated service agreement;

(b) Maintain the assisted living facility free of safety hazards; and

(2) The assisted living facility must:

(a) Develop and maintain written job descriptions for the administrator and each staff position and provide each staff person with a copy of their job description before or upon the start of employment;

(b) Verify staff persons' work references prior to hiring;

(c) Verify prior to hiring that staff persons have the required licenses, certification, registrations, or other credentials for the position, and that such licenses, certifications, registrations, and credentials are current and in good standing;

(d) Document and retain for 12 weeks, weekly staffing schedules, as planned and worked;

(e) Ensure all resident care and services are provided only by staff persons who have the training, credentials, experience, and other qualifications necessary to provide the care and services;

(f) Ensure at least one caregiver, who is 18 years of age or older and has current cardiopulmonary resuscitation and first-aid cards, is present and available to assist residents at all times:

(i) When one or more residents are present on the assisted living facility premises; and

(ii) During assisted living facility activities off of the assisted living facility premises.

(g) Ensure caregiver provides on-site supervision of any resident voluntarily providing services for the assisted living facility;

(h) Provide staff orientation and appropriate training for expected duties when staff begin work in the facility, including, but not limited to:

(i) Organization of the assisted living facility;

(ii) Physical assisted living facility layout;

(iii) Specific duties and responsibilities;

(iv) How to report resident abuse and neglect consistent with chapter 74.34 RCW and assisted living facility policies and procedures;

(v) Policies, procedures, and equipment necessary to perform duties;

(vi) Needs and service preferences identified in the negotiated service agreements of residents with whom the staff persons will be working;

(vii) Resident rights, including without limitation, those specified in chapter 70.129 RCW;

(viii) The facility's comprehensive disaster plan and related on-duty staff procedures; and

(ix) The assisted living facility certified as a memory care facility or memory care unit must train staff on the comprehensive disaster preparedness plan and related on-duty staff procedures, considering the needs of residents with dementia as required in WAC 388-78A-2700.

(i) Develop and implement a process to ensure caregivers:

(i) Acquire the necessary information from the preadmission assessment, on-going assessment, and negotiated service agreement relevant to providing services to each resident with whom the caregiver works;

(ii) Are informed of changes in the negotiated service agreement of each resident with whom the caregiver works; and

(iii) Are given an opportunity to provide information to responsible staff regarding the resident when assessments and negotiated service agreements are updated for each resident with whom the caregiver works.

(j) Ensure all caregivers have access to resident records relevant to effectively providing care and services to the resident.

(3) The assisted living facility certified as a memory care facility or memory care unit must:

(a) Maintain awake caregiving staff 24 hours per day at a level that is adequate to respond to residents' assessed needs, including waking and sleeping patterns;

(b) Maintain, if applicable, in each separate memory care building or memory care cottage at least one awake and physically present caregiving staff 24 hours per day;

(i) Cueing for eating and drinking;

(ii) Physical assistance with eating and drinking such as cutting up food, preparing food and beverages, and bringing food and fluids to the resident; and

(iii) Occasional feeding assistance such as cutting up food and assisting the residents to get food and fluids into their mouth.

(4) Nothing in (3)(c)(iii) is intended to require a memory care facility or memory care unit to provide a resident with total feeding assistance for an extended or indefinite amount of time.

(5) The assisted living facility must:

(a) Protect all residents by ensuring any staff person suspected or accused of abuse, neglect, financial exploitation, or abandonment does not have access to any resident until the assisted living facility investigates and takes action to ensure resident safety;

(b) Not interfere with the investigation of a complaint, coerce a resident or staff person regarding cooperating with a complaint investigation, or conceal or destroy evidence of alleged improprieties occurring within the assisted living facility;

(c) Prohibit staff persons from being directly employed by a resident or a resident's family during the hours the staff person is working for the assisted living facility;

(d) Maintain the following documentation on the assisted living facility premises, during employment, and at least two years following termination of employment:

(i) Staff orientation and training or certification pertinent to duties, including, but not limited to:

(A) Training required by chapter 388-112A WAC;

(B) The assisted living facility certified as a memory care facility or memory care unit must ensure long-term care workers who work directly with memory care residents have at least six hours per year of continuing education related to dementia. The six hours of continuing education related to dementia may be part of the continuing education requirements under chapter 388-112A WAC;

(D) Cardiopulmonary resuscitation; and

(E) First aid;

(ii) Disclosure statements and background checks as required in WAC 388-78A-2461 through 388-78A-2471; and

(iii) Documentation of contacting work references and professional licensing and certification boards as required by subsection (2) of this section.

(6) The assisted living facility is not required to keep on the assisted living facility premises, staff records that are unrelated to staff performance of duties. Such records include, but are not limited to, pay records, and health and insurance benefits for staff.

History

Statutory Authority: RCW 18.20.090 and 18.20.550. WSR 26-15-066, s 388-78A-2450, filed 7/15/26, effective 8/15/26. Statutory Authority: RCW 18.20.090, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 25-16-099, s 388-78A-2450, filed 8/6/25, effective 9/6/25. Statutory Authority: Chapter 18.20 RCW. WSR 18-20-018, § 388-78A-2450, filed 9/21/18, effective 10/22/18
WSR 13-13-063, § 388-78A-2450, filed 6/18/13, effective 7/19/13. Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 10-16-085, § 388-78A-2450, filed 7/30/10, effective 1/1/11. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2450, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2460 Quality assurance committee.

(1) To ensure the proper delivery of services and the maintenance and improvement in quality of care through self-review, any assisted living facility licensed under this chapter may maintain a quality assurance committee that, at a minimum, includes:

(a) A licensed registered nurse under chapter 18.79 RCW;

(b) The administrator; and

(2) When established, the quality assurance committee shall meet at least quarterly to identify issues that may adversely affect quality of care and services to residents and to develop and implement plans of action to correct identified quality concerns or deficiencies in the quality of care provided to residents.

(3) To promote quality of care through self-review without the fear of reprisal, and to enhance the objectivity of the review process, the department shall not require, and the long-term care ombuds program shall not request, disclosure of any quality assurance committee records or reports, unless the disclosure is related to the committee's compliance with this section, if:

(a) The records or reports are not maintained pursuant to statutory or regulatory mandate; and

(b) The records or reports are created for and collected and maintained by the committee.

(4) If the assisted living facility refuses to release records or reports that would otherwise be protected under this section, the department may then request only that information that is necessary to determine whether the assisted living facility has a quality assurance committee and to determine that it is operating in compliance with this section. However, if the assisted living facility offers the department documents generated by, or for, the quality assurance committee as evidence of compliance with assisted living facility requirements, the documents are protected as quality assurance committee documents when in the possession of the department.

(5) Good faith attempts by the committee to identify and correct quality deficiencies shall not be used as a basis for sanctions.

(6) Any records that are created for and collected and maintained by the quality assurance committee shall not be discoverable or admitted into evidence in a civil action brought against an assisted living facility.

(7) Notwithstanding any records created for the quality assurance committee, the facility shall fully set forth in the resident's records, available to the resident, the department, and others as permitted by law, the facts concerning any incident of injury or loss to the resident, the steps taken by the facility to address the resident's needs, and the resident outcome.

History

Statutory Authority: Chapter 18.20 RCW, RCW 18.20.090. WSR 19-14-031, § 388-78A-2460, filed 6/25/19, effective 7/26/19. Statutory Authority: Chapter 18.20 RCW. WSR 14-05-035, § 388-78A-2460, filed 2/12/14, effective 3/15/14
WSR 13-13-063, § 388-78A-2460, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2460, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2461 Background checks—General.

(1) Background checks conducted by the department and required in this chapter include:

(a) Washington state name and date of birth background checks; and

(b) After January 7, 2012, a national fingerprint background check in accordance with RCW 74.39A.056.

(2) Nothing in this chapter should be interpreted as requiring the employment of a person against the better judgment of the assisted living facility.

(3) In addition to chapter 18.20 RCW, these rules are authorized by RCW 43.20A.710, RCW 43.43.830 through 43.43.842 and RCW 74.39A.051.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2461, filed 6/18/13, effective 7/19/13
WSR 12-21-070, § 388-78A-2461, filed 10/18/12, effective 11/18/12. Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 10-16-085, § 388-78A-2461, filed 7/30/10, effective 1/1/11.

Wash. Admin. Code § 388-78A-2462 Background checks—Who is required to have.

(1) Applicants for an assisted living facility license, as defined in WAC 388-78A-2740, must have the following background checks before licensure:

(a) A Washington state name and date of birth background check; and

(b) A national fingerprint background check.

(2) The assisted living facility must ensure that the administrator and all caregivers employed directly or by contract after January 7, 2012 have the following background checks:

(a) A Washington state name and date of birth background check; and

(b) A national fingerprint background check.

(3) The assisted living facility must ensure that the following individuals have a Washington state name and date of birth background check:

(a) Volunteers who are not residents, and students who may have unsupervised access to residents;

(b) Staff persons who are not caregivers or administrators;

(d) Contractors other than the administrator and caregivers who may have unsupervised access to residents.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2462, filed 6/18/13, effective 7/19/13
WSR 12-21-070, § 388-78A-2462, filed 10/18/12, effective 11/18/12. Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 10-16-085, § 388-78A-2462, filed 7/30/10, effective 1/1/11.

Wash. Admin. Code § 388-78A-2464 Background checks—Process—Background authorization form.

Before the assisted living facility employs, directly or by contract, an administrator, staff person or caregiver, or accepts any volunteer, or student, the home must:

(1) Require the person to complete a DSHS background authorization form; and

(2) Submit to the department's background check central unit, including any additional documentation and information requested by the department.

History

Statutory Authority: RCW 74.39A.056, chapter 18.20 RCW. WSR 14-14-031, § 388-78A-2464, filed 6/24/14, effective 7/25/14. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2464, filed 6/18/13, effective 7/19/13
WSR 12-21-070, § 388-78A-2464, filed 10/18/12, effective 11/18/12. Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 10-16-085, § 388-78A-2464, filed 7/30/10, effective 1/1/11.

Wash. Admin. Code § 388-78A-24641 Background checks—Washington state name and date of birth background check.

Unless the individual is eligible for an exception under WAC 388-113-0040, if the results of the Washington state name and date of birth background check indicate the person has a disqualifying criminal conviction or a pending charge for a disqualifying crime under chapter 388-113 WAC, or a disqualifying negative action under WAC 388-78A-2470, then the assisted living facility must:

(1) Not employ, directly or by contract, a caregiver, administrator, or staff person; and

(2) Not allow a volunteer or student to have unsupervised access to residents.

History

Statutory Authority: RCW 74.39A.056, chapter 18.20 RCW. WSR 14-14-031, § 388-78A-24641, filed 6/24/14, effective 7/25/14. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-24641, filed 6/18/13, effective 7/19/13
WSR 12-21-070, § 388-78A-24641, filed 10/18/12, effective 11/18/12.

Wash. Admin. Code § 388-78A-24642 Background checks—National fingerprint background check.

(1) Administrators and all caregivers who are hired after January 7, 2012 and are not disqualified by the Washington state name and date of birth background check, must complete a national fingerprint background check and follow department procedures.

(2) After receiving the results of the national fingerprint background check the assisted living facility must not employ, directly or by contract, an administrator or caregiver who has a disqualifying criminal conviction or pending charge for a disqualifying crime under chapter 388-113 WAC, or that is disqualifying under WAC 388-78A-2470.

(3) The assisted living facility may accept a copy of the national fingerprint background check results letter and any additional information from the department's background check central unit from an individual who previously completed a national fingerprint check through the department's background check central unit, provided the national fingerprint background check was completed after January 7, 2012.

History

Statutory Authority: RCW 74.39A.056, chapter 18.20 RCW. WSR 14-14-031, § 388-78A-24642, filed 6/24/14, effective 7/25/14. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-24642, filed 6/18/13, effective 7/19/13
WSR 12-21-070, § 388-78A-24642, filed 10/18/12, effective 11/18/12.

Wash. Admin. Code § 388-78A-2465 Background check—Results—Inform.

(1) After receiving the results of the Washington state name and date of birth background check, the assisted living facility must:

(a) Inform the person of the results of the background check;

(b) Inform the person that they may request a copy of the results of the background check. If requested, a copy of the background check results must be provided within ten days of the request; and

(c) Notify the department and other appropriate licensing or certification agency of any person resigning or terminated as a result of having a disqualifying criminal conviction or pending charge for a disqualifying crime under chapter 388-113 WAC, or a negative action that is disqualifying under WAC 388-78A-2470.

(2) After receiving the result letter for the national fingerprint background check, the assisted living facility must inform the person:

(a) Of the national fingerprint background check result letter;

(b) That they may request a copy of the national fingerprint check result letter; and

History

Statutory Authority: RCW 74.39A.056, chapter 18.20 RCW. WSR 14-14-031, § 388-78A-2465, filed 6/24/14, effective 7/25/14. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2465, filed 6/18/13, effective 7/19/13
WSR 12-21-070, § 388-78A-2465, filed 10/18/12, effective 11/18/12. Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 10-16-085, § 388-78A-2465, filed 7/30/10, effective 1/1/11.

Wash. Admin. Code § 388-78A-2466 Background checks—Washington state name and date of birth background check—Valid for two years—National fingerprint background check—Valid indefinitely.

(1) A Washington state name and date of birth background check is valid for two years from the initial date it is conducted. The assisted living facility must ensure:

(a) A new DSHS background authorization form is submitted to the department's background check central unit every two years for all administrators, caregivers, staff persons, volunteers and students; and

(b) There is a valid Washington state name and date of birth background check for all administrators, caregivers, staff persons, volunteers and students.

(2) A national fingerprint background check is valid for an indefinite period of time. The assisted living facility must ensure there is a valid national fingerprint background check completed for all administrators and caregivers hired after January 7, 2012. To be considered valid, the national fingerprint background check must be initiated and completed through the department's background check central unit after January 7, 2012.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2466, filed 6/18/13, effective 7/19/13
WSR 12-21-070, § 388-78A-2466, filed 10/18/12, effective 11/18/12. Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 10-16-085, § 388-78A-2466, filed 7/30/10, effective 1/1/11.

Wash. Admin. Code § 388-78A-2467 Background check—Sharing by health care facilities.

In accordance with RCW 43.43.832 a health care facility may share Washington state background check results with other health care facilities under certain circumstances. Results of the national fingerprint checks may not be shared. For the purposes of this section health care facility means a nursing home licensed under chapter 18.51 RCW, an assisted living facility licensed under chapter 18.20 RCW, or an adult family home licensed under chapter 70.128 RCW.

(1) The health care facility may, upon request from another health care facility, share completed Washington state background check results only if:

(a) The health care facility sharing the background check information is reasonably known to be the person's most recent employer;

(b) No more than twelve months has elapsed between the date the individual was last employed at a licensed health care facility and the date of the individual's current employment application;

(d) The assisted living facility has no reason to believe the individual has a disqualifying criminal conviction or pending charge for a disqualifying crime under chapter 388-113 WAC, a negative action that is disqualifying under WAC 388-78A-2470.

(2) The assisted living facility may also establish, maintain and follow a written agreement with home health, hospice, or home care agencies licensed under chapter 70.127 RCW or nursing pools registered under chapter 18.52C RCW in order to ensure that the agency or pool staff meet the requirements of WAC 388-78A-2470.

History

Statutory Authority: RCW 74.39A.056, chapter 18.20 RCW. WSR 14-14-031, § 388-78A-2467, filed 6/24/14, effective 7/25/14. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2467, filed 6/18/13, effective 7/19/13. Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 10-16-085, § 388-78A-2467, filed 7/30/10, effective 1/1/11.

Wash. Admin. Code § 388-78A-2468 Background checks—Employment—Conditional hire—Pending results of Washington state name and date of birth background check.

The assisted living facility may conditionally hire an administrator, caregiver, or staff person directly or by contract, pending the result of the Washington state name and date of birth background check, provided that the assisted living facility:

(1) Submits the background authorization form for the person to the department no later than one business day after he or she starts working;

(2) Requires the person to sign a disclosure statement indicating if he or she has a disqualifying criminal conviction or pending charge for a disqualifying crime under chapter 388-113 WAC, or a negative action that is disqualifying under WAC 388-78A-2470;

(3) Has received three positive references for the person;

(4) Does not allow the person to have unsupervised access to any resident;

(5) Ensures direct supervision of the administrator, all caregivers, and staff persons; and

(6) Ensures that the person is competent, and receives the necessary training to perform assigned tasks and meets the training requirements under chapter 388-112 WAC.

History

Statutory Authority: RCW 74.39A.056, chapter 18.20 RCW. WSR 14-14-031, § 388-78A-2468, filed 6/24/14, effective 7/25/14. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2468, filed 6/18/13, effective 7/19/13
WSR 12-21-070, § 388-78A-2468, filed 10/18/12, effective 11/18/12. Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 10-16-085, § 388-78A-2468, filed 7/30/10, effective 1/1/11.

Wash. Admin. Code § 388-78A-24681 Background checks—Employment—Provisional hire—Pending results of national fingerprint background check.

The assisted living facility may provisionally employ a caregiver and an administrator hired after January 7, 2012 for one hundred and twenty-days and allow the caregiver or administrator to have unsupervised access to residents when:

(1) The caregiver or administrator is not disqualified based on the results of the Washington state name and date of birth background check; and

(2) The results of the national fingerprint background check are pending.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-24681, filed 6/18/13, effective 7/19/13
WSR 12-21-070, § 388-78A-24681, filed 10/18/12, effective 11/18/12.

Wash. Admin. Code § 388-78A-2469 Background check—Disclosure statement.

(1) The assisted living facility must require each administrator, caregiver, staff person, volunteer and student, prior to starting his or her duties, to make disclosures of any crimes or findings consistent with RCW 43.43.834(2). The disclosures must be in writing and signed by the person under penalty of perjury.

(2) The department may require the assisted living facility or any administrator, caregiver, staff person, volunteer or student to complete additional disclosure statements or background authorization forms if the department has reason to believe that a disqualifying criminal conviction or pending charge for a disqualifying crime under chapter 388-113 WAC, or a negative action that is disqualifying under WAC 388-78A-2470 have occurred since completion of the previous disclosure statement or background check.

History

Statutory Authority: RCW 74.39A.056, chapter 18.20 RCW. WSR 14-14-031, § 388-78A-2469, filed 6/24/14, effective 7/25/14. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2469, filed 6/18/13, effective 7/19/13
WSR 12-21-070, § 388-78A-2469, filed 10/18/12, effective 11/18/12. Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 10-16-085, § 388-78A-2469, filed 7/30/10, effective 1/1/11.

Wash. Admin. Code § 388-78A-2470 Background check—Employment-disqualifying information—Disqualifying negative actions.

(1) The assisted living facility must not employ an administrator, caregiver, or staff person, to have unsupervised access to residents, as defined in RCW 43.43.830, if the individual has a disqualifying criminal conviction or pending charge for a disqualifying crime under chapter 388-113 WAC, unless the individual is eligible for an exception under WAC 388-113-0040.

(2) The assisted living facility must not employ an administrator, caregiver, or staff person, or allow an administrator, caregiver, or staff person to have unsupervised access to residents, as defined in RCW 43.43.830, if the individual has one or more of the following disqualifying negative actions:

(a) A court has issued a permanent restraining order or order of protection, either active or expired, against the person that was based upon abuse, neglect, financial exploitation, or mistreatment of a child or vulnerable adult;

(b) The individual is a registered sex offender;

(c) The individual is on a registry based upon a final finding of abuse, neglect or financial exploitation of a vulnerable adult, unless the finding was made by adult protective services prior to October 2003;

(d) A founded finding of abuse or neglect of a child was made against the person, unless the finding was made by child protective services prior to October 1, 1998;

(e) The individual was found in any dependency action to have sexually assaulted or exploited any child or to have physically abused any child;

(f) The individual was found by a court in a domestic relations proceeding under Title 26 RCW, or under any comparable state or federal law, to have sexually abused or exploited any child or to have physically abused any child;

(g) The person has had a contract or license denied, terminated, revoked, or suspended due to abuse, neglect, financial exploitation, or mistreatment of a child or vulnerable adult; or

(h) The person has relinquished a license or terminated a contract because an agency was taking an action against the individual related to alleged abuse, neglect, financial exploitation or mistreatment of a child or vulnerable adult.

History

Statutory Authority: RCW 74.39A.056, chapter 18.20 RCW. WSR 14-14-031, § 388-78A-2470, filed 6/24/14, effective 7/25/14. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2470, filed 6/18/13, effective 7/19/13
WSR 12-21-070, § 388-78A-2470, filed 10/18/12, effective 11/18/12. Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 10-16-085, § 388-78A-2470, filed 7/30/10, effective 1/1/11. Statutory Authority: Chapter 18.20 RCW. WSR 10-03-066, § 388-78A-2470, filed 1/15/10, effective 2/15/10. Statutory Authority: Chapters 18.20 and 74.34 RCW. WSR 09-01-052, § 388-78A-2470, filed 12/10/08, effective 1/10/09. Statutory Authority: RCW 18.20.090 and chapters 18.20 and 74.34 RCW. WSR 08-05-099, § 388-78A-2470, filed 2/15/08, effective 3/17/08. Statutory Authority: RCW 18.20.090. WSR 06-01-047, § 388-78A-2470, filed 12/15/05, effective 1/15/06. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2470, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-24701 Background checks—Employment—Nondisqualifying information.

(1) If the background check results show that an employee or prospective employee has a criminal conviction or pending charge for a crime that is not a disqualifying crime under chapter 388-113 WAC, then the assisted living facility must determine whether the person has the character, competence and suitability to work with vulnerable adults in long-term care.

(2) Nothing in this section should be interpreted as requiring the employment of any person against the better judgment of the assisted living facility.

History

Statutory Authority: RCW 74.39A.056, chapter 18.20 RCW. WSR 14-14-031, § 388-78A-24701, filed 6/24/14, effective 7/25/14. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-24701, filed 6/18/13, effective 7/19/13
WSR 12-21-070, § 388-78A-24701, filed 10/18/12, effective 11/18/12.

Wash. Admin. Code § 388-78A-2471 Background check—Confidentiality—Use restricted—Retention.

The assisted living facility must ensure that all disclosure statements, background authorization forms, background check results and related information are:

(1) Maintained on-site in a confidential and secure manner;

(2) Used for employment purposes only;

(3) Not disclosed to anyone except to the individual, authorized state and federal employees, the Washington state patrol auditor, persons or health care facilities authorized by chapter 43.43 RCW; and

(4) Retained and available for department review during the individual's employment or association with a facility and for at least two years after termination of the employment or association.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2471, filed 6/18/13, effective 7/19/13. Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 10-16-085, § 388-78A-2471, filed 7/30/10, effective 1/1/11.

Wash. Admin. Code § 388-78A-2474 Training and home care aide certification requirements.

(1) The assisted living facility must ensure staff persons hired before January 7, 2012 meet training requirements in effect on the date hired, including requirements in chapter 388-112A WAC.

(2) The assisted living facility must ensure all assisted living facility administrators, or their designees, and caregivers hired on or after January 7, 2012 meet the long-term care worker training requirements of chapter 388-112A WAC, including but not limited to:

(a) Orientation and safety;

(b) Basic;

(c) Specialty for dementia, mental illness and/or developmental disabilities when serving residents with any of those primary special needs;

(d) Cardiopulmonary resuscitation and first aid; and

(e) Continuing education.

(3) The assisted living facility must ensure that all staff receive appropriate training and orientation to perform their specific job duties and responsibilities.

(4) The assisted living facility must ensure all persons listed in subsection (2) of this section, obtain the home-care aide certification.

(5) Under RCW 18.88B.041 and chapter 246-980 WAC, certain individuals including registered nurses, licensed practical nurses, certified nursing assistants, or persons who are in an approved certified nursing assistant training program are exempt from long-term care worker basic training requirements. Continuing education requirements under chapter 388-112A WAC still apply to these individuals, except for registered nurses and licensed practical nurses.

(6) For the purpose of this section, the term "caregiver" has the same meaning as the term "long-term care worker" as defined in RCW 74.39A.009.

History

Statutory Authority: Chapter 18.20 RCW. WSR 18-20-018, § 388-78A-2474, filed 9/21/18, effective 10/22/18
WSR 14-05-035, § 388-78A-2474, filed 2/12/14, effective 3/15/14
WSR 13-13-063, § 388-78A-2474, filed 6/18/13, effective 7/19/13
WSR 12-21-070, § 388-78A-2474, filed 10/18/12, effective 11/18/12
WSR 12-01-003, § 388-78A-2474, filed 12/7/11, effective 1/7/12. Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 10-16-085, § 388-78A-2474, filed 7/30/10, effective 1/1/11.

Wash. Admin. Code § 388-78A-2480 Tuberculosis—Testing—Required.

(1) The assisted living facility must develop and implement a system to ensure each staff person is screened for tuberculosis within three days of employment.

(2) For purposes of WAC 388-78A-2481 through 388-78A-2489, "staff person" means any assisted living facility employee or temporary employee of the assisted living facility, excluding volunteers and contractors.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2480, filed 6/18/13, effective 7/19/13
WSR 10-03-066, § 388-78A-2480, filed 1/15/10, effective 2/15/10. Statutory Authority: RCW 18.20.090. WSR 06-24-073, § 388-78A-2480, filed 12/4/06, effective 1/4/07
WSR 06-01-047, § 388-78A-2480, filed 12/15/05, effective 1/15/06. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2480, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2481 Tuberculosis—Testing method—Required.

The assisted living facility must ensure that all tuberculosis testing is done through either:

(1) Intradermal (Mantoux) administration with test results read:

(a) Within forty-eight to seventy-two hours of the test; and

(b) By a trained professional; or

(2) A blood test for tuberculosis called interferon-gamma release assay (IGRA).

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2481, filed 6/18/13, effective 7/19/13
WSR 10-03-066, § 388-78A-2481, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-78A-2482 Tuberculosis—No testing.

The assisted living facility is not required to have a staff person tested for tuberculosis if the staff person has:

(1) A documented history of a previous positive skin test, with ten or more millimeters induration;

(2) A documented history of a previous positive blood test; or

(3) Documented evidence of:

(a) Adequate therapy for active disease; or

(b) Completion of treatment for latent tuberculosis infection preventive therapy.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2482, filed 6/18/13, effective 7/19/13
WSR 10-03-066, § 388-78A-2482, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-78A-2483 Tuberculosis—One test.

The assisted living facility is only required to have a staff person take one test if the staff person has any of the following:

(1) A documented history of a negative result from a previous two step skin test done no more than one to three weeks apart; or

(2) A documented negative result from one skin or blood test in the previous twelve months.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2483, filed 6/18/13, effective 7/19/13
WSR 10-03-066, § 388-78A-2483, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-78A-2484 Tuberculosis—Two step skin testing.

Unless the staff person meets the requirement for having no skin testing or only one test, the assisted living facility choosing to do skin testing, must ensure that each staff person has the following two-step skin testing:

(1) An initial skin test within three days of employment; and

(2) A second test done one to three weeks after the first test.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2484, filed 6/18/13, effective 7/19/13
WSR 10-03-066, § 388-78A-2484, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-78A-2485 Tuberculosis—Positive test result.

When there is a positive result to tuberculosis skin or blood testing the assisted living facility must:

(1) Ensure that the staff person has a chest X-ray within seven days;

(2) Ensure each resident or staff person with a positive test result is evaluated for signs and symptoms of tuberculosis; and

(3) Follow the recommendation of the resident or staff person's health care provider.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2485, filed 6/18/13, effective 7/19/13
WSR 10-03-066, § 388-78A-2485, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-78A-2486 Tuberculosis—Negative test result.

The assisted living facility may be required by the public health provider or licensing authority to ensure that staff persons with negative test results have follow-up testing in certain circumstances, such as:

(1) After exposure to active tuberculosis;

(2) When tuberculosis symptoms are present; or

(3) For periodic testing as determined by the public health provider.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2486, filed 6/18/13, effective 7/19/13
WSR 10-03-066, § 388-78A-2486, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-78A-2487 Tuberculosis—Declining a skin test.

The assisted living facility must ensure that a staff person take the blood test for tuberculosis if they decline the skin test.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2487, filed 6/18/13, effective 7/19/13
WSR 10-03-066, § 388-78A-2487, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-78A-2488 Tuberculosis—Reporting—Required.

The assisted living facility must:

(1) Report any staff person or resident with tuberculosis symptoms or a positive chest X-ray to the appropriate health care provider, or public health provider;

(2) Follow the infection control and safety measures ordered by the staff person's health care provider including a public health provider;

(3) Institute appropriate infection control measures;

(4) Apply living or work restrictions where residents or staff persons are, or may be, infectious and pose a risk to other residents and staff persons; and

(5) Ensure that staff person's caring for a resident with suspected tuberculosis comply with the WISHA standard for respiratory protection found in chapter 296-842 WAC.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2488, filed 6/18/13, effective 7/19/13
WSR 10-03-066, § 388-78A-2488, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-78A-2489 Tuberculosis—Test records.

The assisted living facility must:

(1) Keep the records of tuberculin test results, reports of X-ray findings, and any physician or public health provider orders in the assisted living facility;

(2) Make the records readily available to the appropriate health provider and licensing agency,

(3) Retain the records for at least two years after the date the staff person either quits or is terminated; and

(4) Provide the staff person a copy of his/her test results.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2489, filed 6/18/13, effective 7/19/13
WSR 10-03-066, § 388-78A-2489, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-78A-2490 Specialized training for developmental disabilities.

The assisted living facility must ensure completion of specialized training, consistent with chapter 388-112A WAC, to serve residents with developmental disabilities, whenever at least one of the residents in the assisted living facility has a developmental disability as defined in WAC 388-823-0040, that is the resident's primary special need.

History

Statutory Authority: Chapter 18.20 RCW. WSR 18-20-018, § 388-78A-2490, filed 9/21/18, effective 10/22/18
WSR 13-13-063, § 388-78A-2490, filed 6/18/13, effective 7/19/13. Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 10-16-085, § 388-78A-2490, filed 7/30/10, effective 1/1/11. Statutory Authority: RCW 18.20.090. WSR 06-01-047, § 388-78A-2490, filed 12/15/05, effective 1/15/06. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2490, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2500 Specialized training for mental illness.

The assisted living facility must ensure completion of specialized training, consistent with chapter 388-112A WAC, to serve residents with mental illness, whenever at least one of the residents in the assisted living facility has a mental illness that is the resident's primary special need and is a person who has been diagnosed with or treated for an Axis I or Axis II diagnosis, as described in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, and:

(1) Who has received the diagnosis or treatment within the previous two years; and

(2) Whose diagnosis was made by, or treatment provided by, one of the following:

(a) A licensed physician;

(b) A mental health professional;

(d) A licensed psychologist.

History

Statutory Authority: Chapter 18.20 RCW. WSR 18-20-018, § 388-78A-2500, filed 9/21/18, effective 10/22/18
WSR 13-13-063, § 388-78A-2500, filed 6/18/13, effective 7/19/13. Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 10-16-085, § 388-78A-2500, filed 7/30/10, effective 1/1/11. Statutory Authority: RCW 18.20.090. WSR 06-01-047, § 388-78A-2500, filed 12/15/05, effective 1/15/06. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2500, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2510 Specialized training for dementia.

The assisted living facility must ensure completion of specialized training, consistent with chapter 388-112A WAC, to serve residents with dementia, whenever at least one of the residents in the assisted living facility has a dementia that is the resident's primary special need and has symptoms consistent with dementia as assessed per WAC 388-78A-2090(7).

History

Statutory Authority: Chapter 18.20 RCW. WSR 18-20-018, § 388-78A-2510, filed 9/21/18, effective 10/22/18
WSR 13-13-063, § 388-78A-2510, filed 6/18/13, effective 7/19/13. Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 10-16-085, § 388-78A-2510, filed 7/30/10, effective 1/1/11. Statutory Authority: RCW 18.20.090. WSR 06-01-047, § 388-78A-2510, filed 12/15/05, effective 1/15/06. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2510, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2520 Administrator qualifications—General.

(1) The licensee must appoint an administrator who is:

(a) At least twenty-one years old;

(b) Not a resident of the assisted living facility; and

(2) The licensee must only appoint as an assisted living facility administrator an individual who meets the requirements of at least one of the following sections in WAC 388-78A-2522 through 388-78A-2527.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2520, filed 6/18/13, effective 7/19/13
WSR 10-03-066, § 388-78A-2520, filed 1/15/10, effective 2/15/10. Statutory Authority: RCW 18.20.090. WSR 06-01-047, § 388-78A-2520, filed 12/15/05, effective 1/15/06. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2520, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2521 Certification of training.

As used in WAC 388-78A-2522 through 388-78A-2527, an individual obtains certification of training as follows. The individual has certification of completing a recognized administrator training course that consists of a minimum of twenty-four hours of instruction or equivalent online training, or certification of passing an administrator examination from or endorsed by a department-recognized national accreditation health or personal care organization such as:

(1) The American association of homes and services for the aging;

(2) The American college of health care administrators;

(3) The American health care association;

(4) The assisted living federation of America; or

(5) The national association of board of examiners of long term care administrators.

History

Statutory Authority: Chapter 18.20 RCW. WSR 10-03-066, § 388-78A-2521, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-78A-2522 Administrator qualifications—Prior to 2004.

The individual was actively employed as an assisted living facility administrator and met existing qualifications on September 1, 2004.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2522, filed 6/18/13, effective 7/19/13
WSR 10-03-066, § 388-78A-2522, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-78A-2523 Administrator qualifications—NH administrator license.

The individual holds a current Washington state nursing home administrator license in good standing.

History

Statutory Authority: Chapter 18.20 RCW. WSR 10-03-066, § 388-78A-2523, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-78A-2524 Administrator qualifications—Certification of training, and three years experience.

Prior to assuming duties as a boarding home administrator, the individual has met the following qualifications:

(1) Obtained certification of completing a recognized administrator training as referenced in WAC 388-78A-2521; and

(2) Has three years paid experience:

(a) Providing direct care to vulnerable adults in a setting licensed by a state agency for the care of vulnerable adults, such as a nursing home, assisted living facility, or adult family home, or a setting having a contract with a recognized social service agency for the provision of care to vulnerable adults, such as supported living; and/or

(b) Managing persons providing direct care to vulnerable adults in a setting licensed by a state agency for the care of vulnerable adults, such as a nursing home, assisted living facility, or adult family home, or a setting having a contract with a recognized social service agency for the provision of care to vulnerable adults, such as supported living.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2524, filed 6/18/13, effective 7/19/13
WSR 10-03-066, § 388-78A-2524, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-78A-2525 Administrator qualifications—Associate degree, certification of training, and two years experience.

The individual holds an associate degree in a related field of study such as health, social work, or business administration and meets the qualifications listed in either subsection (1), (2) or (3) of this section:

(1) Obtains certification of completing a recognized administrator training course as referenced in WAC 388-78A-2521 within six months of beginning duties as the administrator; or

(2) Has two years paid experience:

(3) Has completed a qualifying administrator training program supervised by a qualified administrator according to WAC 388-78A-2530.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2525, filed 6/18/13, effective 7/19/13
WSR 10-03-066, § 388-78A-2525, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-78A-2526 Administrator qualifications—Bachelor's degree, certification of training, and one year experience.

The individual holds a bachelor's degree in a related field of study such as health, social work, or business administration and meets the qualifications listed in either subsection (1), (2) or (3) of this section.

(1) Obtains certification of completing a recognized administrator training course and referenced in WAC 388-78A-2521 within six months of beginning duties as the administrator; or

(2) Has one year paid experience:

(3) Has completed a qualifying administrator training program supervised by a qualified administrator according to WAC 388-78A-2530.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2526, filed 6/18/13, effective 7/19/13
WSR 10-03-066, § 388-78A-2526, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-78A-2527 Administrator qualifications—Five years experience.

Before assuming duties as an administrator, the individual has five years of paid experience:

(1) Providing direct care to vulnerable adults in a setting licensed by a state agency for the care of vulnerable adults, such as a nursing home, assisted living facility, or adult family home, or a setting having a contract with a recognized social service agency for the provision of care to vulnerable adults, such as supported living; and/or

(2) Managing persons providing direct care to vulnerable adults in a setting licensed by a state agency for the care of vulnerable adults, such as a nursing home, assisted living facility, or adult family home, or a setting having a contract with a recognized social service agency for the provision of care to vulnerable adults, such as supported living.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2527, filed 6/18/13, effective 7/19/13
WSR 10-03-066, § 388-78A-2527, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-78A-2530 Qualifying administrator training program.

Before the licensee appoints an individual who must have completed a qualifying administrator training program in order to qualify as an assisted living facility administrator, the licensee must verify the individual has completed the training and obtain documentation from the individual that the training program met the following requirements:

(1) The department was notified of the beginning date of the administrator training program;

(2) The administrator training program was at least six months in duration following notification of the department;

(3) Only training, supervision, and experience occurring following notification of the department were credited to the qualifying training;

(4) The supervising administrator met the qualifications to be an administrator specified in WAC 388-78A-2520;

(5) The trainee was a full-time employee of an assisted living facility and spent at least forty percent of his/her time for six months of the training program performing administrative duties customarily assigned to assisted living facility administrators or included in the job description of the administrator for the assisted living facility in which the training occurred;

(6) The supervising administrator was present on-site at the assisted living facility during the time the trainee performed administrator duties;

(7) The supervising administrator spent a minimum of one hundred direct contact hours with the trainee during the six months supervising and consulting with the trainee;

(8) Both the trainee and supervising administrator signed documentation of the trainee's qualifying experience and the supervising administrator's performance of required oversight duties; and

(9) The individual completing the qualifying administrator training program maintains the documentation of completing the program.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2530, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2530, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2540 Administrator requirements.

The licensee must ensure the assisted living facility administrator:

(1) Meets the training requirements under chapter 388-112A WAC; and

(2) Knows and understands how to apply Washington state statutes and administrative rules related to the operation of an assisted living facility; and

(3) Meets the administrator qualification requirements referenced in WAC 388-78A-2520 through 388-78A-2527.

History

Statutory Authority: Chapter 18.20 RCW. WSR 18-20-018, § 388-78A-2540, filed 9/21/18, effective 10/22/18
WSR 13-13-063, § 388-78A-2540, filed 6/18/13, effective 7/19/13
WSR 10-03-066, § 388-78A-2540, filed 1/15/10, effective 2/15/10. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2540, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2550 Administrator training documentation.

The assisted living facility must maintain for department review, documentation of the administrator completing:

(1) Training required by chapter 388-112A WAC;

(2) Department training in an overview of Washington state statutes and administrative rules related to the operation of an assisted living facility;

(3) As applicable, certification from a department-recognized national accreditation health or personal care organization; and

(4) As applicable, the qualifying administrator-training program.

History

Statutory Authority: Chapter 18.20 RCW. WSR 18-20-018, § 388-78A-2550, filed 9/21/18, effective 10/22/18
WSR 13-13-063, § 388-78A-2550, filed 6/18/13, effective 7/19/13. Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 10-16-085, § 388-78A-2550, filed 7/30/10, effective 1/1/11. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2550, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2560 Administrator responsibilities.

The licensee must ensure the administrator:

(1) Directs and supervises the overall twenty-four-hour-per-day operation of the assisted living facility;

(2) Ensures residents receive adequate care and services that meet the standards of this chapter;

(3) Is readily accessible to meet with residents;

(4) Complies with the assisted living facility's policies;

(5) When the administrator is not available on the premises, either:

(a) Is available by telephone or electronic pager; or

(b) Designates a person approved by the licensee to act in place of the administrator. The designee must be:

(i) Qualified by experience to assume designated duties; and

(ii) Authorized to make necessary decisions and direct operations of the assisted living facility during the administrator's absence.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2560, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2560, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2570 Notification of change in administrator.

The licensee must notify the department in writing within ten calendar days of the effective date of a change in the assisted living facility administrator. The notice must include the full name of the new administrator and the effective date of the change.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2570, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2570, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2580 Use of home health/home care.

If an assisted living facility licensee also has a home health or home care license, the licensee may not provide care or services to nonresident individuals living in independent living units on the assisted living facility premises under the home health or home care license if:

(1) The licensee assumes general responsibility for the safety and well-being of the individual;

(2) The individual requiring such services is not able to receive them in his or her own home and is required to move to another room as a condition for receiving such services;

(3) The individual receiving such services is required to receive them from the licensee as a condition for residing in the building, and is not free to receive such services from any appropriately licensed provider of his or her choice; or

(4) The licensee provides other care or services to the individual that falls under the jurisdiction of assisted living facility licensing and this chapter.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2580, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2580, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2590 Management agreements—General.

(1) If the proposed or current licensee uses a manager, the licensee must have a written management agreement that is consistent with this chapter.

(2) The proposed or current licensee must notify the department of its use of a manager upon:

(a) Initial application for a license;

(b) Retention of a manager following initial application;

(d) Modification of existing management agreement.

(3) The proposed or current licensee must provide to the department a written management agreement, including an organizational chart showing the relationship between the proposed or current licensee, management company, and all related organizations.

(4) The written management agreement must be submitted:

(a) Sixty days before:

(i) The initial licensure date;

(ii) The proposed change of ownership date; or

(iii) The effective date of the management agreement; or

(b) Thirty days before the effective date of any amendment to an existing management agreement.

(5) The proposed licensee or the current licensee must notify the resident and their representatives sixty days before entering into a new management agreement.

(6) A proposed licensee must submit a management agreement attestation form, as required by the assisted living facility application.

History

Statutory Authority: Chapter 18.20 RCW. WSR 18-08-032, § 388-78A-2590, filed 3/27/18, effective 4/27/18
WSR 10-03-066, § 388-78A-2590, filed 1/15/10, effective 2/15/10. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2590, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2592 Management agreements—Licensee.

(1) The licensee is responsible for:

(a) The daily operations and provisions of services in the assisted living facility, as required by WAC 388-78A-2730 (1)(a);

(b) Ensuring the assisted living facility is operated in a manner consistent with all laws and rules applicable to assisted living facilities, as required by WAC 388-78A-2730 (1)(b);

(d) Ensuring the manager does not represent itself as, or give the appearance that it is the licensee.

(2) The licensee must not give the manager responsibilities that are so extensive that the licensee is relieved of daily responsibility for the daily operations and provision of services in the assisted living facility. If the licensee does so, then the department must determine that a change of ownership has occurred.

(3) The licensee and manager must act in accordance with the terms of the management agreements. If the department determines they are not, then the department may impose enforcement remedies.

(4) The licensee may enter into a management agreement only if the management agreement creates a principal/agent relationship between the licensee and manager.

History

Statutory Authority: Chapter 18.20 RCW. WSR 18-08-032, § 388-78A-2592, filed 3/27/18, effective 4/27/18
WSR 13-13-063, § 388-78A-2592, filed 6/18/13, effective 7/19/13
WSR 10-03-066, § 388-78A-2592, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-78A-2593 Management agreements—Terms of agreement.

Management agreements, at a minimum must:

(1) Describe the responsibilities of the licensee and manager, including items, services, and activities to be provided;

(2) Require the licensee's governing body, board of directors, or similar authority to appoint the facility administrator;

(3) Provide for the maintenance and retention of all records in accordance with this chapter and other applicable laws;

(4) Allow unlimited access by the department to documentation and records according to applicable laws or regulations;

(5) Require the manager to immediately send copies of inspections and notices of noncompliance to the licensee;

(6) State that the licensee is responsible for reviewing, acknowledging and signing all assisted living facility initial and renewal license applications;

(7) State that the manager and licensee will review the management agreement annually and notify the department of any change according to applicable regulations;

(8) Acknowledge that the licensee is the party responsible for complying with all laws and rules applicable to assisted living facilities;

(9) Require the licensee to maintain ultimate responsibility over personnel issues relating to the operation of the assisted living facility and care of the residents, including but not limited to, staffing plans, orientation and training;

(10) State the manager will not represent itself, or give the appearance it is the licensee; and

(11) State that a duly authorized manager may execute resident leases or agreements on behalf of the licensee, but all such resident leases or agreements must be between the licensee and the resident.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2593, filed 6/18/13, effective 7/19/13
WSR 10-03-066, § 388-78A-2593, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-78A-2594 Management agreements—Department review.

The department may review a management agreement at any time. Following the review, the department may require:

(1) The proposed or current licensee or manager to provide additional information or clarification;

(2) Any changes necessary to:

(a) Bring the management agreement into compliance with this chapter; and

(b) Ensure that the licensee has not been relieved of the responsibility for the daily operations of the facility.

(3) The licensee to participate in monthly meetings and quarterly on-site visits to the assisted living facility.

History

Statutory Authority: Chapter 18.20 RCW. WSR 18-08-032, § 388-78A-2594, filed 3/27/18, effective 4/27/18
WSR 13-13-063, § 388-78A-2594, filed 6/18/13, effective 7/19/13
WSR 10-03-066, § 388-78A-2594, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-78A-2595 Management agreements—Resident funds.

(1) If the management agreement delegates day-to-day management of resident funds to the manager, the licensee:

(a) Retains all fiduciary and custodial responsibility for funds that have been deposited with the assisted living facility by the resident;

(b) Is directly accountable to the residents for such funds; and

(c) Must ensure any party responsible for holding or managing residents' personal funds is bonded or obtains insurance in sufficient amounts to specifically cover losses of resident funds; and provides proof of bond or insurance.

(2) If responsibilities for the day-to-day management of the resident funds are delegated to the manager, the manager must:

(a) Provide the licensee with a monthly accounting of the resident funds; and

(b) Meet all legal requirements related to holding, and accounting for, resident funds.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2595, filed 6/18/13, effective 7/19/13
WSR 10-03-066, § 388-78A-2595, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-78A-2600 Policies and procedures.

WAC 388-78A-2600

(1) The assisted living facility must develop and implement policies and procedures in support of services that are provided and are necessary to:

(a) Maintain or enhance the quality of life for residents including resident decision-making rights;

(b) Provide the necessary care and services for residents, including those with special needs;

(d) Operate in compliance with state and federal law, including, but not limited to, chapters 7.70, 69.41, 70.122, 70.129, and 74.34 RCW, and any rules promulgated under these statutes.

(2) The assisted living facility must develop, implement, and train staff persons on policies and procedures to address what staff persons must do:

(a) Related to suspected abandonment, abuse, neglect, exploitation, or financial exploitation of any resident;

(b) When there is reason to believe a resident is not capable of making necessary decisions and no substitute decision maker is available;

(d) When a resident stops breathing or a resident's heart appears to stop beating, including, but not limited to, any action staff persons must take related to advance directives and emergency care;

(e) When a resident does not have a personal physician or health care provider;

(f) In response to medical emergencies;

(g) When there are urgent situations in the assisted living facility requiring additional staff support;

(h) In the event of an internal or external disaster, consistent with WAC 388-78A-2700;

(i) To supervise and monitor residents, including accounting for residents who leave the premises;

(j) To appropriately respond to aggressive or assaultive residents, including, but not limited to:

(i) Actions to take if a resident becomes violent;

(ii) Actions to take to protect other residents; and

(iii) When and how to seek outside intervention.

(k) To prevent and limit the spread of infections consistent with WAC 388-78A-2610;

(l) To manage residents' medications, consistent with WAC 388-78A-2210 through 388-78A-2290; sending medications with a resident when the resident leaves the premises;

(m) When services related to medications and treatments are provided under the delegation of a registered nurse consistent with chapter 246-840 WAC;

(n) Related to food services consistent with chapter 246-215 WAC and WAC 388-78A-2300;

(o) Regarding the safe operation of any assisted living facility vehicles used to transport residents, and the qualifications of the drivers;

(p) To coordinate services and share resident information with outside resources, consistent with WAC 388-78A-2350;

(q) To coordinate with state and local agencies and ombuds;

(r) Regarding the management of pets in the assisted living facility, if permitted, consistent with WAC 388-78A-2620;

(s) When receiving and responding to resident grievances consistent with RCW 70.129.060; and

(t) Related to providing respite care services consistent with RCW 18.20.350, if respite care is offered.

(3) For an assisted living facility certified as a memory care facility or memory care unit, the facility must develop, implement, and train staff persons on policies and procedures to address what a staff person must do:

(a) To respond to and manage residents who wander;

(b) When a resident is missing; and

(c) To utilize consultative services, when needed, for residents with behavioral challenges. This policy will identify at a minimum:

(i) A relevant professional, including but not limited to, a clinical psychologist, psychiatrist, psychiatric nurse practitioner, or a specialist with demonstrated experience working with individuals with cognitive disorders;

(ii) When the consultation will be utilized; and

(iii) How the consultation will be utilized.

(4) The assisted living facility must make the policies and procedures specified in subsection (2) and (3) of this section available to staff persons at all times and must inform residents and residents' representatives of their availability and make them available upon request.

History

Statutory Authority: RCW 18.20.090 and 18.20.550. WSR 26-15-066, s 388-78A-2600, filed 7/15/26, effective 8/15/26. Statutory Authority: RCW 18.20.090, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 25-16-099, s 388-78A-2600, filed 8/6/25, effective 9/6/25. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2600, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090, 2008 c 146, and chapter 18.20 RCW. WSR 09-01-079, § 388-78A-2600, filed 12/15/08, effective 1/15/09. Statutory Authority: RCW 18.20.090 and chapters 18.20 and 74.34 RCW. WSR 08-05-099, § 388-78A-2600, filed 2/15/08, effective 3/17/08. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2600, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2610 Infection control.

(1) The assisted living facility must institute appropriate infection control practices in the assisted living facility to prevent and limit the spread of infections.

(2) The assisted living facility must:

(a) Develop and implement a system to identify and manage infections;

(b) Restrict a staff person's contact with residents when the staff person has a known communicable disease in the infectious stage that is likely to be spread in the assisted living facility setting or by casual contact;

(c) Maintain and provide staff persons with the necessary training, supplies, equipment, and personal protective equipment for preventing and controlling the spread of infections by:

(i) Maintaining a list of vendors and suppliers; and

(ii) Ordering supplies when necessary.

(d) Provide all resident care and services according to current acceptable standards for infection control;

(e) Perform all housekeeping, cleaning, laundry, and management of infectious waste according to current acceptable standards for infection control; and

(f) Report communicable diseases in accordance with the requirements in chapter 246-100 WAC.

History

Statutory Authority: RCW 18.20.090, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 25-16-099, s 388-78A-2610, filed 8/6/25, effective 9/6/25. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2610, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2610, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2620 Pets.

If an assisted living facility allows pets to live on the premises, the assisted living facility must:

(1) Develop, implement and disclose to potential and current residents, policies regarding:

(a) The types of pets that are permitted in the assisted living facility; and

(b) The conditions under which pets may be in the assisted living facility.

(2) Ensure animals living on the assisted living facility premises:

(a) Have regular examinations and immunizations, appropriate for the species, by a veterinarian licensed in Washington state;

(b) Are certified by a veterinarian to be free of diseases transmittable to humans;

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2620, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2620, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2630 Reporting abuse and neglect.

WAC 388-78A-2630

(1) The assisted living facility must ensure that each staff person:

(a) Makes a report to the department's complaint resolution unit hotline or complete an online report consistent with chapter 74.34 RCW in all cases where the staff person has reasonable cause to believe that abandonment, abuse, financial exploitation, or neglect of a vulnerable adult has occurred; and

(b) Makes an immediate report to the appropriate law enforcement agency and the department consistent with chapter 74.34 RCW of all incidents of suspected sexual abuse or physical abuse of a resident.

(2) The assisted living facility must prominently post so it is readily visible to staff, residents and visitors, the department's toll-free telephone number for reporting resident abuse and neglect.

History

Statutory Authority: RCW 18.20.090 and 18.20.550. WSR 26-15-066, s 388-78A-2630, filed 7/15/26, effective 8/15/26. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2630, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2630, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2640 Reporting significant change in a resident's condition.

(1) The assisted living facility must consult with the resident's representative, the resident's physician, and other individual(s) designated by the resident as soon as possible whenever:

(a) There is a significant change in the resident's condition;

(b) The resident is relocated to a hospital or other health care facility; or

(2) The assisted living facility must notify any agency responsible for paying for the resident's care and services as soon as possible whenever:

(a) The resident is relocated to a hospital or other health care facility; or

(b) The resident dies.

(3) Whenever the conditions in subsection (1) or (2) of this section occur, the assisted living facility must document in the resident's records:

(a) The date and time each individual was contacted; and

(b) The individual's relationship to the resident.

(4) In case of a resident's death, the assisted living facility must notify the coroner if required by RCW 68.50.010.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2640, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2640, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2650 Reporting fires and incidents.

WAC 388-78A-2650

The assisted living facility must immediately report to the department's complaint resolution unit hotline or complete an online report for:

(1) Any accidental or unintended fire, or any deliberately set but improper fire, such as arson, in the assisted living facility;

(2) Any unusual incident that required implementation of the assisted living facility's disaster plan, including any evacuation of all or part of the residents to another area of the assisted living facility or to another address; and

(3) Circumstances which threaten the assisted living facility's ability to ensure continuation of services to residents.

History

Statutory Authority: RCW 18.20.090 and 18.20.550. WSR 26-15-066, s 388-78A-2650, filed 7/15/26, effective 8/15/26. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2650, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2650, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2651 Written residency agreement—Residents with medicaid as a payor.

(1) For the purposes of this section "residency agreement" means a legally enforceable written document prepared by the assisted living facility that contains the rights and responsibilities of the facility and the resident specific to transfer and discharge and is signed by both parties.

(2) For residents with medicaid as a payor the facility must complete a signed written residency agreement with each resident that:

(a) Is signed by the resident or their legal representative and the facility upon admission of the resident to the facility;

(b) Requires the facility to agree to comply with the long-term care residents rights statute transfer and discharge requirements pursuant to RCW 70.129; and

(c) Requires the facility to provide notice to residents before transfer and discharge that includes information about available legal resources, and notice that, subject to legislative appropriation, residents have the right to legal counsel at public expense upon notice of transfer or discharge.

(3) For residents whose payor status changes from medicaid to private pay, a new residency agreement is required if the resident's payor status returns to medicaid.

(4) A copy of the residency agreement that is signed and dated by both parties must be:

(a) Kept in the resident record; and

(b) Provided to the resident or their representative.

(5) The residency agreement must be in substantially the following form:

Residency agreement—residents with medicaid as a payor.

(a) [facility name] agrees to comply with the long-term care residents rights statute transfer and discharge requirements pursuant to RCW 70.129.

(d) [Signature of facility and date].

Reviser's note: The brackets and enclosed material in the text of the above section occurred in the copy filed by the agency.

Wash. Admin. Code § 388-78A-2660 Resident rights.

The assisted living facility must:

(1) Comply with chapter 70.129 RCW, Long-term care resident rights;

(2) Ensure all staff persons provide care and services to each resident consistent with chapter 70.129 RCW;

(3) Not use restraints on any resident;

(4) Promote and protect the residents' exercise of all rights granted under chapter 70.129 RCW;

(5) Provide care and services to each resident in compliance with applicable state statutes related to substitute health care decision making, including chapters 7.70 and 70.122 RCW;

(6) Reasonably accommodate residents consistent with applicable state and federal law;

(7) Not allow any staff person to abuse or neglect any resident; and

(8) In circumstances in which limitations must be placed on resident visitation due to a public health emergency or other threat to the health and safety of the residents and staff of a facility or nursing home, residents must still be allowed access to an essential support person, subject to reasonable limitations on such access tailored to protecting the health and safety of essential support persons, residents, and staff, as defined in WAC 388-78A-2020.

History

Statutory Authority: RCW 18.20.090, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 25-16-099, s 388-78A-2660, filed 8/6/25, effective 9/6/25. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2660, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090. WSR 06-01-047, § 388-78A-2660, filed 12/15/05, effective 1/15/06. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2660, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2661 Resident rights—Transfer and discharge notice—Residents with medicaid as a payor.

For residents with medicaid as a payor, in addition to the requirements in WAC 388-78A-2660, the assisted living facility must do the following when issuing a written notice of transfer or discharge:

(1) Include in the notice contact information provided by the department for the legal services agencies assigned to provide legal counsel;

(3) Within three calendar days of issuing the notice, provide a copy of the notice to the resident's assigned department case manager;

(4) Within three calendar days of issuing the notice, provide a copy of the notice to the Washington state long-term care ombudsman program; and

(5) Issue the transfer and discharge notice in substantially the following form:

Notice of transfer or discharge—residents with medicaid as a payor:

(a) Resident information;

(i) Resident name;

(ii) Resident address;

(b) Facility information;

(i) Facility name;

(ii) Facility address;

(iii) Contact person's name;

(d) Effective date: Effective date must be at least 30 days from the date notice is given unless an exception applies according to RCW 70.129.110;

(e) Location to where resident is transferred or discharged:

(i) Name;

(ii) Address;

(iii) Phone;

(f) Reason for transfer or discharge: The specific reason for the transfer or discharge must be one or more of the reasons in (i)-(v) of this subsection:

(i) Transfer or discharge is necessary for the resident's welfare and the residents' needs cannot be met in the facility;

(ii) The safety of individuals in the facility is endangered;

(iii) The health of individuals in the facility would otherwise be endangered;

(iv) The resident has failed to make the required payment for their stay;

(v) The facility ceases to operate.

(g) Copy of notice given within three days to:

(i) Department case manager;

(ii) Washington state long-term care ombudsman program;

(h) Your rights and resources;

(iii) Disability rights Washington: If you have a diagnosis of a mental illness or an intellectual disability, you may contact disability rights Washington 1-800-562-2702 or (206) 324-1521. You may also make your request in writing by fax at (206) 957-0729, email at info@dr-wa.org or mail at disability rights Washington, 315 5th Ave S, Suite 850, Seattle WA, 98104.

(iv) DSHS home and community living administration (HCLA): You have the right to make a complaint to the complaint resolution unit (CRU/complaint hotline) 1-800-562-6078.

History

Statutory Authority: RCW 18.20.090, 70.97.230, and 70.128.040. WSR 26-08-074, s 388-78A-2661, filed 3/30/26, effective 4/30/26. Statutory Authority: RCW 18.20.090, 70.97.230, 70.128.040, 74.09.520(2), 74.39A.007, 42 C.F.R. 441.530 (a)(1)(vi)(A), and 441.301 (c)(4)(vi)(A). WSR 25-18-037, s 388-78A-2661, filed 8/25/25, effective 1/1/26.

Wash. Admin. Code § 388-78A-2665 Resident rights—Notice—Policy on accepting medicaid as a payment source.

The assisted living facility must fully disclose the facility's policy on accepting medicaid payments. The policy must:

(1) Clearly state the circumstances under which the assisted living facility provides care for medicaid eligible residents and for residents who become eligible for medicaid after admission;

(2) Be provided both orally and in writing in a language that the resident understands;

(3) Be provided to prospective residents, before they are admitted to the home;

(4) Be provided to any current residents who were admitted before this requirement took effect or who did not receive copies prior to admission;

(5) Be written on a page that is separate from other documents and be written in a type font that is at least fourteen point; and

(6) Be signed and dated by the resident and be kept in the resident record after signature.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2665, filed 6/18/13, effective 7/19/13
WSR 10-03-066, § 388-78A-2665, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-78A-2670 Services by resident for assisted living facility.

If a resident performs services for the assisted living facility, the assisted living facility must ensure:

(1) The resident freely volunteers to perform the services without coercion or pressure from staff persons;

(2) The resident performing services does not supervise, or is not placed in charge of, other residents; and

(3) If the resident regularly performs voluntary services for the benefit of the assisted living facility, the volunteer activity is addressed in the resident's negotiated service agreement.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2670, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2670, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2680 Electronic monitoring equipment—Audio monitoring and video monitoring.

(1) Except as provided in this section or in WAC 388-78A-2690, the assisted living facility must not use the following in the facility or on the premises:

(a) Audio monitoring equipment; or

(b) Video monitoring equipment if it includes an audio component.

(2) The assisted living facility may video monitor and video record activities in the facility or on the premises, without an audio component, only in the following areas:

(a) Entrances, exits, and elevators as long as the cameras are:

(i) Focused only on the entrance or exit doorways; and

(ii) Not focused on areas where residents gather.

(b) Areas used exclusively by staff persons such as, medication preparation and storage areas or food preparation areas, if residents do not go into these areas;

(c) Outdoor areas accessible to both residents and the public, such as, but not limited to, parking lots, provided that the purpose of such monitoring is to prevent theft, property damage, or other crime on the premises.

(d) Outdoor areas not commonly used by residents, such as, but not limited to, delivery areas, emergency exits, or exits from a secured outdoor space for memory care;

(e) Resident fitness centers and pool areas; and

(f) Designated smoking areas, subject to the following conditions:

(i) Residents have been assessed as needing supervision for smoking;

(ii) A staff person watches the video monitor at any time the area is used by such residents;

(iii) The video camera is clearly visible;

(iv) The video monitor is not viewable by general public; and

(v) The facility notifies all residents in writing of the use of video monitoring equipment.

(3) The assisted living facility may only video record community activities in the facility or on the premises with the audio component when the following are met:

(a) A resident requests an activity be recorded;

(b) A sign is posted at the entry to the activity area in which the event occurs and at the time of the event, to notify residents of the video, audio recording, or both; and

(c) The facility notifies all residents in writing for each use of video and audio monitoring equipment, providing that the residents' likeness will not be used in promotional materials without their written consent.

(4) The presence of cameras must not alter the obligation of the assisted living facility to provide appropriate in-person assistance and monitoring due to individual physical or cognitive limitations.

History

Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 20-02-104, § 388-78A-2680, filed 12/31/19, effective 1/31/20. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2680, filed 6/18/13, effective 7/19/13. Statutory Authority: Chapters 18.20 and 74.34 RCW. WSR 09-01-052, § 388-78A-2680, filed 12/10/08, effective 1/10/09. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2680, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2690 Electronic monitoring equipment—Resident requested use.

(1) Audio or video monitoring equipment may not be installed in the assisted living facility to monitor any resident apartment or sleeping area unless the resident or the residents' representative has requested and consents to the monitoring.

(2) Electronic monitoring equipment must be installed in a manner that is safe for residents.

(3) A facility must not refuse to admit an individual, or discharge a resident, because of a request to conduct authorized electronic monitoring.

(4) A resident may limit his or her consent for use of electronic monitoring devices to specific times or situation, pointing the camera in a particular direction, or prohibiting the use of certain devices.

(5) The release of audio or video monitoring recordings by the facility is prohibited. Each person or organization with access to the electronic monitoring must be identified in the resident's negotiated service agreement.

(6) If the resident requests the assisted living facility to conduct audio or video monitoring of his or her apartment or sleeping area, before any electronic monitoring occurs, the assisted living facility must ensure:

(a) That the electronic monitoring does not violate chapter 9.73 RCW;

(b) The resident's roommate has provided written consent to electronic monitoring, if the resident has a roommate; and

(c) The resident and the assisted living facility have agreed upon a specific duration for the electronic monitoring and the agreement is documented in writing.

(7) The assisted living facility must:

(a) Reevaluate the need for the electronic monitoring with the resident at least quarterly; and

(b) Have each reevaluation in writing, signed and dated by the resident.

(8) The assisted living facility must immediately stop electronic monitoring if the:

(a) Resident no longer wants electronic monitoring;

(b) Roommate objects or withdraws the consent to the electronic monitoring; or

(c) The resident becomes unable to give consent, unless consent has been provided by a resident's representative as described in this section.

(9) For the purpose of consenting to video electronic monitoring without an audio component, the term "resident" includes the resident's representative.

(10) For the purposes of consenting to any audio electronic monitoring, the term "resident" includes:

(a) The individual residing in the assisted living facility; or

(11) If a resident's decision maker consents to audio electronic monitoring as specified in (10) above, the assisted living facility must maintain a copy of the court order authorizing such consent in the resident's record.

(12) If the assisted living facility determines that a resident, resident's family, or other third party is electronically monitoring a resident's room or apartment without complying with the requirements of this section, the assisted living facility must disconnect or remove such equipment until the appropriate consent is obtained and notice given as required by this section.

(13) Nothing in this section prohibits or limits an assisted living facility from implementing electronic monitoring pursuant to a resident's negotiated service plan, including but not limited to motion sensor alerts, floor pressure sensors, or global positioning devices, where the monitoring does not entail the transmittal or recording of a human-viewable image, sound or resident name.

History

Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 20-02-104, § 388-78A-2690, filed 12/31/19, effective 1/31/20. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2690, filed 6/18/13, effective 7/19/13. Statutory Authority: Chapters 18.20 and 74.34 RCW. WSR 09-01-052, § 388-78A-2690, filed 12/10/08, effective 1/10/09. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2690, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2700 Emergency and disaster preparedness.

WAC 388-78A-2700

(1) The assisted living facility must:

(a) Maintain the premises free of hazards;

(b) Maintain any vehicles used for transporting residents in a safe condition;

(c) Provide, and tell staff persons of a means of emergency access to resident-occupied bedrooms, toilet rooms, bathing rooms, and other rooms;

(d) Provide emergency lighting or flashlights in all areas accessible to residents of the assisted living facility;

(e) Make sure first-aid supplies are:

(i) Readily available and not locked;

(ii) Clearly marked;

(iii) Able to be moved to the location where needed; and

(iv) Stored in containers that protect them from damage, deterioration, or contamination.

(f) Make sure first-aid supplies are appropriate for:

(i) The size of the assisted living facility;

(ii) The services provided;

(iii) The residents served; and

(iv) The response time of emergency medical services.

(2) The assisted living facility must develop and maintain a written emergency preparedness plan that describes measures to take in the event of emergencies or disasters, including, but not limited to:

(a) Fires;

(b) Earthquakes;

(d) Extreme heat;

(e) Floods;

(f) Infectious disease outbreaks;

(g) Loss of power or water; and

(h) Other events that may require sheltering in place, evacuations, or other emergency measures to protect the health and safety of residents.

(3) The assisted living facility's emergency preparedness plan must include procedures for:

(a) Staff roles and responsibilities;

(b) Identifying and locating residents;

(d) Communicating emergency information to staff and residents as well as external partners, including emergency contacts for residents, state and local agencies, developmental disability ombuds, and long-term care ombuds;

(e) How resident care and treatment needs will be maintained;

(f) Provision of essential resident needs and supplies, including water, food, medications, and personal care items;

(g) Alternative resident accommodations; and

(h) An assisted living facility certified as a memory care facility or memory care unit must address the special needs of residents with dementia.

(4) The assisted living facility must incorporate infection prevention and control capability into its emergency preparedness plan. At minimum, the plan must:

(a) Include procedures for the procurement, inventory, tracking, safe storage, and rotation of personal protective equipment to ensure supplies remain within manufacturer recommended shelf life and are available for use; and

(b) Describe how the facility will ensure adequate staffing and implement isolation or cohorting procedures during an infectious disease emergency.

(5) In addition to the plan requirements, the assisted living facility must:

(a) Maintain an adequate supply of personal protective equipment appropriate to the facility size and resident population, including, but not limited to: gloves, gowns, surgical masks, eye protection, and NIOSH–approved respirators;

(b) Train all employees in the comprehensive emergency preparedness plan and staff procedures upon hire and reviewed annually thereafter;

(d) Communicate the location of the emergency preparedness plan to residents and staff to ensure access as needed during emergencies; and

(e) Comply with WAC 388-78A-3140.

History

Statutory Authority: RCW 18.20.090 and 18.20.550. WSR 26-15-066, s 388-78A-2700, filed 7/15/26, effective 8/15/26. Statutory Authority: RCW 18.20.090, 18.51.070, 70.97.230, chapters 70.129, 74.42, and 74.39 RCW. WSR 26-02-045, s 388-78A-2700, filed 1/2/26, effective 2/2/26. Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 20-02-104, § 388-78A-2700, filed 12/31/19, effective 1/31/20. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2700, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090. WSR 06-01-047, § 388-78A-2700, filed 12/15/05, effective 1/15/06. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2700, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2703 Safety of the built environment.

The assisted living facility must provide a safe environment and promote the safety of each resident whenever the resident is on the premises or under the supervision of staff persons consistent with the resident's negotiated service agreement, and must maintain the premises and equipment used in resident care so as to be free of hazards, including:

(1) Providing handrails in halls, corridors, lobbies, and other circulation spaces accessible to residents appropriate to the population served and consistent with the facility functional program.

(2) Maintaining nonskid surfaces on all stairways and ramps used by residents.

(3) Keeping exterior grounds, assisted living facility structures, and component parts safe, sanitary, and in good repair.

(4) Providing door hardware to ensure:

(a) Residents cannot lock themselves in, or out of, rooms or areas accessible to them; and

(b) Residents cannot become locked in storage rooms, closets, or other rooms or areas not intended for resident access.

(5) Providing and informing staff persons of a means of emergency access to resident-occupied bedrooms, toilet rooms, bathing rooms, and other rooms.

History

Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 20-02-104, § 388-78A-2703, filed 12/31/19, effective 1/31/20.

Wash. Admin. Code § 388-78A-2710 Disclosure of services.

(1) The assisted living facility must disclose to residents, the resident's representative, if any, and interested consumers upon request, the scope of care and services it offers, on the department's approved disclosure forms. The disclosure form shall not be construed as an implied or express contract between the assisted living facility and the resident, but is intended to assist consumers in selecting assisted living facility services.

(2) The assisted living facility must provide the services disclosed.

(3) The assisted living facility must provide a minimum of thirty days written notice to the residents and the residents' representatives, if any:

(a) Before the effective date of any decrease in the scope of care or services provided by the assisted living facility, due to circumstances beyond the assisted living facility's control; and

(b) Before the effective date of any voluntary decrease in the scope of care or services provided by the assisted living facility, and any such decrease in the scope of services provided will not result in the discharge of one or more residents.

(4) The assisted living facility must provide a minimum of ninety days written notice to the residents and the residents' representative, if any, before the effective date of any voluntary decrease in the scope of care or services provided by the assisted living facility, and any such decrease in the scope of services provided will result in the discharge of one or more residents.

(5) If the assisted living facility increases the scope of services that it chooses to provide, the assisted living facility must promptly provide written notice to the residents and residents' representative, if any, and must indicate the date on which the increase in the scope of care or services is effective.

(6) When the care needs of a resident exceed the disclosed scope of care or services that an assisted living facility provides, the assisted living facility may exceed the care or services disclosed consistent with RCW 70.129.030(3) and 70.129.110 (3)(a).

(7) Even though the assisted living facility may disclose that it can provide certain care or services to residents or prospective residents or residents' representative, if any, the assisted living facility may deny admission to a prospective resident when the assisted living facility determines that the needs of the prospective resident cannot be met, as long as the assisted living facility operates in compliance with state and federal law, including reasonable accommodation requirements and RCW 70.129.030(3).

(8) The assisted living facility must notify prospective residents of their rights regarding health care decision making consistent with applicable state and federal laws and rules, before or at the time the individual moves into the assisted living facility.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2710, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2710, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2720 Timing of disclosure.

(1) The assisted living facility must provide the disclosure form completed by the assisted living facility:

(a) In response to a request by a prospective resident or his or her representative, if any, for written information about the assisted living facility's services and capabilities; or

(b) At the time the assisted living facility provides an application for residency, an admission agreement or contract, if not previously received by the prospective resident or his or her representative, if any.

(2) The assisted living facility is not required to provide the disclosure of care and services contained on the department's approved disclosure forms:

(a) In advertisements;

(b) In general marketing information to the public; or

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2720, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2720, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2730 Licensee's responsibilities.

WAC 388-78A-2730

(1) The assisted living facility licensee is responsible for:

(a) The operation of the assisted living facility;

(b) Complying at all times with the requirements of this chapter, chapter 18.20 RCW, and other applicable laws and rules; and

(2) The licensee must:

(a) Maintain the occupancy level at or below the licensed resident bed capacity of the assisted living facility;

(b) Maintain and post in a size and format that is easily read, in a conspicuous place on the assisted living facility premises:

(i) A current assisted living facility license, including any related conditions on the license;

(ii) A current memory care certification as required in RCW 18.20.540;

(iii) The name, address, and telephone number of:

(A) The department;

(B) Appropriate resident advocacy groups; and

(iv) A copy of the report, including the cover letter, and plan of correction of the most recent full inspection conducted by the department; and

(v) Post stop placement and limited stop placement orders as required in RCW 18.20.520.

(c) Ensure any party responsible for holding or managing residents' personal funds is bonded or obtains insurance in sufficient amounts to specifically cover losses of resident funds; and provides proof of bond or insurance to the department.

(3) The licensee must not delegate to any person responsibilities that are so extensive that the licensee is relieved of responsibility for the daily operations and provisions of services in the assisted living facility.

(4) The licensee must act in accord with any department-approved management agreement, if the licensee has entered into a management agreement.

(5) The licensee must appoint the assisted living facility administrator consistent with WAC 388-78A-2520.

History

Statutory Authority: RCW 18.20.090 and 18.20.550. WSR 26-15-066, s 388-78A-2730, filed 7/15/26, effective 8/15/26. Statutory Authority: RCW 18.20.090, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 25-16-099, s 388-78A-2730, filed 8/6/25, effective 9/6/25. Statutory Authority: Chapter 18.20 RCW. WSR 14-05-035, § 388-78A-2730, filed 2/12/14, effective 3/15/14
WSR 13-13-063, § 388-78A-2730, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090, 2008 c 146, and chapter 18.20 RCW. WSR 09-01-079, § 388-78A-2730, filed 12/15/08, effective 1/15/09. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2730, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2732 Liability insurance required—Ongoing.

The assisted living facility must:

(1) Obtain liability insurance upon licensure and maintain the insurance as required in WAC 388-78A-2733 and 388-78A-2734; and

(2) Have evidence of liability insurance coverage available if requested by the department.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2732, filed 6/18/13, effective 7/19/13
WSR 10-03-066, § 388-78A-2732, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-78A-2733 Liability insurance required—Commercial general liability insurance or business liability insurance coverage.

The assisted living facility must have commercial general liability insurance or business liability insurance that includes:

(1) Coverage for the acts and omissions of any employee and volunteer;

(2) Coverage for bodily injury, property damage, and contractual liability;

(3) Coverage for premises, operations, independent contractor, products-completed operations, personal injury, advertising injury, and liability assumed under an insured contract; and

(4) Minimum limits of:

(a) Each occurrence at one million dollars; and

(b) General aggregate at two million dollars.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2733, filed 6/18/13, effective 7/19/13
WSR 10-03-066, § 388-78A-2733, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-78A-2734 Liability insurance required—Professional liability insurance coverage.

The assisted living facility must have professional liability insurance or error and omissions insurance if the assisted living facility licensee has a professional license, or employs professionally licensed staff. The insurance must include:

(1) Coverage for losses caused by errors and omissions of the assisted living facility, its employees, and volunteers; and

(2) Minimum limits of:

(a) Each occurrence at one million dollars; and

(b) Aggregate at two million dollars.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2734, filed 6/18/13, effective 7/19/13
WSR 10-03-066, § 388-78A-2734, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-78A-2740 Licensee qualifications.

The department must consider separately and jointly as applicants each person named in the application for an assisted living facility license.

(1) If the department finds any person unqualified as specified in WAC 388-78A-3190, the department must deny, terminate, or not renew the license.

(2) If the department finds any person unqualified as specified in WAC 388-78A-3170, the department may deny, terminate, or not renew the license.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2740, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2740, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2750 Application process.

WAC 388-78A-2750

(1) To apply for an assisted living facility license, a person must:

(a) Submit to the department a complete license application on forms designated by the department at least 90 days prior to the proposed effective date of the license;

(b) Submit all relevant attachments specified in the application;

(d) Sign the application;

(e) Submit the license fee as specified in WAC 388-78A-3230;

(f) Submit verification that construction plans have been approved by construction review services;

(g) Submit a revised application before the license is issued if any information has changed since the initial license application was submitted; and

(h) Submit a revised application containing current information about the proposed licensee or any other persons named in the application, if a license application is pending for more than one year.

(2) If the licensee's agent prepares an application on the licensee's behalf, the licensee must review, sign, and attest to the accuracy of the information contained in the application.

(3) The department may consider an application void when the applicant or licensee's agent does not return information to the department within 60 days of the first request for additional information for an incomplete application.

(4) A license must be issued only to the person who applied for the license.

(5) A license may not exceed 12 months in duration and expires on a date set by the department.

(6) To apply for a memory care certification, a person must:

(a) Submit to the department a complete application for certification on the form designated by the department at least 90 days prior to the proposed date of certification;

(b) Sign the application for memory care certification; and

(7) If the licensee's agent prepares the memory care certification application on behalf of the licensee, the licensee must review, sign, and attest to the accuracy of the information contained in the certification application.

(8) A memory care certification must only be issued to the entity who applied for the certification.

(9) A certification may not exceed 12 months in duration and expires on the date set by the department.

History

Statutory Authority: RCW 18.20.090 and 18.20.550. WSR 26-15-066, s 388-78A-2750, filed 7/15/26, effective 8/15/26. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2750, filed 6/18/13, effective 7/19/13
WSR 12-21-070, § 388-78A-2750, filed 10/18/12, effective 11/18/12
WSR 12-01-003, § 388-78A-2750, filed 12/7/11, effective 1/7/12. Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 10-16-085, § 388-78A-2750, filed 7/30/10, effective 1/1/11. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2750, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2760 Necessary information.

WAC 388-78A-2760

(1) In making a determination whether to issue an assisted living facility license, in addition to the information for each person named in the application, the department may review other documents and information the department deems relevant, including inspection and complaint investigation findings for each facility with which the applicant or any partner, officer, director, managerial employee, or owner of five percent or more of the applicant has been affiliated.

(2) In making a determination whether to issue a certification for memory care, the department may review other documents and information the department deems relevant, including enforcement remedies, inspections, and complaint investigation findings for each facility applying for certification.

History

Statutory Authority: RCW 18.20.090 and 18.20.550. WSR 26-15-066, s 388-78A-2760, filed 7/15/26, effective 8/15/26. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2760, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2760, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2770 Change in licensee/change of ownership—When change in licensee is required.

The licensee of an assisted living facility must change whenever the following events occur, including, but not limited to:

(1) The licensee's form of legal organization is changed (e.g., a sole proprietor forms a partnership or corporation);

(2) The licensee transfers ownership of the assisted living facility business enterprise to another party regardless of whether ownership of some or all of the real property and/or personal property assets of the assisted living facility is also transferred;

(3) The licensee dissolves, or consolidates or merges with another legal organization and the licensee's legal organization does not survive;

(4) If, during any continuous twenty-four-month period, fifty percent or more of the "licensed entity" is transferred, whether by a single transaction or multiple transactions, to:

(a) A different person (e.g., new or former shareholders or partners); or

(b) A person that had less than a five percent ownership interest in the assisted living facility at the time of the first transaction.

(5) Any other event or combination of events that results in a substitution, elimination, or withdrawal of the licensee's control of the assisted living facility. As used in this section, "control" means the possession, directly or indirectly, of the power to direct the management, operation and/or policies of the licensee or assisted living facility, whether through ownership, voting control, by agreement, by contract or otherwise.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2770, filed 6/18/13, effective 7/19/13
WSR 09-06-063, § 388-78A-2770, filed 3/2/09, effective 4/2/09. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2770, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2773 Change in licensee/change of ownership—When change in licensee not required.

The licensee is not required to change when only the following, without more, occur:

(1) The licensee contracts with a party to manage the assisted living facility enterprise for the licensee pursuant to an agreement as specified in WAC 388-78A-2590; or

(2) The real property or personal property assets of the assisted living facility are sold or leased, or a lease of the real property or personal property assets is terminated, as long as there is not a substitution or substitution of control of the licensee or assisted living facility.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2773, filed 6/18/13, effective 7/19/13
WSR 09-06-063, § 388-78A-2773, filed 3/2/09, effective 4/2/09.

Wash. Admin. Code § 388-78A-2775 Change in licensee/change of ownership—Application.

WAC 388-78A-2775

(1) The prospective licensee must complete, sign, and submit to the department a change of ownership application prior to the proposed date of change in licensee.

(2) The annual assisted living facility license fee, if a license fee is due, must accompany the change in ownership application.

(3) The prospective licensee must submit the following information that must be submitted along with the change of ownership application:

(a) Evidence of control of the real estate on which the assisted living facility is located, such as a purchase and sales agreement, lease contract, or other appropriate document; and

(b) Any other information requested by the department.

(4) The prospective licensee must submit the completed application to the department within the applicable time frames of WAC 388-78A-2785 or 388-78A-2787.

(5) A prospective licensee completing a change of ownership for an assisted living facility with a memory care certification must:

(a) Apply for a memory care certification at the same time an application for change of ownership is submitted to the department; and

(b) Submit the initial certification fee with the certification application.

History

Statutory Authority: RCW 18.20.090 and 18.20.550. WSR 26-15-066, s 388-78A-2775, filed 7/15/26, effective 8/15/26. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2775, filed 6/18/13, effective 7/19/13
WSR 09-06-063, § 388-78A-2775, filed 3/2/09, effective 4/2/09.

Wash. Admin. Code § 388-78A-2777 Change in licensee/change of ownership—Revised application.

The prospective licensee must submit a revised application to the department if:

(1) Any information included on the original application is no longer accurate; or

(2) Requested by the department.

History

Statutory Authority: Chapter 18.20 RCW. WSR 09-06-063, § 388-78A-2777, filed 3/2/09, effective 4/2/09.

Wash. Admin. Code § 388-78A-2780 Change in licensee/change of ownership—Notice to department and residents.

(1) In order to change the licensee of an assisted living facility, the current licensee must notify the following in writing of the proposed change in licensee:

(a) The department; and

(b) All residents, or resident representatives (if any).

(2) The licensee must include the following information in the written notice:

(a) Name of the present licensee and prospective licensee;

(b) Name and address of the assisted living facility for which the licensee is being changed;

(d) If the assisted living facility contracts with the department, health care authority or other public agencies that may make payments for residential care on behalf of residents, the anticipated effect, such as discharge from the assisted living facility, the change of licensee will have on residents whose care and services are supported through these contracts.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2780, filed 6/18/13, effective 7/19/13
WSR 12-01-003, § 388-78A-2780, filed 12/7/11, effective 1/7/12
WSR 09-06-063, § 388-78A-2780, filed 3/2/09, effective 4/2/09. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2780, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2783 Change in licensee/change of ownership—Relinquishment of license.

(1) On the effective date of the change in licensee, the current assisted living facility licensee is required to relinquish their assisted living facility license.

(2) To relinquish a license, the licensee must mail the department the assisted living facility license along with a letter, addressed to the department, stating licensee's intent to relinquish the assisted living facility license to the department.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2783, filed 6/18/13, effective 7/19/13
WSR 09-06-063, § 388-78A-2783, filed 3/2/09, effective 4/2/09.

Wash. Admin. Code § 388-78A-2785 Change in licensee/change of ownership—Ninety days notice.

The current assisted living facility licensee must provide written notice to the department and residents, or resident representatives (if any), ninety calendar days prior to the date of the change of licensee, if the proposed change of assisted living facility licensee is anticipated to result in the discharge or transfer of any resident.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2785, filed 6/18/13, effective 7/19/13
WSR 09-06-063, § 388-78A-2785, filed 3/2/09, effective 4/2/09.

Wash. Admin. Code § 388-78A-2787 Change in licensee/change of ownership—Sixty days notice.

The current assisted living facility licensee must provide written notice to the department and residents, or resident representatives (if any), at least sixty calendar days prior to the date of the change of licensee, if the proposed change of assisted living facility licensee is not anticipated to result in the discharge or transfer of any resident.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2787, filed 6/18/13, effective 7/19/13
WSR 09-06-063, § 388-78A-2787, filed 3/2/09, effective 4/2/09.

Wash. Admin. Code § 388-78A-2790 Annual renewal.

WAC 388-78A-2790

To renew an assisted living facility license, the assisted living facility must:

(1) Submit a completed license renewal application on forms designated by the department, at least 30 days prior to the license expiration date;

(2) Sign the application;

(3) Submit the annual license fee as specified in WAC 388-78A-3230; and

(4) If the licensee's agent prepares a renewal application on the licensee's behalf, the licensee must review, sign, and attest to the accuracy of the information contained on the renewal application.

(5) To renew a memory care certification, the assisted living facility must:

(a) Have a valid, current, assisted living facility license; and

(b) Submit the annual certification fee with the department designated form at least 30 days prior to the certification expiration date.

(6) The assisted living facility certified as a memory care facility or memory care unit must ensure the department receives the annual certification fee when it is due.

(7) If the assisted living facility does not pay the annual certification fee the department will impose remedies.

History

Statutory Authority: RCW 18.20.090 and 18.20.550. WSR 26-15-066, s 388-78A-2790, filed 7/15/26, effective 8/15/26. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2790, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2790, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2800 Changes in licensed bed capacity.

(1) To change the licensed bed capacity in an assisted living facility, the assisted living facility must:

(a) Submit a completed request for approval to the department at least one day before the intended change;

(b) Submit the prorated fee for additional beds to DSHS within thirty calendar days, if applicable;

(d) Post an amended license obtained from the department, indicating the new licensed bed capacity; and

(e) Meet the additional requirements under WAC 388-78A-2810.

(2) Facilities may maintain prepaid licensed beds as "stand-by" beds for the conversion of a nonresident to a resident or admission of a resident. A "stand-by" bed is defined as a bed that is not occupied by a resident and was not designated on the department room list by the facility as a paid licensed bed.

History

Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 20-02-104, § 388-78A-2800, filed 12/31/19, effective 1/31/20. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2800, filed 6/18/13, effective 7/19/13
WSR 12-01-003, § 388-78A-2800, filed 12/7/11, effective 1/7/12. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2800, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2810 Criteria for increasing licensed bed capacity.

Before the licensed bed capacity in an assisted living facility may be increased, the assisted living facility must:

(1) Obtain construction review services' review and approval of the additional rooms or beds, and related auxiliary spaces, if the rooms were not previously reviewed and approved for the physical plant requirements at time of construction; and

(2) Ensure that each additional licensed bed or "stand-by" bed meets the assisted living licensing requirements under this chapter and chapter 388-110 WAC, when applicable.

(3) Before approving any increase in licensed bed capacity, the department will determine the facility's maximum facility capacity to ensure that any increase is consistent with this chapter and chapter 388-110 WAC, when applicable.

History

Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 20-02-104, § 388-78A-2810, filed 12/31/19, effective 1/31/20. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2810, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2810, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2821 Design, construction review, and approval plans.

(1) Drawings and specifications for new construction must be prepared by, or under the direction of, an architect registered under chapter 18.08 RCW. The services of a consulting engineer registered under chapter 18.43 RCW may be used for the various branches of work where appropriate. The services of a registered engineer may be used in lieu of the services of an architect if the scope of work is primarily engineering in nature.

(2) The assisted living facility will meet the following requirements:

(a) Preconstruction. Request and attend a presubmission conference for projects with a construction value of two hundred and fifty thousand dollars or more. The presubmission conference shall be scheduled to occur for the review of construction documents that are no less than fifty percent complete, or as coordinated with plan reviewer.

(b) Construction document review. Submit construction documents for proposed new construction to the department for review within ten days of submission to the local authorities. Compliance with these standards and regulations does not relieve the facility of the need to comply with applicable state and local building and zoning codes. The construction documents must include:

(i) A written functional program consistent with WAC 388-78A-2361 containing, but not limited to, the following:

(A) Information concerning services to be provided and the methods to be used;

(B) An interim life safety measures plan to ensure the health and safety of occupants during construction;

(C) An infection control risk assessment indicating appropriate infection control measures, keeping the surrounding area free of dust and fumes, and ensuring rooms or areas are well ventilated, unoccupied, and unavailable for use until free of volatile fumes and odors;

(D) An analysis of likely adverse impacts on current assisted living facility residents during construction and the facilities plans to eliminate or mitigate such adverse impacts including ensuring continuity of services;

(ii) Drawings and specifications to include coordinated architectural, mechanical, and electrical work. Each room, area, and item of fixed equipment and major movable equipment must be identified on all drawings to demonstrate that the required facilities for each function are provided;

(iii) Floor plan of the existing building showing the alterations and additions, and indicating location of any service or support areas;

(iv) Required paths of exit serving the alterations or additions; and

(v) Verification that the capacities and loads of infrastructure systems will accommodate the planned load.

(c) Resubmittals. The assisted living facility will respond in writing when the department requests additional or corrected construction documents;

(d) Construction. Comply with the following requirements during the construction phase:

(i) The assisted living facility will not begin construction until all of the following items are complete:

(A) Construction review services has approved construction documents or granted authorization to begin construction;

(B) The local jurisdictions have issued a building permit; and

(C) The construction review services will issue an "authorization to begin construction" when the construction documents have been conditionally approved.

(ii) Submit to the department for review any addenda or modifications to the construction documents.

(iii) Assure construction is completed in compliance with the final construction review services approved documents. Compliance with these standards and regulations does not relieve the facility from compliance with applicable state and local building and zoning codes. Where differences in interpretations occur, the facility will follow the most stringent requirement.

(vi) The assisted living facility will allow any necessary inspections for the verification of compliance with the construction documents, addenda, and modifications.

(e) Project closeout. The facility will not use any new or remodeled areas for resident use of licensed space until:

(i) The department has approved construction documents;

(ii) The local jurisdictions have completed all required inspections and approvals, when applicable or given approval to occupy; and

(iii) The facility notifies the department in writing when construction is completed and includes:

(A) Copy of the local jurisdiction's approval for occupancy;

(B) Copy of reduced floor plans; and

History

Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 20-02-104, § 388-78A-2821, filed 12/31/19, effective 1/31/20.

Wash. Admin. Code § 388-78A-2830 Conversion of licensed nursing homes.

(1) If a person intends to convert a licensed nursing home building into a licensed assisted living facility, the building must meet all assisted living facility licensing requirements specified in this chapter and chapter 18.20 RCW unless the licensee has a contract with the department to provide enhanced adult residential care services in the assisted living facility per RCW 18.20.220.

(2) If the licensee provides contracted enhanced adult residential care services in the building converted from a licensed nursing home into a licensed assisted living facility, the assisted living facility licensing requirements for the physical structure are considered to be met if the most recent nursing home inspection report for the nursing home building demonstrates compliance, and compliance is maintained, with safety standards and fire regulations:

(a) As required by RCW 18.51.140; and

(b) Specified in the applicable building code, as required by RCW 18.51.145, including any waivers that may have been granted, except that the licensee must ensure the building meets the licensed assisted living facility standards, or their functional equivalency, for:

(i) Resident to bathing fixture ratio required per WAC 388-78A-3030;

(ii) Resident to toilet ratio required per WAC 388-78A-3030;

(iii) A call system required per WAC 388-78A-2930;

(iv) Resident room door closures; and

(v) Resident room windows required per WAC 388-78A-3010.

(3) If the licensee does not continue to provide contracted enhanced adult residential care services in the assisted living facility converted from a licensed nursing home, the licensee must meet all assisted living facility licensing requirements specified in this chapter and chapter 18.20 RCW.

History

Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 20-02-104, § 388-78A-2830, filed 12/31/19, effective 1/31/20. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2830, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2830, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2840 Licenses for multiple buildings.

(1) The licensee may have multiple buildings operating under a single assisted living facility license if:

(a) All of the buildings are located on the same property with the same legal description; or

(b) All of the buildings are located on contiguous properties undivided by:

(i) Public streets, not including alleyways used primarily for delivery services or parking; or

(ii) Other land that is not owned and maintained by the owners of the property on which the assisted living facility is located.

(2) The licensee must have separate assisted living facility licenses for buildings that are not located on the same or contiguous properties.

(3) Buildings that construction review services reviewed only as an addition to, or a remodel of, an existing assisted living facility must not have separate assisted living facility licenses.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2840, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2840, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2850 Required reviews of building plans.

(1) A person or assisted living facility must notify construction review services of all planned construction regarding an assisted living facility prior to beginning work on any of the following:

(a) A new building or portion thereof to be used as an assisted living facility;

(b) An addition of, or modification or alteration to an existing assisted living facility, including, but not limited to, the assisted living facility's:

(i) Physical structure;

(ii) Electrical fixtures or systems;

(iii) Mechanical equipment or systems;

(iv) Fire alarm fixtures or systems;

(v) Fire sprinkler fixtures or systems;

(vi) Wall coverings 1/28 inch thick or thicker; or

(vii) Kitchen or laundry equipment.

(c) A change in the department-approved use of an existing assisted living facility or portion of an assisted living facility; and

(d) An existing building or portion thereof to be converted for use as an assisted living facility.

(2) A person or assisted living facility does not need to notify construction review services of the following:

(a) Repair or maintenance of equipment, furnishings or fixtures;

(b) Replacement of equipment, furnishings or fixtures with equivalent equipment, furnishings or fixtures;

(c) Repair or replacement of damaged construction if the repair or replacement is performed according to construction documents approved by construction review services within eight years preceding the current repair or replacement;

(d) Painting; or

(e) Cosmetic changes and changes to approved use that do not affect areas providing, or utilities serving resident activities, services, or care and are performed in accordance with the current edition of the building code; or

(f) Construction in buildings not accessible to residents and not directly supporting resident services.

(3) The assisted living facility must submit plans to construction review services as directed by construction review services and consistent with WAC 388-78A-2361 for approval prior to beginning any construction.

History

Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 20-02-104, § 388-78A-2850, filed 12/31/19, effective 1/31/20. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2850, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2850, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2851 Applicability requirements for physical plant.

(1) The purpose of physical environment requirements is to provide for a safe and effective resident care environment in the buildings or portions of buildings licensed as assisted living facilities and used to provide assisted living services. This section applies to new construction which includes:

(a) New buildings to be licensed;

(b) Conversion of an existing building or portion of an existing building;

(d) Alterations; and

(e) Excludes buildings used exclusively for administration functions.

(2) Standards for design and construction:

(a) The physical environment requirements of this chapter that are in effect at the time the application and fee is submitted to construction review services, and the project number is assigned by construction review services, apply for the duration of the construction project;

(b) Newly licensed assisted living facilities and new construction in existing assisted living facilities must meet the requirements of all current state and local building and zoning codes and applicable sections of this chapter; and

(c) Where permitted by the state building code, in resident rooms, spaces, and areas, including sleeping, treatment, diagnosis, and therapeutic uses, the design and installation of an NFPA 72 private operating mode fire alarm shall be permitted.

(3) Existing licensed assisted living facilities must continue to meet the applicable codes in force at the time of construction, the fire code adopted by the Washington state building code council and the following sections:

(a) WAC 388-78A-2700 Emergency and disaster preparedness;

(b) WAC 388-78A-2880 Changing use of rooms;

(d) WAC 388-78A-2960 Sewage and liquid waste disposal; and

(e) WAC 388-78A-2970 Garbage and refuse disposal.

(4) Where applicable, existing facilities may choose to meet either the requirements of chapter 388-78A WAC in effect at the time a project number is assigned by construction review services consistent with subsection (2)(a) of this section or the following standards:

(a) WAC 388-78A-2381 General design requirements for memory care;

(b) WAC 388-78A-2880(3) Freedom of movement;

(d) WAC 388-78A-2920 Area for nursing supplies and equipment.

(5) The department may require a facility to meet requirements if building components or systems are deemed by the department to jeopardize the health or safety of residents.

(6) The assisted living facility must ensure that construction is completed in compliance with the final construction review services approved documents. Compliance with these standards and regulations does not relieve the assisted living facility of the need to comply with applicable state and local building and zoning codes.

History

Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 20-03-122 and WSR 20-02-104, § 388-78A-2851, filed 1/17/20 and 12/31/19, effective 2/17/20 and 1/31/20.

Wash. Admin. Code § 388-78A-2852 Exemptions or alternative methods.

(1) The department may exempt an assisted living facility from meeting a specific requirement related to the physical environment or may approve an alternative method for meeting the requirement, if the department determines the exemptions or alternative method will:

(a) Not jeopardize the health or safety of residents;

(b) Not adversely affect the residents' quality of life;

(c) Not change the fundamental nature of the assisted living facility operation into something other than an assisted living facility;

(d) Demonstrate that the proposed alterations will serve to correct deficiencies or upgrade the facility in order to better serve residents; and

(e) Demonstrate to the director of residential care services, that substitution of procedures, materials, or equipment for requirements specified in this chapter would better serve residents.

(2) To request an exemption, or to request an approval of an alternative method, an assisted living facility must submit a written request to the department that includes:

(a) A description of the requested exemption or alternative method; and

(b) The specific rule for which the exemption is sought.

(3) The assisted living facility may not appeal the department's denial of a request for an exemption or alternative method.

(4) The assisted living facility must retain in the assisted living facility a copy of each approved exemption or alternative method.

History

Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 20-02-104, § 388-78A-2852, filed 12/31/19, effective 1/31/20.

Wash. Admin. Code § 388-78A-2853 New licenses and use of construction.

The department will not issue an assisted living facility license unless:

(1) Construction review services:

(a) Notifies the department that construction has been completed; and

(b) Provides the department:

(i) A copy of the certificate of occupancy granted by the local building official;

(ii) A copy of the functional program; and

(iii) A reduced copy of the approved floor plan indicating room numbers or names and the approved use; and

(2) Facilities will not use areas of new construction, as described in WAC 388-78A-2821, until one of the following events has occurred:

(a) Construction review services has approved the construction, and the scope of work does not require inspection by DSHS for a licensing inspection, or office of the state fire marshal (OSFM). Examples of such projects include:

(i) Minor additions (sunroom, dining room, offices);

(ii) New buildings without resident care space or critical systems;

(iii) Minor moving of walls in resident care spaces;

(iv) Major renovations in non-resident spaces; and

(v) Phased construction projects not falling under subsection (3)(b)(ii) and (iii) of this section; or

(b) Construction review services has recommended approval, and a DSHS inspection has approved the finished work, and the scope of work is for:

(i) Major alterations of resident spaces;

(ii) Alterations of significant scope;

(iii) Conversion of support spaces to resident rooms;

(iv) Addition of licensed beds not previously reviewed and approved by construction review services;

(v) New resident care buildings (under existing license);

(vi) New resident support spaces such as kitchens and secured outdoor areas; and

(vii) License type/contract care conversions; or

(c) Construction review services has recommended approval, OSFM has inspected, and DSHS issues a license and the scope of the work is for:

(i) Buildings and areas supporting an initial facility license;

(ii) Buildings and spaces seeking licensure after an expired license; or

(iii) Facility relocation.

History

Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 20-02-104, § 388-78A-2853, filed 12/31/19, effective 1/31/20.

Wash. Admin. Code § 388-78A-2860 Relocation of residents during construction.

(1) Prior to moving residents out of the assisted living facility during construction, the assisted living facility must:

(a) Notify the residents and the residents' representatives at least thirty days prior to the anticipated move date, of the required move, and their options consistent with chapter 70.129 RCW;

(b) Notify the department at least thirty days prior to the anticipated move date of the assisted living facility's plans for relocating residents, including:

(i) The location to which the residents will be relocated;

(ii) The assisted living facility's plans for providing care and services during the relocation;

(iii) The assisted living facility's plans for returning residents to the building; and

(iv) The projected time frame for completing the construction.

(2) If the assisted living facility moves all of the residents from the assisted living facility without first obtaining the department's approval of the relocation plans, the assisted living facility is ordered to stop placement, and the department may revoke the assisted living facility license.

History

Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 20-02-104, § 388-78A-2860, filed 12/31/19, effective 1/31/20. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2860, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2860, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2870 Vacant buildings.

Whenever an assisted living facility moves out all residents and ceases operation for reasons other than construction, under WAC 388-78A-2860, the licensee must relinquish or the department may revoke the assisted living facility license.

History

Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 20-02-104, § 388-78A-2870, filed 12/31/19, effective 1/31/20. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2870, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2870, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2880 Changing use of rooms.

Prior to using a room for a purpose other than what was approved by construction review services, the assisted living facility must:

(1) Notify construction review services:

(a) In writing;

(b) Thirty days or more before the intended change in use;

(d) Provide all additional documentation as requested by construction review services;

(2) Obtain the written approval of construction review services for the new use of the room; and

(3) Ensure the facility functional program and room list are updated to reflect the change.

History

Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 20-02-104, § 388-78A-2880, filed 12/31/19, effective 1/31/20. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2880, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2880, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2900 Retention of approved construction documents.

The assisted living facility must retain paper or electronic copies of the following on the assisted living facility premises:

(1) Specification data on materials used in construction, for the life of the product;

(2) Stamped "approved" set of construction documents;

(3) The certificate of occupancy or final inspection granted by the local building official;

(4) The functional program required under WAC 388-78A-2361; and

(5) Any approved exemption or alternative methods of compliance issued by the department.

History

Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 20-02-104, § 388-78A-2900, filed 12/31/19, effective 1/31/20. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2900, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2900, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2920 Area for nursing supplies and equipment.

(1) In each building, the assisted living facility must provide for the safe and sanitary storage and handling of nursing equipment and supplies appropriate to the needs of their residents, as well as for the soiled nursing equipment by providing:

(a) A "clean" utility area for the purposes of storing and preparing nursing supplies, or durable and disposable medical equipment equipped with:

(i) A work counter or table; and

(ii) A handwashing sink, with soap and paper towels or other approved hand-drying device;

(b) A "soiled" utility room for the purposes of storing soiled linen, cleaning nursing care equipment, and disposing of refuse and infectious waste, equipped with:

(i) A work counter or table;

(ii) A two-compartment sink for handwashing and equipment cleaning and sanitizing;

(iii) Soap and paper towels or other approved hand-drying device; and

(iv) Locked storage for cleaning supplies, if stored in the area.

(i) A work surface; and

(ii) An adjacent hand-washing sink, with soap and paper towels or other approved hand-drying device.

(2) "Clean" and "soiled" utility areas must be accessible by staff persons, or residents with appropriate staff assistance if those "clean" or "soiled" areas contain resident laundry facilities.

(3) Single designs meeting the functional intent and built to address issues of infection control, work process, and mechanical ventilation may be approved.

(4) Each assisted living facility:

(a) May combine areas used for storing, handling, and cleaning soiled laundry and linens, areas used for cleaning nursing care equipment, areas for disposing of refuse and infectious waste, and/or areas for storing housekeeping and cleaning supplies, into a single area on the premises only when the assisted living facility equips the area with:

(i) A two-compartment sink for handwashing and sanitizing;

(ii) A work counter or table;

(iii) A mechanical ventilation to the outside of the assisted living facility; and

(iv) Locked storage for cleaning supplies, if stored in the area.

(b) Must ensure that any work or function performed in or around a combined utility area as described in subsection (4)(a) of this section is performed without significant risk of contamination to:

(i) Storing or handling clean nursing supplies or equipment;

(ii) Storing or handling clean laundry;

(iii) Providing resident care;

(iv) Food storage, preparation, or service; or

(v) Other operations or services of functions in the assisted living facility sensitive to infection control practices.

History

Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 20-02-104, § 388-78A-2920, filed 12/31/19, effective 1/31/20. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2920, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090. WSR 06-01-047, § 388-78A-2920, filed 12/15/05, effective 1/15/06. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2920, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2930 Communication system.

(1) The assisted living facility must:

(a) Provide residents and staff persons with the means to summon on-duty staff assistance from all resident-accessible areas including:

(i) Bathrooms and toilet rooms;

(ii) Resident living rooms and resident sleeping rooms; and

(iii) Corridors, as well as common and outdoor areas accessible to residents.

(b) Provide the resident with personal wireless communication devices, such as pendants or wristbands, when a communication device is not installed in the resident's sleeping room, and when wireless communications are used:

(i) The system must be designed and installed consistent with industry standards and perform reliably throughout the facility; and

(ii) The facility must have a policy and procedure describing the mitigating measures in the event of system disruption, including for maintenance and loss of power; and

(c) Provide residents, families, and other visitors with a means to contact a staff person inside the building from outside the building after hours.

(2) The assisted living facility must provide one or more nonpay telephones to allow for communication between residents and their family members, medical providers, the resident's emergency contact, interested parties, ombuds, and other individuals the resident chooses to communicate with outside of the facility:

(a) In each building located for ready access for staff persons;

(b) On the premises with reasonable access and privacy by residents; and

(3) The assisted living facility must equip each resident room with access to telephone service.

(4) If an assisted living facility chooses to install an intercom system, the intercom system must be equipped with a mechanism that allows a resident to control:

(a) Whether or not announcements are broadcast into the resident's room; and

(b) Whether or not voices or conversations within the resident's room can be monitored or listened to by persons outside the resident's room.

(5) The facility must provide wireless internet access.

History

Statutory Authority: RCW 18.20.090, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 25-16-099, s 388-78A-2930, filed 8/6/25, effective 9/6/25. Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 20-02-104, § 388-78A-2930, filed 12/31/19, effective 1/31/20. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2930, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090. WSR 06-01-047, § 388-78A-2930, filed 12/15/05, effective 1/15/06. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2930, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2940 Two-way intercom systems.

The assisted living facility may use a two-way intercom system between staff persons and residents in other rooms only when:

(1) A resident initiates the contact; or

(2) Staff persons announce to the resident that the intercom has been activated at the time it is activated, and:

(a) The resident and any others in the room agree to continue the contact;

(b) The assisted living facility deactivates the intercom when the conversation is complete; and

(c) The assisted living facility ensures each resident is aware the intercom is operating at all times the intercom is in use in the resident's room.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2940, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090. WSR 06-01-047, § 388-78A-2940, filed 12/15/05, effective 1/15/06. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2940, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2950 Water supply.

The assisted living facility must:

(1) Provide water meeting the provisions of chapter 246-290 WAC, Group A public water supplies or chapter 246-291 WAC, Group B public water systems;

(2) Protect and maintain the assisted living facility water systems against cross-connection in accordance with American Water Works Association (AWWA) Recommended Practice for Backflow Prevention and Cross-Connection Control.

(3) Meet the requirements of the plumbing code adopted by the Washington state building code council;

(4) Install vacuum breakers or backflow prevention devices on hose bibs and supply nozzles used to connect hoses or tubing to housekeeping sinks, and where used, bedpan-flushing attachments;

(5) Provide hot and cold water under adequate pressure readily available throughout the assisted living facility;

(6) Provide all sinks in resident rooms, toilet rooms and bathrooms, and bathing fixtures used by residents with hot water between 105°F and 120°F at all times; and

(7) Label or color code nonpotable water supplies as "unsafe for domestic use."

History

Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 20-02-104, § 388-78A-2950, filed 12/31/19, effective 1/31/20. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2950, filed 6/18/13, effective 7/19/13. Statutory Authority: Chapters 18.20 and 74.34 RCW. WSR 09-01-052, § 388-78A-2950, filed 12/10/08, effective 1/10/09. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2950, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2960 Sewage and liquid waste disposal.

WAC 388-78A-2960

The assisted living facility must:

(1) Ensure that all sewage and waste water drain into a municipal sewage disposal system according to chapter 173-240 WAC, if available; or

(2) Provide on-site sewage disposal systems designed, constructed, and maintained as required by chapters 246-272A and 246-272B WAC, and local ordinances.

History

Statutory Authority: RCW 18.20.090 and 18.20.550. WSR 26-15-066, s 388-78A-2960, filed 7/15/26, effective 8/15/26. Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 20-02-104, § 388-78A-2960, filed 12/31/19, effective 1/31/20. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2960, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090. WSR 06-01-047, § 388-78A-2960, filed 12/15/05, effective 1/15/06. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2960, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2970 Garbage and refuse disposal.

The assisted living facility must:

(1) Provide an adequate number of garbage containers to store refuse generated by the assisted living facility:

(a) Located in a storage area convenient for resident and staff use;

(b) Constructed of nonabsorbent material;

(i) Entrance of insects, rodents, birds, or other pests;

(ii) Odors; and

(iii) Other nuisances.

(2) Assure garbage and waste containers are emptied frequently to prevent hazards and nuisances; and

(3) Provide for safe and sanitary collection and disposal of:

(a) Garbage and refuse;

(b) Infectious waste; and

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2970, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2970, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2980 Lighting.

(1) The assisted living facility must provide emergency lighting in residents units, dining and activity rooms, laundry rooms, and other spaces where residents may be at the time of a power outage.

(2) The assisted living facility must maintain electric light fixtures and lighting necessary for the comfort and safety of residents and for the activities of residents and staff.

(3) The assisted living facility must provide enough lighting in each resident's room to meet the resident's needs, preferences and choices.

(4) New assisted living facility construction must, at a minimum, meet the Illuminating Engineering Society of North America (IESNA) recommendations for lighting in common areas as established in the IESNA lighting handbook. The applicable handbook is the edition in effect on the date a construction review fee is paid to the department of health, construction review services, for new assisted living facility construction.

(5) Existing assisted living facility construction must maintain, at a minimum, the Illuminating Engineering Society of North America (IESNA) recommendations for lighting in common areas as established in the IESNA lighting handbook. The applicable handbook is the edition in effect on the date a construction review fee was paid to the department of health, construction review services, for the assisted living facility or that portion of the assisted living facility that underwent construction review.

History

Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 20-02-104, § 388-78A-2980, filed 12/31/19, effective 1/31/20. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2980, filed 6/18/13, effective 7/19/13. Statutory Authority: Chapters 18.20 and 74.34 RCW. WSR 09-01-052, § 388-78A-2980, filed 12/10/08, effective 1/10/09. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2980, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-2990 Heating-cooling—Temperature.

The assisted living facility must:

(1) Equip each resident-occupied building with an approved heating system capable of maintaining a minimum temperature of 70°F. The assisted living facility must:

(a) Maintain the assisted living facility at a minimum temperature of 60°F during sleeping hours; and

(b) Maintain the assisted living facility at a minimum of 68°F during waking hours, except in rooms:

(i) Designated for activities requiring physical exertion;

(ii) Where residents can individually control the temperature in their own living units, independent from other areas; or

(iii) Where residents cannot individually control the temperature in their own living units, maintain all living units at a temperature range of 70°F to 75°F;

(2) Equip each resident-occupied building with a mechanical air cooling system or equivalent capable of maintaining a temperature of 75°F in communities where the design dry bulb temperature exceeds 85°F two percent of the year per the ASHRAE standards;

(3) Equip each assisted living facility with a backup source of heat in enough common areas to keep all residents adequately warm during interruptions of normal heating operations;

(4) Prohibit the use of portable space heaters unless approved in writing by the Washington state director of fire protection;

(5) Equip each resident sleeping room with individual temperature controls located between eighteen and forty-eight inches above the floor capable of maintaining room temperature plus or minus 3°F from setting, within a range of minimum 60°F to maximum 85°F, these individual temperature controls may be modified to prevent resident access only when:

(a) Appropriate, as documented in resident assessment(s) and their negotiated service plan; and

(b) The temperature range is maintained at a range of 70°F to 75°F.

History

Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 20-02-104, § 388-78A-2990, filed 12/31/19, effective 1/31/20. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-2990, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090. WSR 06-01-047, § 388-78A-2990, filed 12/15/05, effective 1/15/06. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-2990, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-3000 Ventilation.

The assisted living facility must meet the ventilation requirements of the mechanical code as adopted and amended by the Washington state building council; and

(1) Ventilate rooms to:

(a) Prevent excessive odors or moisture; and

(b) Remove smoke.

(2) If provided, locate outdoor smoking areas in accordance with Washington state law;

(3) Provide intact sixteen mesh screens on operable windows and openings used for ventilation; and

(4) Ensure window screens that may restrict or hinder escape or rescue through emergency exit openings, do not present an obstacle to facility emergency plans as coordinated with local fire and rescue services.

History

Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 20-02-104, § 388-78A-3000, filed 12/31/19, effective 1/31/20. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-3000, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-3000, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-3010 Resident units.

WAC 388-78A-3010

The assisted living facility resident units must have the following:

(1) General characteristics:

(a) Units must have lever door hardware and option for lockable entry doors;

(i) Locking entry doors must unlock with single lever handle motion;

(b) Residents may not enter their rooms through another resident unit or resident bedroom;

(c) The functional program shall identify the number of units or number of licensed beds designed for staff assisted movement, bathing and toileting;

(2) Number of residents: Each resident unit shall be limited to not more than two residents.

(3) Unit configuration types:

(a) A studio unit or single room;

(b) A companion unit sized appropriately to provide two separate sleeping rooms or spaces of a common entry vestibule;

(d) A two bedroom unit with separate living and sleeping rooms;

(4) Bathrooms: Access to bathing/toileting facilities within the resident unit must not be through a resident sleeping room or otherwise compromise resident dignity or privacy.

(5) Sleeping rooms size:

(a) One person rooms shall have not less than 80 square feet of usable floor space;

(b) Two person rooms shall not have less than 70 square feet of usable floor space per individual;

(i) The private apartment includes a resident sleeping room, a resident living room, and a private bathroom;

(ii) The total square footage in the private apartment equals or exceeds 220 square feet excluding the bathroom;

(iii) There are no more than two residents living in the apartment; and

(iv) Both residents mutually agree to share the resident sleeping room; and

(v) If all other requirements of this section are met, then the two residents may share a sleeping room with less than 140 square feet; and

(d) All sleeping rooms must be of sufficient size to allow three feet between the bed and the adjacent walls or furnishings and five feet between other beds.

(6) Calculating floor space:

(a) Usable floor space in a resident's sleeping room is calculated by measuring from interior wall to interior wall surface;

(b) Including areas of door swings and entryways into the sleeping room; and

(c) Excluding areas under ceilings less than seven feet high, closet space and built-in storage, areas under counters, sinks, or appliances, bathroom, and toilet rooms.

(7) Room arrangement:

(a) Each sleeping room must have unrestricted direct access to a hallway, living room, outside, or other common-use area;

(b) A resident sleeping room may not be used as a passageway, hall, intervening room, or corridor.

(8) Miscellaneous: Each sleeping room must have:

(a) One or more outside windows with:

(i) Window sills at or above grade, with grade extending horizontally 10 or more feet from the building; and

(ii) Adjustable curtains, shades, blinds, or equivalent for visual privacy.

(b) Electrical receptacles consistent with the requirements of the electrical code;

(d) An individual towel and washcloth rack or equivalent, except when there is a private bathroom attached to the resident sleeping or living room, the individual towel and washcloth rack may be located in the attached private bathroom;

(e) A lockable drawer, cupboard, or other secure space measuring a least one-half cubic foot with a minimum dimension of four inches;

(f) Separate storage facilities for each resident in or immediately adjacent to that residents sleeping room to adequately store a reasonable quantity of clothing and personal possessions; and

(g) Separate storage containers for materials used in the administration of intermittent nursing services appropriate to the needs of the resident and documented in the functional program.

History

Statutory Authority: RCW 18.20.090 and 18.20.550. WSR 26-15-066, s 388-78A-3010, filed 7/15/26, effective 8/15/26. Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 20-02-104, § 388-78A-3010, filed 12/31/19, effective 1/31/20. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-3010, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090. WSR 06-01-047, § 388-78A-3010, filed 12/15/05, effective 1/15/06. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-3010, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-3011 Resident unit furnishings.

(1) The assisted living facility must ensure each resident sleeping room contains:

(a) A bed for each resident, except when:

(i) Two residents mutually agree to share a bed; or

(ii) A resident requests or provides alternate furniture for sleeping.

(b) The bed must be thirty-six or more inches wide for a single resident and fifty-four or more inches wide for two residents, including, but not limited to:

(i) Standard household bed;

(ii) Studio couch;

(iii) Hide-a-bed;

(iv) Day bed; or

(v) Water bed, if structurally and electrically safe.

(i) Fits the bed frame;

(ii) Is in good condition; and

(iii) Is at least four inches thick unless otherwise requested or necessary for resident health or safety.

(d) One or more pillows for each resident;

(e) Bedding for each bed, in good repair; and

(f) Lighting at the resident's bedside when requested by the resident.

(2) The assisted living facility may use or allow use of carpets and other floor coverings only when the carpet is:

(a) Securely fastened to the floor or provided with nonskid backing; and

(b) Kept clean and free of hazards, such as curling edges or tattered sections.

(3) The assisted living facility must ensure each resident has either a sleeping room or resident living room that contains a sturdy chair. This requirement does not mean an assisted living facility is responsible for supplying specially designed orthotic or therapeutic chairs, including those with mechanical lifts or adjustments.

History

Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 20-02-104, § 388-78A-3011, filed 12/31/19, effective 1/31/20.

Wash. Admin. Code § 388-78A-3030 Toilet rooms and bathrooms.

WAC 388-78A-3030

(1) The assisted living facility must provide private or common-use toilet rooms and bathrooms to meet the needs of each resident.

(2) The assisted living facility must provide each toilet room and bathroom with:

(a) Water resistant, smooth, low gloss, nonslip, and easily cleanable materials;

(b) Washable walls to the height of splash or spray;

(i) Bathing fixture; and

(ii) Toilet.

(d) Plumbing fixtures designed for easy use and cleaning and kept in good repair; and

(e) Provide mechanical ventilation to the outside; and

(f) Separation from other rooms or areas by four walls and a door.

(3) The assisted living facility must provide each toilet room with a:

(a) Toilet with a clean, nonabsorbent seat free of cracks;

(b) Handwashing sink in or adjacent to the toilet room; and

(4) The assisted living facility must provide a toilet and handwashing sink in, or adjoining, each bathroom.

(5) When providing common-use toilet rooms and bathrooms, for residents who do not have access to a private toilet room in their apartment, the assisted living facility must provide toilets and handwashing sinks for residents in the ratios of one toilet and one handwashing sink for every eight residents. For example: One toilet and one handwashing sink for one to eight residents, two for nine to 16 residents, three for 17 to 24 residents, and so on.

(6) When providing common-use toilet rooms and bathrooms for residents who do not have access to a private bathroom in their apartment, the assisted living facility must provide bathing fixtures for residents in the ratio of one bathing fixture for every 12 residents. For example: One bathing fixture for one to 12 residents, two for 13 to 24 residents, three for 25 to 36 residents, and so on.

(7) When providing common-use toilet rooms and bathrooms, the assisted living facility must:

(a) Designate toilet rooms containing more than one toilet for use by men or women;

(b) Designate bathrooms containing more than one bathing fixture for use by men or women, unless the bathroom is identified as a single resident use only;

(c) Equip each toilet room and bathroom designed for use by, or used by, more than one person at a time, in a manner to ensure visual privacy for each person using the room. The assisted living facility is not required to provide additional privacy features in private bathrooms with a single toilet and a single bathing fixture located within a private apartment;

(d) Provide a handwashing sink with soap and single use or disposable towels, blower, or equivalent hand-drying device in each toilet room;

(e) Provide reasonable access to bathrooms and toilet rooms for each resident by:

(i) Locating a toilet room on the same floor or level as the sleeping room of the resident served;

(ii) Locating a bathroom on the same floor or level, or adjacent floor or level, as the sleeping room of the resident served;

(iii) Providing access without passage through any kitchen, pantry, food preparation, food storage, or dishwashing area, or from one bedroom through another bedroom; and

(f) Provide and ensure toilet paper is available at each common-use toilet.

(8) The assisted living facility must ensure 25 percent of all resident use, and at least one common use bathing fixtures are roll-in type showers that have:

(a) One-half inch or less threshold that may be a collapsible rubber water barrier; and

(b) A minimum size of 30 inches by 60 inches.

History

Statutory Authority: RCW 18.20.090 and 18.20.550. WSR 26-15-066, s 388-78A-3030, filed 7/15/26, effective 8/15/26. Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 20-02-104, § 388-78A-3030, filed 12/31/19, effective 1/31/20. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-3030, filed 6/18/13, effective 7/19/13
WSR 10-03-066, § 388-78A-3030, filed 1/15/10, effective 2/15/10. Statutory Authority: Chapters 18.20 and 74.34 RCW. WSR 09-01-052, § 388-78A-3030, filed 12/10/08, effective 1/10/09. Statutory Authority: RCW 18.20.090. WSR 06-01-047, § 388-78A-3030, filed 12/15/05, effective 1/15/06. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-3030, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-3040 Laundry.

WAC 388-78A-3040

(1) The assisted living facility must provide laundry and linen services on the premises, or by commercial laundry.

(2) The assisted living facility must handle, clean, and store linen according to acceptable methods of infection control. The assisted living facility must:

(a) Provide separate areas for handling clean laundry and soiled laundry;

(b) Ensure clean laundry is not processed in, and does not pass through, areas where soiled laundry is handled;

(d) Ensure all staff persons wear gloves and use other appropriate infection control practices when handling soiled laundry; and

(e) Have a utility sink and a table or counter for folding clean laundry.

(3) The assisted living facility must use washing machines that have a continuous supply of hot water with a temperature of 140°F measured at the washing machine intake, or that automatically dispenses a chemical sanitizer as specified by the manufacturer, or that employs alternate sanitization methods recommended by the manufacturer.

(4) The assisted living facility or a resident washing an individual resident's personal laundry, separate from other laundry, may wash the laundry at temperatures below 140°F and without the use of a chemical sanitizer.

(5) The assisted living facility must ventilate laundry rooms and areas to the outside of the assisted living facility, including areas or rooms where soiled laundry is held for processing by off site commercial laundry services.

(6) The assisted living facility must locate laundry equipment in rooms other than those used for open food storage, food preparation, or food service.

(7) The assisted living facility must provide a laundry area or develop and implement policy and procedure to ensure residents have access to an area where residents' may do their personal laundry that is:

(a) Equipped with:

(i) A utility sink;

(ii) A table or counter for folding clean laundry;

(iii) At least one washing machine and one clothes dryer; and

(iv) Mechanical ventilation to the outside of the assisted living facility.

(b) Arranged to reduce the chances of soiled laundry contaminating clean laundry.

History

Statutory Authority: RCW 18.20.090 and 18.20.550. WSR 26-15-066, s 388-78A-3040, filed 7/15/26, effective 8/15/26. Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 20-02-104, § 388-78A-3040, filed 12/31/19, effective 1/31/20. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-3040, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090. WSR 06-01-047, § 388-78A-3040, filed 12/15/05, effective 1/15/06. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-3040, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-3050 Common areas.

(1) The assisted living facility must provide one or more common areas in which residents may participate in social and recreational activities. Common areas include, but are not limited to:

(a) Solariums;

(b) Enclosed sun porches;

(d) Dining rooms; and

(e) Living rooms.

(2) The assisted living facility must provide a total minimum floor space for common areas of one hundred-fifty square feet, or twenty square feet per resident, whichever is larger.

(3) The assisted living facility must provide common areas with furniture and furnishings that meet the residents' needs.

History

Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 20-02-104, § 388-78A-3050, filed 12/31/19, effective 1/31/20. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-3050, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-3050, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-3060 Storage space.

The assisted living facility must:

(1) Provide adequate storage space for supplies, equipment and linens;

(2) Provide separate, locked storage for disinfectants and poisonous compounds; and

(3) Maintain storage space to prevent fire or safety hazards.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-3060, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-3060, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-3090 Maintenance and housekeeping.

(1) The assisted living facility must:

(a) Provide a safe, sanitary and well-maintained environment for residents;

(b) Keep exterior grounds, assisted living facility structure, and component parts safe, sanitary and in good repair;

(d) Ensure each resident or staff person maintains the resident's quarters in a safe and sanitary condition consistent with the negotiated service agreement.

(2) The assisted living facility must provide housekeeping supply room(s):

(a) Located on each floor of the assisted living facility, except only one housekeeping supply room is required for assisted living facilities licensed for sixteen or fewer beds when there is a means other than using a stairway, for transporting mop buckets between floors;

(b) In proximity to laundry and kitchen areas; and

(i) A utility sink or equivalent means of obtaining and disposing of mop water, away from food preparation and service areas;

(ii) Storage for wet mops;

(iii) Locked storage for cleaning supplies; and

(iv) Mechanical ventilation to the outside of the assisted living facility.

History

Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 20-02-104, § 388-78A-3090, filed 12/31/19, effective 1/31/20. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-3090, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090. WSR 06-01-047, § 388-78A-3090, filed 12/15/05, effective 1/15/06. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-3090, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-3100 Safe storage of supplies and equipment.

The assisted living facility must secure potentially hazardous supplies and equipment commensurate with the assessed needs of residents and their functional and cognitive abilities. In determining what supplies and equipment may be accessible to residents, the assisted living facility must consider at a minimum:

(1) The residents' characteristics and needs;

(2) The degree of hazardousness or toxicity posed by the supplies or equipment;

(3) Whether or not the supplies and equipment are commonly found in a private home, such as hand soap or laundry detergent; and

(4) How residents with special needs are individually protected without unnecessary restrictions on the general population.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-3100, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-3100, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-3130 Plant restrictions.

The assisted living facility must not use poisonous or toxic plants in areas of the assisted living facility premises accessible to residents who, based on their diagnosed condition or cognitive disabilities, may ingest or have harmful contact with such plants.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-3130, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-3130, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-3140 Responsibilities during inspections.

The assisted living facility must:

(1) Cooperate with the department during any on-site inspection or complaint investigation;

(2) Provide requested records to the representatives of the department; and

(3) Ensure the assisted living facility administrator or the administrator's designee is available during any inspection or complaint investigation to respond to questions or issues identified by department staff.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-3140, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-3140, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-3141 Inspection timelines.

(1) In response to the COVID-19 pandemic, the governor suspended the requirement for the department to conduct full licensing inspections of assisted living facilities required by RCW 18.20.110.

(2) During the suspension of the full licensing inspection requirements, the department continued to conduct complaint investigations in assisted living facilities when it became aware of information that indicated an immediate threat to resident health and safety may exist.

(3) The department must prioritize and resume full licensing inspections of assisted living facilities affected by the suspension of the inspection requirements by applying the following criteria collectively:

(a) The department has identified an ongoing threat to the health and safety of residents through one or more reported complaints, previous inspections, or previous investigations;

(b) Whether the assisted living facility has had a remedy imposed in the last 24 months; and

(4) The department must conduct a full licensing inspection for assisted living facilities licensed after the reinstatement of RCW 18.20.110 in accordance with the schedule set by that section.

History

Statutory Authority: RCW 18.20.090, 70.97.100, 70.97.230, 70.128.040, and 74.42.620. WSR 22-17-051, § 388-78A-3141, filed 8/11/22, effective 9/11/22.

Wash. Admin. Code § 388-78A-3150 Statements of deficiencies.

The department will give the administrator or the administrator's designee a written statement of deficiencies report specifying any violations of chapters 18.20, 70.129, or 74.34 RCW, this chapter, or any other applicable laws or rules that the department found during any inspection or complaint investigation.

History

Statutory Authority: RCW 18.20.090, 2008 c 146, and chapter 18.20 RCW. WSR 09-01-079, § 388-78A-3150, filed 12/15/08, effective 5/1/09. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-3150, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-3152 Plan of correction—Required.

(1) The assisted living facility must comply with all applicable licensing laws and regulations at all times.

(2) When the department finds the assisted living facility out of compliance with any licensing law or regulation the department will send the home an inspection report with an attestation of correction statement for each cited deficiency.

(3) The assisted living facility must complete an attestation of correction for any inspection report as the department requires.

(4) For purposes of this section an "attestation of correction statement" means a statement developed by the department and signed and dated by the home, that the home:

(a) Has or will correct each cited deficiency; and

(b) Will maintain correction of each cited deficiency.

(5) The home must be able to show to the department, upon request, that, for each deficiency cited, the home has:

(a) A plan of correction and maintaining correction;

(b) Corrected or is correcting each deficiency; and

(6) On each attestation of correction statement, the home must:

(a) Give a date, approved by the department, showing when the cited deficiency has been or will be corrected; and

(b) By signature and date showing that the home has or will correct, and maintain correction, of each deficiency.

(7) The home must return the inspection report, with completed attestation of correction statements, to the department within ten calendar days of receiving the report.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-3152, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090, 2008 c 146, and chapter 18.20 RCW. WSR 09-01-079, § 388-78A-3152, filed 12/15/08, effective 5/1/09.

Wash. Admin. Code § 388-78A-3160 Authorized enforcement remedies.

WAC 388-78A-3160

(1) Whenever the circumstances in WAC 388-78A-3170(1) are present, the department may impose any one or more of the following enforcement remedies authorized by RCW 18.20.050, 18.20.185, and 18.20.190 on an assisted living facility, including:

(a) Denying an assisted living facility license;

(b) Suspending an assisted living facility license or memory care certification;

(d) Refusing to renew an assisted living facility license or memory care certification;

(e) Suspending admissions to an assisted living facility, memory care facility, or memory care unit;

(f) Suspending admissions to an assisted living facility of a specific category or categories of residents as related to cited problems;

(g) Imposing conditions on the assisted living facility license;

(h) Imposing civil penalties of not more than $3,000 per day per violation.

(2) Notwithstanding subsection (1) of this section, the department may impose a civil penalty on an assisted living facility of up to $3,000 per day per violation for interference, coercion, discrimination, or reprisal by an assisted living facility as set forth in RCW 18.20.185.

History

Statutory Authority: RCW 18.20.090 and 18.20.550. WSR 26-15-066, s 388-78A-3160, filed 7/15/26, effective 8/15/26. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-3160, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-3160, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-3170 Circumstances that may result in enforcement remedies.

WAC 388-78A-3170

(1) The department is authorized to impose enforcement remedies described in WAC 388-78A-3160 if any person described in subsection (2) of this section is found by the department to have:

(a) A history of significant noncompliance with federal or state laws or regulations in providing care or services to frail elders, vulnerable adults, or children, whether as a licensee, contractor, managerial employee, or otherwise. Evidence of significant noncompliance may include, without limitation:

(i) Citations for violation of laws or regulations imposed by regulating entities;

(ii) Sanctions for violation of laws or regulations imposed by regulating entities;

(iii) Involuntary termination, cancellation, suspension, or nonrenewal of a medicaid contract or medicare provider agreement, or any other agreement with a public agency for the care or treatment of children, frail elders, or vulnerable adults;

(iv) Been denied a license or contract relating to the care of frail elders, vulnerable adults, or children; or

(v) Relinquished or failed to renew a license or contract relating to care of frail elders, vulnerable adults, or children following written notification of the licensing agency's initiation of denial, suspension, cancellation, or revocation of a license.

(b) Failed to provide appropriate care to frail elders, vulnerable adults, or children under a contract, or having such contract terminated, or not renewed by the contracting agency due to such failure;

(c) Failed or refused to comply with the requirements of chapter 18.20 RCW, applicable provisions of chapter 70.129 RCW, or this chapter;

(d) Retaliated against a staff person, resident, or other individual for:

(i) Reporting suspected abuse, neglect, financial exploitation, or other alleged improprieties;

(ii) Providing information to the department during the course of an inspection of the assisted living facility; or

(iii) Providing information to the department during the course of a complaint investigation in the assisted living facility.

(e) Operated a facility for the care of children or vulnerable adults without a current, valid license or under a defunct or revoked license;

(f) Attempted to obtain a contract or license from the department by fraudulent means or by misrepresentation;

(g) A conviction or pending charge for a crime that is not automatically disqualifying under chapter 388-113 WAC, but that:

(i) Was committed on an assisted living facility premises; or knowingly permitted, aided, or abetted an illegal act on an assisted living facility premises;

(ii) Involved the illegal use of drugs or the excessive use of alcohol; or

(iii) Is reasonably related to the competency of the person to operate an assisted living facility.

(h) Abused, neglected, or exploited a vulnerable adult;

(i) Had a sanction or corrective or remedial action taken by federal, state, county, or municipal officials, or safety officials related to the care or treatment of children or vulnerable adults;

(j) Failed to report alleged abuse, neglect, or exploitation of a vulnerable adult in violation of chapter 74.34 RCW;

(k) Failed to exercise fiscal accountability and responsibility involving a resident, the department, public agencies, or the business community; or to have insufficient financial resources or unencumbered income to sustain the operation of the assisted living facility;

(l) Knowingly or with reason to know, made false statements of material fact in the application for the license or the renewal of the license or any data attached thereto, or in any matter under investigation by the department;

(m) Willfully prevented or interfered with or attempted to impede in any way any inspection or investigation by the department, or the work of any authorized representative of the department, or the lawful enforcement of any provision of this chapter;

(n) Refused to allow department representatives or agents to examine any part of the licensed premises including the books, records, and files required under this chapter;

(o) Continue to use terminology such as memory care facility, or dementia care facility, without having been issued a certification under RCW 18.20.540;

(p) Continue to operate a facility or unit within a facility, that has restricted egress, without having been issued a certification under RCW 18.20.540;

(q) Moved all residents out of the assisted living facility without the department's approval and appears to be no longer operating as an assisted living facility; or

(r) Demonstrated any other factors that give evidence the applicant lacks the appropriate character, suitability, and competence to provide care or services to vulnerable adults.

(2) This section applies to any assisted living facility:

(a) Applicant;

(b) Partner, officer, or director;

(d) Majority owner of the applicant or licensee:

(i) Who is involved in the management or operation of the assisted living facility;

(ii) Who may have direct access to assisted living facility residents;

(iii) Who controls or supervises the provision of care or services to assisted living facility residents; or

(iv) Who exercises control over daily operations of the assisted living facility.

(3) For other circumstances resulting in discretionary enforcement remedies, see WAC 388-78A-3200.

History

Statutory Authority: RCW 18.20.090 and 18.20.550. WSR 26-15-066, s 388-78A-3170, filed 7/15/26, effective 8/15/26. Statutory Authority: RCW 74.39A.056, chapter 18.20 RCW. WSR 14-14-031, § 388-78A-3170, filed 6/24/14, effective 7/25/14. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-3170, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-3170, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-3180 Required enforcement remedies.

The department must impose an appropriate remedy consistent with RCW 18.20.125 and as otherwise authorized by RCW 18.20.185 or 18.20.190 whenever the department finds an assisted living facility has:

(1) A serious problem, a recurring problem, or an uncorrected problem;

(2) Created a hazard that causes or is likely to cause death or serious harm to one or more residents;

(3) Discriminated or retaliated in any manner against a resident, employee, or any other person because that person or any other person made a complaint or provided information to the department, the attorney general, a law enforcement agency, or the long-term care ombuds; or

(4) Willfully interfered with the performance of official duties by a long-term care ombuds.

History

Statutory Authority: Chapter 18.20 RCW. WSR 14-05-035, § 388-78A-3180, filed 2/12/14, effective 3/15/14
WSR 13-13-063, § 388-78A-3180, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-3180, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-3181 Remedies—Specific—Civil penalties.

WAC 388-78A-3181

(1) The department may impose civil penalties of at least $100 per day per violation.

(2) Fines up to $1,000 per day per violation may be issued under RCW 18.20.190 through June 30, 2019, and thereafter as follows:

(a) Beginning July 1, 2019, through June 30, 2020, the civil penalties may not exceed $2,000 per day per violation; and

(b) Beginning July 1, 2020, the civil penalties may not exceed $3,000 per day per violation.

(3) Fines up to $3,000 may be issued under RCW 18.20.185 for willful interference with a representative of the long-term care ombuds.

(4) Fines up to $3,000 may be issued under RCW 74.39A.060 for retaliation against a resident, employee, or any other person making a complaint, providing information to, or cooperating with, the ombuds, the department, the attorney general's office, or a law enforcement agency.

(5) Fines up to $10,000 may be issued under RCW 18.20.190 for a current or former licensed provider who is operating an unlicensed assisted living facility, uncertified memory care facility, or uncertified memory care unit.

(6) When the assisted living facility fails to pay a fine under this chapter when due, the department may, in addition to other remedies, withhold an amount equal to the fine plus interest, if any, from any contract payment due to the provider from the department.

(7) Civil monetary penalties are due 28 days after the assisted living facility or the owner or operator of an unlicensed assisted living facility is served with notice of the penalty unless the assisted living facility requests a hearing in compliance with chapter 34.05 RCW, RCW 43.20A.215, and this chapter. If the hearing is requested, the penalty becomes due 10 days after a final decision affirming the assessed civil penalty. Thirty days after the department serves the assisted living facility with notice of the penalty, interest begins to accrue at a rate of one percent per month as authorized under RCW 43.20B.695.

(8) All receipts from civil penalties imposed under this chapter must be deposited in the assisted living facility temporary management account per RCW 18.20.430.

History

Statutory Authority: RCW 18.20.090 and 18.20.550. WSR 26-15-066, s 388-78A-3181, filed 7/15/26, effective 8/15/26. Statutory Authority: RCW 18.20.090. WSR 20-09-108, § 388-78A-3181, filed 4/16/20, effective 5/17/20. Statutory Authority: Chapter 18.20 RCW. WSR 19-18-031, § 388-78A-3181, filed 8/29/19, effective 9/29/19.

Wash. Admin. Code § 388-78A-3183 Remedies—Civil fine grid.

Effective May 17, 2020, the department will consider the guidance in the tiered sanction grid below when imposing civil fine remedies:

Beginning July 1, 2019, the department will consider the guidance in the tiered sanction grid below when imposing civil fine remedies:

| No Harm | Minimal to Moderate Harm | Severe Harm | Imminent Danger, Immediate Threat, or Both | | | | --- | --- | --- | --- | --- | --- | | Recurring/Uncorrected | Initial | Recurring/Uncorrected | Initial | Recurring/Uncorrected | Any Violation | | Civil fine of at least one hundred dollars per violation. | Civil fine up to two hundred and fifty dollars per violation or a daily civil fine of at least one hundred and twenty-five dollars per day. | Civil fine up to five hundred dollars per violation or a daily civil fine of at least two hundred and fifty dollars per day. | Civil fine up to one thousand dollars per violation or a daily civil fine of at least five hundred dollars per day. | Civil fine up to one thousand five hundred dollars per violation or a daily civil fine of at least seven hundred and fifty dollars per day. | Civil fine of two thousand dollars or daily civil fine of at least one thousand dollars per day. |

Beginning July 1, 2020, the department will consider the guidance in the tiered sanction grid below when imposing civil fine remedies:

| No Harm | Minimal to Moderate Harm | Severe Harm | Imminent Danger, Immediate Threat, or Both | | | | --- | --- | --- | --- | --- | --- | | Recurring/Uncorrected | Initial | Recurring/Uncorrected | Initial | Recurring/Uncorrected | Any Violation | | Civil fine of at least one hundred dollars per violation. | Civil fine up to five hundred dollars per violation or a daily civil fine of at least two hundred and fifty dollars per day. | Civil fine up to one thousand dollars per violation or a daily civil fine of at least five hundred dollars per day. | Civil fine up to two thousand dollars per violation or a daily civil fine of at least one thousand dollars per day. | Civil fine up to three thousand dollars per violation or a daily civil fine of at least one thousand five hundred dollars per day. | Civil fine of three thousand dollars or daily civil fine of at least one thousand dollars per day. |

For the purpose of this section, the following definitions of harm apply:

(1) "Minimal" means violations that result in little to no negative outcome or little or no potential harm for a resident.

(2) "Moderate" means violations that result in negative outcome and actual or potential harm for a resident.

(3) "Severe" means violations that either result in one or more negative outcomes and significant actual harm to residents that does not constitute imminent danger, or there is a reasonable predictability of recurring actions, practices, situations, or incidents with potential for causing significant harm to a resident, or both.

(4) "Imminent danger" or "immediate threat" means serious physical harm to or death of a resident has occurred, or there is a serious threat to the resident's life, health, or safety.

History

Statutory Authority: RCW 18.20.090. WSR 20-09-108, § 388-78A-3183, filed 4/16/20, effective 5/17/20. Statutory Authority: Chapter 18.20 RCW. WSR 19-18-031, § 388-78A-3183, filed 8/29/19, effective 9/29/19.

Wash. Admin. Code § 388-78A-3190 Denial, suspension, revocation, or nonrenewal of license statutorily required.

(1) The department must deny, suspend, revoke, or refuse to renew an assisted living facility license if any person described in subsection (2) of this section is found by the department to have:

(b) The individual is a registered sex offender;

(d) A founded finding of abuse or neglect of a child was made against the person, unless the finding was made by child protective services prior to October 1, 1998;

(e) The individual was found in any dependency action to have sexually assaulted or exploited any child or to have physically abused any child;

(g) The person has had a contract or license denied, terminated, revoked, or suspended due to abuse, neglect, financial exploitation, or mistreatment of a child or vulnerable adult; or

(2) This section applies to any assisted living facility:

(a) Applicant;

(b) Partner, officer or director;

(d) Owner of five percent or more of the applicant:

(i) Who is involved in the operation of the assisted living facility; or

(ii) Who controls or supervises the provision of care or services to the assisted living facility residents; or

(iii) Who exercises control over daily operations.

History

Statutory Authority: RCW 74.39A.056, chapter 18.20 RCW. WSR 14-14-031, § 388-78A-3190, filed 6/24/14, effective 7/25/14. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-3190, filed 6/18/13, effective 7/19/13. Statutory Authority: Chapters 18.20 and 74.39A RCW. WSR 10-16-085, § 388-78A-3190, filed 7/30/10, effective 1/1/11. Statutory Authority: Chapter 18.20 RCW. WSR 10-03-066, § 388-78A-3190, filed 1/15/10, effective 2/15/10. Statutory Authority: RCW 18.20.090. WSR 06-01-047, § 388-78A-3190, filed 12/15/05, effective 1/15/06. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-3190, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-3200 Progression of enforcement remedies.

(1) When the department cites an assisted living facility for an initial problem that does not represent a recurring problem, serious problem, or uncorrected problem, and that results in minimal or moderate harm that is limited in scope, the department may:

(a) Require a plan of correction from the assisted living facility;

(b) Impose conditions on the assisted living facility license; and/or

(2) The department may take any of the actions specified in subsection (1) of this section and/or impose a stop placement or limited stop placement on an assisted living facility when:

(a) There is a reasonable probability, at the time the stop placement or limited stop placement is imposed, at least a moderate degree of harm will occur or recur as a result of a single problem or by a combination of problems; and

(b) The threatening problem is more than an isolated event or occurrence.

(3) The department may take any of the actions specified in subsections (1) and (2) of this section and/or summarily suspend an assisted living facility's license when:

(a) There is an imminent threat that a serious degree of harm may occur to residents as a result of a single problem or a combination of problems; and

(b) The threatening problem is more than an isolated event or occurrence.

(4) The assisted living facility must:

(a) Publicly post any department issued notice of a stop placement order or limited stop placement order in a place visible to residents, visitors, and staff within the assisted living facility; and

(b) Leave the posted notice in place until the department has terminated the stop placement order or limited stop placement order.

(5) The department may take any of the actions specified in subsections (1), (2) and (3) of this section and/or revoke an assisted living facility's license when:

(a) The department has cause to summarily suspend the assisted living facility's license;

(b) There is a current problem with the assisted living facility and the assisted living facility has a history of having enforcement remedies imposed by the department;

(c) There is a current problem with the assisted living facility and the assisted living facility has a history of noncompliance representing problems that were at least moderate in nature and moderate in scope;

(d) The assisted living facility has moved all residents out of the assisted living facility without the department's approval and is no longer operating as an assisted living facility; or

(e) There is a serious current problem, which may not warrant a summary suspension, with the assisted living facility that does not have a history of noncompliance. Examples of the types of serious current problems that may warrant license revocation include, but are not limited to:

(i) The licensee has been found or convicted by a court of competent jurisdiction to have engaged in fraudulent activity; or

(ii) The licensee is experiencing significant financial problems resulting in poor care or jeopardizing the care and services that can be provided to residents, and possible business failure; or

(f) The assisted living facility fails to cooperate with the department during any inspection or complaint investigation.

History

Statutory Authority: RCW 18.20.090, 18.51.070, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 26-05-046, s 388-78A-3200, filed 2/12/26, effective 3/15/26. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-3200, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-3200, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-3210 Informal dispute resolution.

The assisted living facility has a right to an informal dispute resolution meeting according to department procedure and consistent with RCW 18.20.195. The assisted living facility must make a request for an informal dispute resolution meeting in writing within ten days of the receipt of the written notice of deficiency.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-3210, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-3210, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-3220 Appeal rights.

(1) An applicant or assisted living facility:

(a) May contest an enforcement remedy imposed by the department pursuant to RCW 18.20.190 according to the provisions of chapter 34.05 RCW and chapters 10-08 and 388-02 WAC;

(b) Must file any request for an adjudicative proceeding with the office of administrative hearings at the mailing address specified in the notice of imposition of an enforcement remedy within twenty-eight days of receiving the notice.

(2) Orders of the department imposing licensing suspension, stop-placement, or conditions for continuation of a license are effective immediately upon notice and shall continue pending any hearing.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-3220, filed 6/18/13, effective 7/19/13. Statutory Authority: RCW 18.20.090. WSR 06-01-047, § 388-78A-3220, filed 12/15/05, effective 1/15/06. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-3220, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-3230 Fees.

WAC 388-78A-3230

(1) The assisted living facility must:

(a) Submit an annual per bed license fee based on the licensed bed capacity and as established in the state's biennial omnibus appropriation act and any amendment or addition made to that act;

(b) Submit an additional late fee in the amount of $10 per day from the license renewal date until the date of mailing the fee, as evidenced by the postmark; and

(c) Submit to construction review services a fee for the review of the construction documents per the review fee schedule that is based on the project cost.

(2) The assisted living facility must submit an initial certification fee as established by the department when applying for memory care certification.

(3) The assisted living facility must submit an annual certification fee as established by the department when renewing a memory care certification.

History

Statutory Authority: RCW 18.20.090 and 18.20.550. WSR 26-15-066, s 388-78A-3230, filed 7/15/26, effective 8/15/26. Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-3230, filed 6/18/13, effective 7/19/13
WSR 12-01-003, § 388-78A-3230, filed 12/7/11, effective 1/7/12. Statutory Authority: RCW 18.20.050 and 2010 c 37 § 206 (19)(a). WSR 10-21-036, § 388-78A-3230, filed 10/12/10, effective 10/29/10. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. WSR 04-16-065, § 388-78A-3230, filed 7/30/04, effective 9/1/04.

Wash. Admin. Code § 388-78A-4000 Notice—Service complete.

Service of the department notices is complete when:

(1) Personal service is made;

(2) The notice is addressed to the individual or facility at his or her last known address, and deposited in the United States mail;

(3) The notice is faxed and the department receives evidence of transmission;

(4) Notice is delivered to a commercial delivery service with charges prepaid; or

(5) Notice is delivered to a legal messenger service with charges prepaid.

History

Statutory Authority: Chapter 18.20 RCW. WSR 10-03-066, § 388-78A-4000, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-78A-4010 Notice—Proof of service.

The department may establish proof of service by any of the following:

(1) A declaration of personal service;

(2) An affidavit or certificate of mailing to the assisted living facility or to the individual to whom notice is directed;

(3) A signed receipt from the person who accepted the certified mail, the commercial delivery service, or the legal messenger service package; or

(4) Proof of fax transmission.

History

Statutory Authority: Chapter 18.20 RCW. WSR 13-13-063, § 388-78A-4010, filed 6/18/13, effective 7/19/13
WSR 10-03-066, § 388-78A-4010, filed 1/15/10, effective 2/15/10.

Chapter 388-79A Guardianship fees for medicaid clients.

Wash. Admin. Code § 388-79A-001 Definitions.

The following definitions apply to this chapter:

(1) "Client" means a person who is eligible for and is receiving medicaid-funded long-term care.

(2) "Guardianship fees" or "fees" means necessary fees charged by a guardian for services rendered on behalf of a client.

(3) "Participate" or "participation" means the amount a client must pay each month toward the cost of long-term care services received each month. It is the amount remaining after the post-eligibility process under:

(a) WAC 182-513-1380 for a client residing in a medical institution, as defined under WAC 182-500-0050;

(b) WAC 182-515-1509 for a client receiving home and community services (HCS) waivered services in an alternate living facility (ALF), as defined under WAC 182-513-1100, or in an at-home setting; or

(c) WAC 182-515-1514 for a client receiving developmental disability administration (DDA) waivered services in an ALF, as defined under WAC 182-513-1100, or in an at-home setting.

(4) "Related costs" or "costs" means necessary costs paid by the guardian, including attorney fees.

History

Statutory Authority: RCW 43.20B.460, 11.92.180, and 74.08.090. WSR 18-10-067, § 388-79A-001, filed 4/30/18, effective 6/1/18.

Wash. Admin. Code § 388-79A-005 Maximum amount of guardianship fees and related costs for a long-term care medicaid eligible client.

(1) As mandated by RCW 43.20B.460 and in accordance with RCW 11.92.180, the maximum amount of guardianship fees and related costs must not exceed the limits of this section when the person under guardianship is:

(a) A medicaid eligible client, residing in:

(i) A medical institution, as defined under WAC 182-500-0050;

(ii) An alternate living facility (ALF), as defined under WAC 182-513-1100; or

(iii) An at-home setting; and

(b) Required under chapter 182-513 WAC or chapter 182-515 WAC to participate towards the cost of long-term care.

(2) The maximum amount of guardianship fees and related costs must not exceed the limits of WAC 388-79A-010 when:

(a) The most recent court order establishing or continuing a guardianship was entered before June 1, 2018; and

(b) The client under guardianship was receiving medicaid-funded long-term care before June 1, 2018.

(3) For all other clients not described under subsection (2) of this section, the maximum amount of guardianship fees and related costs must not exceed the limits under WAC 182-513-1530.

History

Statutory Authority: RCW 43.20B.460, 11.92.180, and 74.08.090. WSR 19-04-100, § 388-79A-005, filed 2/5/19, effective 3/8/19
WSR 18-10-067, § 388-79A-005, filed 4/30/18, effective 6/1/18.

Wash. Admin. Code § 388-79A-010 Maximum guardianship fees and related costs before June 1, 2018.

(1) This section sets the maximum guardianship fees and related costs when:

(a) The court order was entered before June 1, 2018; and

(b) The client under guardianship was receiving medicaid-funded long-term care before June 1, 2018.

(2) For court orders entered before June 1, 2018, where the order establishes or continues a legal guardianship for a client:

(a) Guardianship fees must not exceed $175 per month;

(b) Costs directly related to establishing a guardianship for a client must not exceed $700; and

History

WSR 18-11-039, recodified as § 388-79A-010, filed 5/8/18, effective 6/1/18. Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 18-10-024, § 182-513-1515, filed 4/24/18, effective 6/1/18. WSR 16-15-042, recodified as § 182-513-1515, filed 7/14/16, effective 7/14/16. Statutory Authority: RCW 11.92.180, 43.20B.460. WSR 03-16-022, § 388-79-030, filed 7/28/03, effective 8/28/03
WSR 98-10-055, § 388-79-030, filed 4/30/98, effective 5/31/98.

Wash. Admin. Code § 388-79A-015 Procedure for allowing guardianship fees and related costs from client participation before June 1, 2018.

(1) This section describes the procedure for allowing guardianship fees and related costs from client participation when:

(a) A court order was entered before June 1, 2018; and

(b) The client under guardianship was receiving medicaid-funded long-term care before June 1, 2018.

(2) The medicaid agency or the agency's designee, after receiving the court order, adjusts the client's current participation to reflect the amounts, as allowed under WAC 182-513-1380, 183-515-1509, or 183-515-1514.

(3) A client's participation cannot be prospectively or retrospectively reduced to pay guardianship fees and related costs incurred:

(a) Before the client's long-term care medicaid eligibility effective date;

(b) During any time when the client was not eligible for or did not receive long-term care services; or

(4) The fees and costs allowed by the court at the final accounting must not exceed the amounts advanced and paid to the guardian from the client's participation if:

(a) The court, at a prior accounting, allowed the guardian to receive guardianship fees and related costs from the client's participation in advance of services rendered by the guardian; and

(b) The client dies before the next accounting.

History

WSR 18-11-039, recodified as § 388-79A-015, filed 5/8/18, effective 6/1/18. Statutory Authority: RCW 41.05.021 and 41.05.160. WSR 18-10-024, § 182-513-1525, filed 4/24/18, effective 6/1/18. WSR 16-15-042, recodified as § 182-513-1525, filed 7/14/16, effective 7/14/16. Statutory Authority: RCW 11.92.180, 43.20B.460. WSR 03-16-022, § 388-79-050, filed 7/28/03, effective 8/28/03.

Chapter 388-96 Nursing facility medicaid payment system.

Wash. Admin. Code § 388-96-010 Definitions.

Unless the context indicates otherwise, the following definitions apply in this chapter.

"Accounting" means activities providing information, usually quantitative and often expressed in monetary units, for:

(1) Decision making;

(2) Planning;

(3) Evaluating performance;

(4) Controlling resources and operations; and

(5) External financial reporting to investors, creditors, regulatory authorities, and the public.

"Accrual method of accounting" is a method of accounting in which revenues are reported in the period when they are earned, regardless of when they are collected, and expenses are reported in the period in which they are incurred, regardless of when they are paid.

"Administration and management" means activities used to maintain, control, and evaluate the efforts and resources of an organization for the accomplishment of the objectives and policies of that organization.

"Allowable costs" are documented costs that are necessary, ordinary, reasonable, and related to the care of medicaid recipients, and are not expressly declared nonallowable by this chapter or chapter 74.46 RCW. Costs are ordinary if they are of the nature and magnitude that prudent and cost conscious management would pay.

"Assignment of contract" means:

(1) A new nursing facility licensee has elected to care for medicaid residents;

(2) The department finds no good cause to object to continuing the medicaid contract at the facility; and

(3) The new licensee accepts assignment of the immediately preceding contractor's contract at the facility.

"Bad debts" are amounts considered to be uncollectible from accounts and notes receivable.

"Banked beds" are beds removed from service under chapter 246-310 WAC.

"Beneficial owner" is any one or more of the following:

(1) Any person who, directly or indirectly, through any contract, arrangement, understanding, relationship, or otherwise has or shares one or more of the following:

(a) Voting power which includes the power to vote, or to direct the voting of such ownership interest; or

(b) Investment power which includes the power to dispose, or to direct the disposition of such ownership interest.

(2) Any person who, directly or indirectly, creates or uses a trust, proxy, power of attorney, pooling arrangement, or any other contract, arrangement, or device with the effect of divesting himself or herself of beneficial ownership of an ownership interest or preventing the vesting of such beneficial ownership as part of a plan or scheme to evade the reporting requirements of this chapter;

(3) Any person who, subject to (b) of this subsection, has the right to acquire beneficial ownership of such ownership interest within sixty days, including but not limited to any right to acquire:

(a) Through the exercise of any option, warrant, or right;

(b) Through the conversation of an ownership interest;

(d) Pursuant to the automatic termination of a trust, discretionary account, or similar arrangement; except that, any person who acquires an ownership interest or power specified in (a), (b), or (c) of this subsection with the purpose or effect of changing or influencing the control of the contractor, or in connection with or as a participant in any transaction having such purpose or effect, immediately upon such acquisition shall be deemed to be the beneficial owner of the ownership interest which may be acquired through the exercise or conversion of such ownership interest or power;

(4) Any person who in the ordinary course of business is a pledgee of ownership interest under a written pledge agreement shall not be deemed to be the beneficial owner of such pledged ownership interest until the pledgee has taken all formal steps necessary which are required to declare a default and determines that the power to vote or to direct the vote or to dispose or to direct the disposition of such pledged ownership interest will be exercised; except that:

(a) The pledgee agreement is bona fide and was not entered into with the purpose nor with the effect of changing or influencing the control of the contractor, nor in connection with any transaction having such purpose or effect, including persons meeting the conditions set forth in (b) of this subsection; and

(b) The pledgee agreement, prior to default, does not grant to the pledgee:

(i) The power to vote or to direct the vote of the pledged ownership interest; or

(ii) The power to dispose or direct the disposition of the pledged ownership interest, other than the grant of such power(s) pursuant to a pledge agreement under which credit is extended and in which the pledgee is a broker or dealer.

"Building" means the basic structure, shell, structures, or shells of a facility and additions thereto. All allowable sections of a building are enclosed on all sides with a roof and are permanent.

"Building improvements" are betterments and additions made by a building owner to the building.

"Capital" means the component of the rate that uses a fair market rental system to set a price per bed.

"Capitalized lease" means a lease required to be recorded as an asset and associated liability in accordance with generally accepted accounting principles.

"Cash method of accounting" means a method of accounting in which revenues are recorded when cash is received, and expenditures for expense and asset items are not recorded until cash is disbursed for those expenditures and assets.

"Change of ownership" means a substitution, elimination, or withdrawal of the individual operator or operating entity contracting with the department to deliver care services to medical care recipients in a nursing facility and ultimately responsible for the daily operational decisions of the nursing facility.

(1) Events which constitute a change of ownership include, but are not limited to, the following:

(a) Changing the form of legal organization of the contractor, such as a sole proprietor forms a partnership or corporation;

(b) Transferring ownership of the nursing facility business enterprise to another party, regardless of whether ownership of some or all of the real property or personal property assets of the facility are also transferred;

(d) Dissolving the corporation, merging the corporation with another corporation, which is the survivor, or consolidating with one or more other corporations to form a new corporation;

(e) Transferring, whether by a single transaction or multiple transactions within any continuous twenty-four-month period, fifty percent or more of the stock to one or more:

(i) New or former stockholders; or

(ii) Present stockholders each having held less than five percent of the stock before the initial transaction;

(f) Substituting of the individual operator or the operating entity by any other event or combination of events that results in a substitution or substitution of control of the individual operator or the operating entity contracting with the department to deliver care services; or

(g) A nursing facility ceases to operate.

(2) Ownership does not change when the following, without more, occurs:

(a) A party contracts with the contractor to manage the nursing facility enterprise as the contractor's agent, i.e., subject to the contractor's general approval of daily operating and management decisions; or

(b) The real property or personal property assets of the nursing facility change ownership or are leased, or a lease of them is terminated, without a substitution of individual operator or operating entity and without a substitution of control of the operating entity contracting with the department to deliver care services.

"Charity allowance" means a reduction in charges made by the contractor because of the indigence or medical indigence of a patient.

"Component rate allocation" means the initial component rate allocation of the rebased rate for a rebase period effective July 1st. If a month and a day, other than July 1st with a year precedes "component rate allocation," it means the initial component rate allocation of the rebased rate of the rebase period has been amended or updated effective the date that precedes it, e.g., October 1, 1999 direct care component rate allocation.

"Contract" means an agreement between the department and a contractor for the delivery of nursing facility services to medical care recipients.

"Cost report" means all schedules of a nursing facility's cost report submitted according to the department's instructions.

"Courtesy allowances" are reductions in charges in the form of an allowance to physicians, clergy, and others, for services received from the contractor. Employee fringe benefits are not considered courtesy allowances.

"Department" means department of social and health services and its employees.

"Direct care suppliesor "DCS" means:

(1) Those supplies:

(a) Used by staff providing direct care to residents;

(b) Consumed during a single accounting period; and

(2) Supplies excluded from DCS include but are not limited to the following:

(a) Medical equipment (such as IV poles);

(b) Items covered by medicaid fee-for-service system; and

"Donated asset" means an asset the contractor acquired without making any payment for the asset either in cash, property, or services. An asset is not a donated asset if the contractor:

(1) Made even a nominal payment in acquiring the asset; or

(2) Used donated funds to purchase the asset.

"Equity capital" means total tangible and other assets that are necessary, ordinary, and related to patient care from the most recent provider cost report minus related total long-term debt from the most recent provider cost report plus working capital defined as current assets minus current liabilities.

"Fiscal year" means the operating or business year of a contractor. All contractors report on the basis of a twelve month fiscal year, but provision is made in this chapter for reports covering abbreviated fiscal periods. As determined by context or otherwise, "fiscal year" may also refer to a state fiscal year extending from July 1st through June 30th of the following year and comprising the first or second half of a state fiscal biennium.

"Fixed equipment" means attachments to buildings including, but not limited to, wiring, electrical fixtures, plumbing, elevators, heating system, and air conditioning system. Generally, fixed equipment is permanently attached to the building and not subject to transfer.

"Goodwill" means the excess of the price paid for a nursing facility business over the fair market value of all net identifiable tangible and intangible assets acquired, as measured in accordance with generally accepted accounting principles.

"Imprest fund" means a fund that is regularly replenished in exactly the amount expended from it.

"Intangible asset" is an asset that lacks physical substance but possesses economic value.

"Interest" means the cost incurred for the use of borrowed funds, generally paid at fixed intervals by the user.

"Joint facility costs" are any costs that benefit more than one facility, or one facility and any other entity.

"Leasehold improvements" are betterments and additions made by the lessee to the leased property that become the property of the lessor after the expiration of the lease.

"Licensed beds" means the adjusted reported beds from the cost report associated with the cost year of the component being set. This is the number of licensed beds in a facility on December 31st of the cost report year according to the department of health.

"Nonadministrative wages and benefits" are wages, benefits, and corresponding payroll taxes paid for nonadministrative personnel, not including the administrator, assistant administrator, or administrator-in-training.

"Nonallowable costs" are the same as "unallowable costs."

"Nonrestricted funds" are funds that are not restricted to a specific use by the donor, such as general operating funds.

"Nursing facility occupancy percentage" is a percentage determined by multiplying the number of calendar days for the cost report period by the number of licensed beds, regardless of how many beds are set up, in use, or banked under chapter 246-310 WAC, for the same cost report period. Then, the product is divided into the nursing facility's actual resident days for the same cost report period. Banked beds are not counted as licensed beds for nursing facility occupancy percentage calculation.

"Operating lease" means a lease under which rental or lease expenses are included in current expenses in accordance with generally accepted accounting principles.

"Ownership interest" means all interests beneficially owned by a person, calculated in the aggregate, regardless of the form the beneficial ownership takes.

"Per diem costs," or "per patient day costs," or "per patient days costs" mean total allowable costs for a fiscal period divided by total patient or resident days for the same period.

"Prospective daily payment rate" means the rate assigned by the department to a contractor for providing service to medical care recipients prior to the application of settlement principles.

"Real property," whether leased or owned by the contractor, means the building, allowable land, land improvements, and building improvements associated with a nursing facility.

"Recipient" means a medicaid recipient.

"Related care" means only those services that are directly related to providing direct care to nursing facility residents including but not limited to:

(1) The director of nursing services;

(2) Nursing direction and supervision;

(3) Activities and social services programs;

(4) Medical and medical records specialists; and

(5) Consultation provided by:

(a) Medical directors; and

(b) Pharmacists.

"Relative" includes:

(1) Spouse;

(2) Natural parent, child, or sibling;

(3) Adoptive child, parent, or sibling;

(4) Stepparent, stepchild, stepbrother, stepsister;

(5) Father-in-law, mother-in-law, son-in-law, daughter-in-law, brother-in-law, sister-in-law;

(6) Grandparent and grandchild; and

(7) Uncle, aunt, nephew, niece, and cousin.

"Related organization" means an entity under common ownership or common control with, or has control of or is controlled by the contractor.

(1) "Common ownership" exists when an entity or person is the beneficial owner of five percent or more ownership interest in the contractor and any other entity.

(2) "Control" exists where an entity or person has the power, directly or indirectly, significantly to influence or direct the actions or policies of an organization or institution, whether or not it is legally enforceable and however it is exercisable and exercised.

"Renovations" means the cost of the building, building improvements, leasehold improvements, and fixed equipment used to calculate a facility's age. In order to be used to calculate a facility's age, the cost of renovations in a calendar year must be two thousand dollars or greater per licensed bed.

"Restricted fund" means those funds in which either the principal or income, or both, is limited by agreement with or direction of the donor to a specific purpose.

"Significant renovations" are renovations that exceed two thousand dollars per licensed bed in a calendar year as reported on the adjusted annual cost report.

"Start up costs" are the one-time preopening costs incurred from the time preparation begins on a newly constructed or purchased building until the first patient is admitted. Start up costs include:

(1) Administrative and nursing salaries;

(2) Utility costs;

(3) Taxes;

(4) Insurance;

(5) Repairs and maintenance; and

(6) Training costs.

Start up costs do not include expenditures for capital assets.

"Total rate allocation" means the initial rebased rate for a rebase period effective July 1st. If a month and a day, other than July 1st, with a year precedes "total rate allocation," it means the initial rebased rate of the rebase period has been amended or updated effective the date that precedes it, such as October 1, 1999 direct care component rate allocation.

"Unallowable costs" are costs that do not meet every test of an allowable cost.

"Uniform chart of accounts" are account titles identified by code numbers established by the department for contractors to use in reporting costs.

"Vendor number" means a number assigned to each contractor delivering care services to medical care recipients.

History

Statutory Authority: RCW 74.46.800, 74.46.561(1). WSR 17-22-037, § 388-96-010, filed 10/24/17, effective 11/24/17. Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-010, filed 2/14/11, effective 2/26/11. Statutory Authority: RCW 74.46.800. WSR 01-12-037, § 388-96-010, filed 5/29/01, effective 6/29/01. Statutory Authority: Chapter 74.46 RCW, 1999 c 376 § 3 amending c 309 § 207. WSR 99-24-084, § 388-96-010, filed 11/30/99, effective 12/31/99. Statutory Authority: RCW 74.46.800. WSR 98-20-023, § 388-96-010, filed 9/25/98, effective 10/1/98
WSR 97-17-040, § 388-96-010, filed 8/14/97, effective 9/14/97. Statutory Authority: RCW 74.46.800 and 1995 1st sp.s. c 18. WSR 95-19-037 (Order 3896), § 388-96-010, filed 9/12/95, effective 10/13/95. Statutory Authority: RCW 74.46.800. WSR 94-12-043 (Order 3737), § 388-96-010, filed 5/26/94, effective 6/26/94. Statutory Authority: RCW 74.46.800 and 74.09.120. WSR 93-19-074 (Order 3634), § 388-96-010, filed 9/14/93, effective 10/15/93. Statutory Authority: RCW 74.09.120. WSR 91-22-025 (Order 3270), § 388-96-010, filed 10/29/91, effective 11/29/91. Statutory Authority: RCW 79.09.120 [74.09.120] and 74.46.800. WSR 90-09-061 (Order 2970), § 388-96-010, filed 4/17/90, effective 5/18/90. Statutory Authority: 1987 c 476. WSR 88-01-126 (Order 2573), § 388-96-010, filed 12/23/87. Statutory Authority: RCW 74.09.120 and 74.46.800. WSR 85-13-060 (Order 2240), § 388-96-010, filed 6/18/85. Statutory Authority: RCW 74.09.120. WSR 84-24-050 (Order 2172), § 388-96-010, filed 12/4/84. Statutory Authority: RCW 74.46.800. WSR 84-12-039 (Order 2105), § 388-96-010, filed 5/30/84. Statutory Authority: RCW 74.09.120. WSR 83-19-047 (Order 2025), § 388-96-010, filed 9/16/83
WSR 82-21-025 (Order 1892), § 388-96-010, filed 10/13/82
WSR 81-22-081 (Order 1712), § 388-96-010, filed 11/4/81. Statutory Authority: RCW 74.09.120 and 74.46.800. WSR 81-06-024 (Order 1613), § 388-96-010, filed 2/25/81. Statutory Authority: RCW 74.09.120. WSR 80-09-083 (Order 1527), § 388-96-010, filed 7/22/80
WSR 79-04-061 (Order 1381), § 388-96-010, filed 3/28/79. Statutory Authority: RCW 74.08.090 and 74.09.120. WSR 78-06-080 (Order 1300), § 388-96-010, filed 6/1/78
Order 1262, § 388-96-010, filed 12/30/77.

Wash. Admin. Code § 388-96-011 Conditions of participation.

In order to participate in the nursing facility medicaid payment system established by this chapter and chapter 74.46 RCW, the person or legal entity responsible for operation of a facility shall:

(1) Obtain a state certificate of need and/or federal capital expenditure review (section 1122) approval pursuant to chapter 70.38 RCW and Part 100, Title 42 C.F.R. where required;

(2) Hold the appropriate current license;

(3) Hold current Title XIX certification;

(4) Hold a current contract to provide services under this chapter and chapter 74.46 RCW;

(5) Comply with all provisions of the contract and all applicable statutes and regulations, including but not limited to the provisions of this chapter and chapter 74.46 RCW; and

(6) Obtain and maintain medicare certification, under Title XVIII of the Social Security Act, 42 U.S.C. Sec. 1395, as amended, for a portion of the facility's licensed beds.

History

Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-011, filed 2/14/11, effective 2/26/11.

Wash. Admin. Code § 388-96-012 Public disclosure.

(1) Cost reports and final audit reports filed by the contractor shall be subject to public disclosure pursuant to chapter 42.56 RCW.

(2) Subsection (1) of this section does not prevent a contractor from having access to its own records or from authorizing an agent or designee to have access to the contractor's records.

(3) Regardless of whether any document or report submitted to the department pursuant to this chapter is subject to public disclosure, copies of such documents or reports shall be provided by the department, upon written request, to the legislature and to federal, state, or local agencies or law enforcement officials who have an official interest in the contents thereof.

History

Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-012, filed 2/14/11, effective 2/26/11.

Wash. Admin. Code § 388-96-020 Prospective cost-related payment.

The nursing facility medicaid payment system is the system used by the department to pay for nursing facility services provided to medical care recipients. Payment for nursing facility care shall be determined in accordance with this chapter and chapter 74.46 RCW. The provisions of chapter 74.46 RCW are incorporated by reference in this chapter as if fully set forth.

History

Statutory Authority: RCW 74.46.800. WSR 98-20-023, § 388-96-020, filed 9/25/98, effective 10/1/98. Statutory Authority: RCW 74.09.120 and 74.46.800. WSR 85-13-065 (Order 2245), § 388-96-020, filed 6/18/85. Statutory Authority: RCW 74.09.120. WSR 83-19-047 (Order 2025), § 388-96-020, filed 9/16/83
WSR 82-21-025 (Order 1892), § 388-96-020, filed 10/13/82. Statutory Authority: RCW 74.08.090 and 74.09.120. WSR 78-06-080 (Order 1300), § 388-96-020, filed 6/1/78
Order 1262, § 388-96-020, filed 12/30/77.

Wash. Admin. Code § 388-96-022 Due dates for cost reports.

(1) The contractor must submit annually a complete report of costs and financial conditions of the contractor that is prepared and presented in a standardized manner and in accordance with this chapter and chapter 74.46 RCW.

(2) The department will review the contractor's costs and financial conditions in accordance with the methodology effective at the time the contractor incurred the costs as described in chapters 388-96 WAC and 74.46 RCW.

(3) Not later than March 31st of each year, each contractor must submit to the department an annual cost report for the period from January 1st through December 31st of the preceding year.

(4) Cost reports for new contractors must be submitted in accordance with WAC 388-96-026.

(5) To properly complete the cost report, the contractor must submit the entire cost report, including the certification page to the document electronically. A cost report is not complete until the department receives both documents.

(6) Not later than one hundred twenty days following the termination or assignment of a contract, the terminating or assigning contractor must submit to the department a cost report for the period from January 1st through the date the contract was terminated or assigned.

(7) If the contractor does not properly complete the cost report or the department does not receive it by the due date established in this section, the department may withhold all or part of any payments due under the contract until the department receives the contractor's properly completed cost report.

(8) The department may impose civil fines or take adverse rate action against contractors and former contractors who do not submit properly completed cost reports by the applicable due date established in this section.

History

Statutory Authority: RCW 74.46.800, 74.46.561(1). WSR 17-22-037, § 388-96-022, filed 10/24/17, effective 11/24/17. Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-022, filed 2/14/11, effective 2/26/11.

Wash. Admin. Code § 388-96-026 New contractors.

(1) For purposes of administering the payment system, the department shall consider a "new contractor" as one who receives a new vendor number and:

(a) Builds from the ground-up a new facility; and operates the new facility with completely new staff, administration and residents. If the "new contractor" operated a nursing facility immediately before the opening of the new facility, then the "new contractor" must operate the new facility with:

(i) Staff and administration that are substantially to completely different than the previous operation of the "new contractor"; and

(ii) A resident population that is substantially to completely different than the residents residing in the previous nursing facility; or

(b) Currently operates, acquires, or assumes responsibility for operating an existing nursing facility that was not operated under a medicaid contract immediately prior to the effective date of the new medicaid contract; or

(c) Purchases or leases a nursing facility that, at the time of the purchase or lease, was operated under a medicaid contract.

(2) A new contractor shall submit:

(a) At least sixty days before the effective date of the contract or assignment, a statement disclosing the identity of individuals or organizations who:

(i) Have a beneficial ownership interest in the current operating entity or the land, building, or equipment of the facility; or

(ii) Have a beneficial ownership interest in the purchasing or leasing entity.

(b) By March 31st of the following year, a cost report for the period from the effective date of the contract or assignment through December 31st of year the contract or assignment was effective.

History

Statutory Authority: Chapter 74.46 RCW as amended by 1998 c 322 § 19(11) and RCW 74.46.800. WSR 98-20-023, § 388-96-026, filed 9/25/98, effective 10/1/98. Statutory Authority: RCW 74.46.800, 74.46.450 and 74.09.120. WSR 93-12-051 (Order 3555), § 388-96-026, filed 5/26/93, effective 6/26/93. Statutory Authority: RCW 74.46.800. WSR 92-16-013 (Order 3424), § 388-96-026, filed 7/23/92, effective 8/23/92. Statutory Authority: RCW 74.09.180 and 74.46.800. WSR 89-01-095 (Order 2742), § 388-96-026, filed 12/21/88. Statutory Authority: RCW 74.09.120. WSR 83-19-047 (Order 2025), § 388-96-026, filed 9/16/83
Order 1262, § 388-96-026, filed 12/30/77.

Wash. Admin. Code § 388-96-099 Completing cost reports and maintaining records.

(1) To determine reported costs, nursing facility contractors shall use generally accepted accounting principles, the provisions of this chapter, and chapter 74.46 RCW. In the event of conflict, chapter 74.46 RCW, this chapter, and instructions issued by the department take precedence over generally accepted accounting principles.

(2) A nursing facility's records shall be maintained on the accrual method of accounting and agree with or be reconcilable to the cost report. All revenue and expense accruals shall be reversed against the appropriate accounts unless they are received or paid, respectively, within one hundred twenty days after the accrual is made. However, if the contractor can document a good faith billing dispute with the supplier or vendor, the period may be extended, but only for those portions of billings subject to good faith dispute. Accruals for vacation, holiday, sick pay, payroll, and real estate taxes may be carried for longer periods, provided the contractor follows generally accepted accounting principles and pays this type of accrual when due.

History

Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-099, filed 2/14/11, effective 2/26/11.

Wash. Admin. Code § 388-96-102 Requirements for retention of records by the contractor.

(1) The contractor shall specify a location in the state of Washington at which the contractor shall retain all records supporting the cost reports for a period of four years following the filing of the required cost reports. Also, at the same location, for a period of four years, for each calendar year, the contractor shall retain all records supporting trust funds established under WAC 388-96-366(2) and account receivables. For example, supporting records for 2009 trust funds and accounts receivables must be kept through 2013.

(2) When there is (are) an unresolved issue(s) on a cost report, the department may direct supporting records to be retained for a longer period. All such records shall be made available upon demand to authorized representatives of the department, the office of the state auditor, and the Centers for Medicare and Medicaid Services (CMS).

(3) When a contract is terminated or assigned, all payments due the terminating or assigning contractor will be withheld until accessibility and preservation of the records within the state of Washington are assured.

History

Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-102, filed 2/14/11, effective 2/26/11.

Wash. Admin. Code § 388-96-105 Retention of cost reports and resident assessment information by the department.

The department will retain cost reports for one year after final settlement or reconciliation, or the period required under chapter 40.14 RCW, whichever is longer. Resident assessment information and records shall be retained as provided in statute or by department rule.

History

Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-105, filed 2/14/11, effective 2/26/11.

Wash. Admin. Code § 388-96-107 Requests for extensions.

(1) A contractor may request in writing an extension for submitting cost reports. Contractor requests must:

(a) Be addressed to the manager, nursing facility rates program;

(b) State the circumstances prohibiting compliance with the report due date; and

(2) The department may grant two extensions of up to thirty days each, only if the circumstances, stated clearly, indicate the due date cannot be met and the following conditions are present:

(a) The circumstances were not foreseeable by the provider; and

(b) The circumstances were not avoidable by advance planning.

History

Statutory Authority: RCW 74.46.800, 74.46.561(1). WSR 17-22-037, § 388-96-107, filed 10/24/17, effective 11/24/17. Statutory Authority: RCW 74.09.180 and 74.46.800. WSR 89-01-095 (Order 2742), § 388-96-107, filed 12/21/88. Statutory Authority: RCW 74.09.120. WSR 83-19-047 (Order 2025), § 388-96-107, filed 9/16/83
Order 1262, § 388-96-107, filed 12/30/77.

Wash. Admin. Code § 388-96-108 Failure to submit final reports.

(1) If a nursing facility's contract is terminated or assigned, and the nursing facility does not submit a final cost report as required by WAC 388-96-022, the nursing facility shall return to the department all payments made to the terminating or assigning contractor relating to the period for which a report has not been received within sixty days after the terminating or assigning contractor receives a written demand from the department.

(2) Effective sixty days after the terminating or assigning contractor receives a written demand for payment, interest will begin to accrue payable to the department on any unpaid balance at the rate of one percent per month.

History

Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-108, filed 2/14/11, effective 2/26/11. Statutory Authority: RCW 74.46.040 and 74.46.050 as amended by 1998 c 322 §§ 3 and 4. WSR 98-20-023, § 388-96-108, filed 9/25/98, effective 10/1/98. Statutory Authority: RCW 74.46.800 and 1995 1st sp.s. c 18. WSR 95-19-037 (Order 3896), § 388-96-108, filed 9/12/95, effective 10/13/95. Statutory Authority: RCW 74.09.120. WSR 83-19-047 (Order 2025), § 388-96-108, filed 9/16/83. Statutory Authority: RCW 74.08.090. WSR 82-21-025 (Order 1892), § 388-96-108, filed 10/13/82.

Wash. Admin. Code § 388-96-117 Certification requirement.

The contractor as defined in RCW 74.46.020(13) must certify under penalty of perjury that the cost report or an amendment to it is a true, correct, and complete representation of actual costs related to patient care prepared in accordance with applicable instructions provided by the department, chapter 388-96 WAC, and chapter 74.46 RCW. Further, where other costs not related to patient care are shown, they are classified as unallowable.

History

Statutory Authority: RCW 74.46.431 (11) and (12), 74.46.800, chapter 74.46 RCW, 2004 c 276 § 913, 2001 1st sp.s. c 8. WSR 04-21-027, § 388-96-117, filed 10/13/04, effective 11/13/04. Statutory Authority: RCW 74.09.120, 74.46.840 and 74.46.800. WSR 85-17-052 (Order 2270), § 388-96-117, filed 8/19/85
Order 1262, § 388-96-117, filed 12/30/77.

Wash. Admin. Code § 388-96-119 Reports—False information.

(1) If a contractor knowingly or with reason to know files a report containing false information, such action constitutes good cause for termination of its contract with the department.

(2) In accordance with RCW 74.46.531, the department will make adjustments to payment rates because a false report was filed.

(3) Contractors filing false reports may be referred for prosecution under applicable statutes.

History

Statutory Authority: Chapter 74.46 RCW as amended by 1998 c 322 §§ 19(11) and 31 and RCW 74.46.800. WSR 98-20-023, § 388-96-119, filed 9/25/98, effective 10/1/98
Order 1262, § 388-96-119, filed 12/30/77.

Wash. Admin. Code § 388-96-122 Amendments to reports.

(1) For the purpose of determining allowable costs, the department must consider an amendment to an annual report only if filed by the provider before the receipt by the provider of the notification scheduling the department's audit. The contractor may file an amendment subsequent to such notification and pursuant to the provisions of RCW 74.46.531 to adjust a payment rate allocation because of an error or omission. When the provider files an amendment, the department must consider it only if significant errors or omissions are discovered. The department must deem errors or omissions "significant" when the errors or omissions would mean a net difference of two cents or more per patient day or one thousand dollars or more in reported costs, whichever is higher, in any component rate allocation.

(2) To file an amendment, the provider must submit the amended cost report and amended cost report certification page to the department electronically. An amended cost report is not complete until the department receives both documents.

(3) If an amendment is filed, a contractor shall also submit with the amendment an account of the circumstances relating to and the reasons for the amendment, along with supporting documentation. The department must refuse to consider an amendment resulting in a more favorable settlement or payment rate allocation to a contractor if the amendment is not the result of circumstances beyond the control of the contractor or the result of good-faith error under the system of cost allocation and accounting in effect during the reporting period in question.

(4) Acceptance or use by the department of an amendment to a cost report is not a release of applicable civil or criminal liability.

History

Statutory Authority: RCW 74.46.800, 74.46.561(1). WSR 17-22-037, § 388-96-122, filed 10/24/17, effective 11/24/17. Statutory Authority: Chapter 74.46 as amended by 1998 c 322 §§ 19(11) and 31 and RCW 74.46.800. WSR 98-20-023, § 388-96-122, filed 9/25/98, effective 10/1/98. Statutory Authority: RCW 74.46.800. WSR 86-10-055 (Order 2372), § 388-96-122, filed 5/7/86, effective 7/1/86
WSR 84-12-039 (Order 2105), § 388-96-122, filed 5/30/84. Statutory Authority: RCW 74.09.120. WSR 82-11-065 (Order 1808), § 388-96-122, filed 5/14/82
WSR 79-03-021 (Order 1370), § 388-96-122, filed 2/21/79
Order 1262, § 388-96-122, filed 12/30/77.

Wash. Admin. Code § 388-96-205 Purposes of department audits—Examination—Incomplete or incorrect reports—Contractor's duties—Access to facility—Fines—Adverse rate actions.

(1) The purposes of department audits and examinations under this chapter and chapter 74.46 RCW are to ascertain that:

(a) Allowable costs for each year for each medicaid nursing facility are accurately reported;

(b) Cost reports accurately reflect the true financial condition, revenues, expenditures, equity, beneficial ownership, related party status, and records of the contractor;

(c) The contractor's revenues, expenditures, building, building square footage, building improvements, leasehold improvements, fixed equipment, and age are recorded in compliance with department requirements, instructions, and generally accepted accounting principles;

(d) The contractor is in compliance with the direct care staffing requirements found in this chapter and chapter 74.42 RCW;

(e) The responsibility of the contractor has been met in the maintenance and disbursement of patient trust funds; and

(f) The contractor has reported and maintained accounts receivable in compliance with this chapter and chapter 74.46 RCW.

(2) The department must examine the submitted cost report, or a portion thereof, of each contractor for each nursing facility for each report period to determine whether the information is correct, complete, and reported in conformance with department instructions and generally accepted accounting principles, the requirements of this chapter, and chapter 74.46 RCW. The department must determine the scope of the examination.

(3) When the department finds that the cost report is incorrect or incomplete, the department may make adjustments to the reported information for purposes of establishing component rate allocations or in determining amounts to be recovered in direct care under WAC 388-96-218 or in any component rate resulting from undocumented or misreported costs. A schedule of the adjustments must be provided to the contractor, including dollar amount and explanations for the adjustments. Adjustments are subject to review under WAC 388-96-901 and 388-96-904.

(4) Audits of resident trust funds and receivables must be reported separately and in accordance with the provisions of this chapter and chapter 74.46 RCW.

(5) The contractor must:

(a) Provide access to the nursing facility, all financial and statistical records, and all working papers that are in support of the cost report, receivables, and resident trust funds. To ensure accuracy, the department may require the contractor to submit for departmental review any underlying financial statements or other records, including income tax returns, relating to the cost report directly or indirectly;

(b) Make available to the department staff an individual or individuals to respond to questions and requests for information from department staff. The designated individual or individuals must have sufficient knowledge of the issues, operations, or functions to provide accurate and reliable information; and

(i) Applicable federal income and federal and state payroll tax returns; and

(ii) The records for the period covered by the cost report.

(6) If an examination discloses material discrepancies, undocumented costs, or mishandling of resident trust funds, the department may open or reopen one or both of the two preceding cost reports or resident trust fund periods, whether examined or unexamined, for indication of similar discrepancies, undocumented costs, or mishandling of resident trust funds.

(7) Any assets, liabilities, revenues, or expenses reported as allowable that are not supported by adequate documentation in the contractor's records must be disallowed. Documentation must show both that costs reported were incurred during the period covered by the report and were related to resident care, and that assets reported were used in the provision of resident care.

(8) When access is required at the facility or at another location in the state, the department must notify the contractor of its intent to examine all financial and statistical records, and all working papers that are in support of the cost report, receivables, and resident trust funds.

(9) The department is authorized to assess civil fines and take adverse rate action if a contractor, or any of its employees, do not allow access to the contractor's nursing facility records.

History

Statutory Authority: RCW 74.46.800, 74.46.561(1). WSR 17-22-037, § 388-96-205, filed 10/24/17, effective 11/24/17. Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-205, filed 2/14/11, effective 2/26/11.

Wash. Admin. Code § 388-96-208 Reconciliation of medicaid resident days to billed days and medicaid payments—Payments due—Accrued interest—Withholding funds.

(1) The department must reconcile medicaid resident days to billed days and medicaid payments for each medicaid nursing facility for each calendar year, or for that portion of the calendar year the provider's contract was in effect.

(2) The contractor must make any payment owed the department as determined by either reconciliation or settlement, or both, at the lower of cost or rate within sixty days after the department notifies the contractor of the amount owed.

(3) The department must pay the contractor within sixty days after it notifies the contractor of an underpayment.

(4) Interest at the rate of one percent per month accrues against the department or the contractor on an unpaid balance existing sixty days after notification of the contractor. Accrued interest must be adjusted back to the date it began to accrue if the payment obligation is subsequently revised after administrative or judicial review.

(5) The department may withhold funds from the contractor's payment for services and may take all other actions authorized by law to recover from the contractor amounts due and payable including any accrued interest. Neither a timely filed appeal under WAC 388-96-901 and 388-96-904 nor the commencement of judicial review as may be available to the contractor in law to contest a payment obligation determination shall delay recovery from the contractor or payment to the contractor.

(6) For all cost report periods ending on or before December 31, 2015, the contractor must make payment owed to the department for direct care, therapy, and support services at the lower of the cost or rate.

(7) For all cost report periods beginning January 1, 2016 and ending on or before December 31, 2016, cost in direct care, therapy, and support services must be combined and compared to the combined weighted rates for direct care, therapy, and support services. The contractor must make payment owed to the department for combined direct care, therapy, and support services at the lower of the cost or rate.

(8) For all cost report periods beginning on or after January 1, 2017, the contractor must make payment owed to the department for direct care at the lower of the cost or rate.

History

Statutory Authority: RCW 74.46.800, 74.46.561(1). WSR 17-22-037, § 388-96-208, filed 10/24/17, effective 11/24/17. Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-208, filed 2/14/11, effective 2/26/11.

Wash. Admin. Code § 388-96-211 Proposed settlement report—Payment refunds—Overpayments—Determination of unused rate funds—Total and component payment rates.

(1) Contractors must submit with each annual nursing facility cost report a proposed settlement report showing underspending or overspending in each component rate during the cost report year on a per-resident day basis. The department must accept or reject the proposed settlement report, explain any adjustments, and if needed, issue a revised settlement report.

(2) Contractors are not required to refund payments made to cost components not identified in WAC 388-96-208 (7) or (8) in excess of the adjusted costs of providing services corresponding to these components.

(3) The facility must return to the department any overpayment amounts identified in WAC 388-96-208 (7) or (8) that the department identifies following the examination and settlement procedures as described in this chapter, provided that the contractor may retain any overpayment that does not exceed one percent of the facility's component rate identified in WAC 388-96-208 (7) or (8). However, no overpayments may be retained in a cost center to which savings have been shifted to cover a deficit, as provided in subsection (5) of this section. Facilities that are not in substantial compliance for more than ninety days and facilities that provide substandard quality of care at any time during the period for which settlement is calculated, will not be allowed to retain any amount of overpayment in the facility's cost components identified in WAC 388-96-208 (7) or (8). The terms "not in substantial compliance" and "substandard quality of care" must be defined by federal survey regulations.

(4) Total and component payment rates assigned to a nursing facility, as calculated and revised, if needed, under the provisions of this chapter and chapter 74.46 RCW represent the maximum payment for nursing facility services rendered to medicaid recipients for the period the rates are in effect. No increase in payment to a contractor shall result from spending above the total payment rate or in any rate component.

(5) For cost reports ending on or before December 31, 2016, determination of unused rate funds, including the amounts of direct care, therapy, and support services to be recovered, must be done separately for each rate component and, except as otherwise provided in this subsection, neither costs nor rate payments may be shifted from one component rate or corresponding services are to another in determining the degree of underspending or recover, if any. In calculating a preliminary or final settlement, savings in the support services cost center must be shifted to cover a deficit in the direct care or therapy cost centers up to the amount of any savings but no more than twenty percent of the support services component rate may be shifted. In calculating a preliminary or final settlement, savings in direct care and therapy may be shifted to cover a deficit in these two cost centers up to the amount of savings in each, regardless of the percentage of either component rate shifted. Contractor retained overpayments up to one percent of direct care, therapy, and support services rate components, as authorized in subsection (4) of this section, must be calculated and applied after all shifting is completed.

(6) For the 2016 calendar year cost report, the following components must be combined for settlement purposes in the following manner:

(a) The direct care, therapy, and support services costs for services provided on or before June 30, 2016 must be combined with the direct care costs for services provided on or after July 1, 2016 and compared to the total combined weighted rate for direct care, therapy, and support services.

(b) The operations rate for services provided on or before June 30, 2016 must be combined with the indirect care rate for services provided on or after July 1, 2016.

(c) The property rate for services provided on or before June 30, 2016 must be combined with the fair market rental rate for services provided on or after July 1, 2016.

(7) The facility must return to the department any overpayment amounts based on the aggregated cost versus rate that the department identifies following the examination and settlement procedures as described in this chapter. The contractor may retain any overpayment that does not exceed one percent of the facility's combined direct care component rate. However, facilities that are not in substantial compliance for more than ninety days and facilities that provide substandard quality of care at any time during the period for which settlement is calculated will not be allowed to retain any amount of overpayment in the facility's direct care component rate.

(8) Contractors are not required to refund payments made in the indirect care, capital, and quality enhancement component rates in excess of the adjusted costs of providing services corresponding to these components.

(9) For the 2017 calendar year cost report and later, the facility must return to the department any overpayment amounts in the direct care rate component that the department identifies following the examination and settlement procedures as described in this chapter. The contractor may retain any overpayment that does not exceed one percent of the facility's direct care component rate. However, facilities that are not in substantial compliance for more than ninety days and facilities that provide substandard quality of care at any time during the period for which settlement is calculated, will not be allowed to retain any amount of overpayment in the facility's direct care component rate. The terms "not in substantial compliance" and "substandard quality of care" must be defined by federal survey regulations.

(10) Total and component payment rates assigned to a nursing facility, as calculated and revised, if needed, under the provisions of this chapter and chapter 74.46 RCW represent the maximum payment for nursing facility services rendered to medicaid recipients for the period the rates are in effect. Spending above the total payment rate or any rate component must not increase payment to a contractor.

(11) While the provisions of RCW 74.46.561(10) are in effect, any reductions and caps must be proportionally allocated to all components before settlement is calculated.

History

Statutory Authority: RCW 74.46.800, 74.46.561(1). WSR 17-22-037, § 388-96-211, filed 10/24/17, effective 11/24/17. Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-211, filed 2/14/11, effective 2/26/11.

Wash. Admin. Code § 388-96-217 Civil fines.

(1) The department may deny, suspend, or revoke a license or provisional license or, in lieu thereof or in addition thereto, assess monetary penalties of a civil nature not to exceed one thousand dollars per violation in any case in which it finds that the licensee, or any partner, officer, director, owner of five percent or more of the assets of the nursing home, or managing employee has failed or refused to comply with any requirement of chapters 74.46 RCW or 388-96 WAC.

(2) The department may fine a contractor or former contractor or any partner, officer, director, owner of five percent or more of the stock of a current or former corporate contractor, or managing agent for the following but not limited to the following:

(a) Failure to file a mathematically accurate and complete cost report, including a final cost report, on or prior to the applicable due date established by this chapter or authorized by extension granted in writing by the department;

(b) Failure to permit an audit authorized by this chapter or to grant access to all records and documents deemed necessary by the department to complete such an audit;

(c) Has knowingly or with reason to know made a false statement of a material fact in any record required by this chapter and/or chapter 74.46 RCW;

(d) Refused to allow representatives or agents of the department to inspect all books, records, and files required by this chapter to be maintained or any portion of the premises of the nursing home;

(e) Willfully prevented, interfered with, or attempted to impede in any way the work of any duly authorized representative of the department and the lawful enforcement of any provision of this chapter and/or chapter 74.46 RCW; or

(f) Willfully prevented or interfered with any representative of the department in the preservation of evidence of any violation of any of the provisions of this chapter or chapter 74.46 RCW.

(3) Every day of noncompliance with any requirement of subsection (1) and/or (2) of this section is a separate violation.

(4) The department shall send notice of a fine assessed under subsection (1) and/or (2) of this section by certified mail return receipt requested to the current contractor, administrator, or former contractor informing the addressee of the following:

(a) The fine shall become effective the date of receipt of the notice by the addressee; and

(b) If within two weeks of the date of receipt of the notice by the addressee, the addressee complies with the requirement(s) of subsection (1) and (2), the department may waive the fine.

History

Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-217, filed 2/14/11, effective 2/26/11. Statutory Authority: RCW 74.46.050, 74.46.431, 74.46.800, chapter 74.46 RCW, 2004 c 276 § 913, 2001 1st sp.s. c 8. WSR 04-21-027, § 388-96-217, filed 10/13/04, effective 11/13/04. Statutory Authority: RCW 74.46.800. WSR 94-12-043 (Order 3737), § 388-96-217, filed 5/26/94, effective 6/26/94
WSR 87-09-058 (Order 2485), § 388-96-217, filed 4/20/87.

Wash. Admin. Code § 388-96-218 Proposed, preliminary, and final settlements.

(1) For each component rate, the department must calculate a proposed, preliminary, or final settlement at the lower of prospective payment rate or audited allowable costs, except as otherwise provided in this chapter or chapter 74.46 RCW.

(2) As part of the cost report, the proposed settlement report is due in accordance with WAC 388-96-022. In the proposed preliminary settlement report, a contractor must compare the contractor's payment rates during a cost report period, weighted by the number of resident days reported for the same cost report period to the contractor's allowable costs for the cost report period. In accordance with WAC 388-96-205, 388-96-208, and 388-96-211 the contractor must take into account all authorized shifting, retained savings, and upper limits to rates on a cost center basis.

(3) The department will review the proposed preliminary settlement report for accuracy and accept or reject the contractor's proposal. If accepted, the proposed preliminary settlement report must become the preliminary settlement report. If rejected, the department must issue, by component payment rate allocation, a preliminary settlement report fully substantiating disallowed costs, refunds, or underpayments due and adjustments to the proposed preliminary settlement.

(4) When the department receives the proposed preliminary settlement report by the cost report due date specified in WAC 388-96-022, it will issue the preliminary settlement report within one hundred twenty days of the cost report due date.

When the department receives the proposed preliminary settlement report after the cost report due date specified in WAC 388-96-022, it will issue the preliminary settlement report within one hundred twenty days of the date the cost report was received.

In its discretion, the department may designate a date later than the dates specified in this subsection to issue preliminary settlements.

(5) A contractor has twenty-eight days after receipt of a preliminary settlement report to contest such report under WAC 388-96-901 and 388-96-904. Upon expiration of the twenty-eight day period, the department must not review or adjust a preliminary settlement report. Any administrative review of a preliminary settlement must be limited to either calculation of the settlement or application of settlement principles and rules, or both, and must not encompass rate or audit issues.

(6) The department must issue a final settlement report to the contractor after the completion of the department audit process, including exhaustion or termination of any administrative review and appeal of audit findings or determinations requested by the contractor, but not including judicial review as may be available to and commenced by the contractor.

(7) The department must prepare a final settlement by component payment rate allocation and must fully substantiate disallowed costs, refunds, underpayments, or adjustments to the cost report and financial statements, reports, and schedules submitted by the contractor. The department must take into account all authorized shifting, savings, and upper limits to rates on a component payment rate allocation basis. For the final settlement report, the department must compare the payment rates it paid the contractor for the facility in question during the report period, weighted by the number of allowable resident days reported for the period each rate was in effect to the contractor's:

(a) Audited allowable costs for the reporting period; or

(b) Reported costs for the nonaudited reporting period.

(8) A contractor has twenty-eight days after the receipt of a final settlement report to contest such report pursuant to WAC 388-96-901 and 388-96-904. Upon expiration of the twenty-eight day period, the department must not review a final settlement report. Any administrative review of a final settlement must be limited to either calculation of the settlement or application of settlement principles and rules, or both, and must not encompass rate or audit issues.

(9) The department may reopen a final settlement if it is necessary to make adjustments based upon findings resulting from a department audit performed pursuant to WAC 388-96-205. The department may also reopen a final settlement to recover an industrial insurance dividend or premium discount under RCW 51.16.035 in proportion to a contractor's medicaid recipient days.

(10) In computing a preliminary or final settlement, a contractor must comply with the requirements of WAC 388-96-211 for retaining or refunding to the department payments made in excess of the adjusted costs of providing services corresponding to each component rate allocation.

(11) The nursing facility contractor must refund all amounts due the department within sixty days after the department notifies the contractor of the overpayment and demands repayment. When notification is by postal mail, the department must deem the contractor to have received the department's notice five calendar days after the date of the notification letter, unless proof of the date of receipt of the department's notification letter exists, in which case the actual date of receipt must be used to determine the sixty day period for repayment. After the sixty day period, interest on any unpaid balance will accrue at one percent per month.

(12) Repayment will be without prejudice to obtain review of the settlement determination pursuant to WAC 388-96-901 and 388-96-904. If the payment obligation is reduced after an administrative hearing or judicial review, the department will rescind the difference between the accrued interest on the payment obligation and the interest that would have accrued on the reduced payment obligation from the date interest began to accrue on the original payment obligation.

(13) In determining whether a facility has forfeited unused rate funds in its direct care, therapy care, and support services component rates under WAC 388-96-211, the following rules apply:

(a) Federal or state survey officials must determine when a facility is not in substantial compliance or is providing substandard care, according to federal and state nursing facility survey regulations;

(b) Correspondence from state or federal survey officials notifying a facility of its compliance status must be used to determine the beginning and ending dates of any period of noncompliance; and

(c) Forfeiture must occur if the facility was out of substantial compliance more than ninety days during the settlement period. The ninety-day period need not be continuous if the number of days of noncompliance exceed ninety days during the settlement period regardless of the length of the settlement period. Also, forfeiture must occur if the nursing facility was determined to have provided substandard quality of care at any time during the settlement period.

History

Statutory Authority: RCW 74.46.800, 74.46.561(1). WSR 17-22-037, § 388-96-218, filed 10/24/17, effective 11/24/17. Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-218, filed 2/14/11, effective 2/26/11. Statutory Authority: RCW 74.46.155, 74.46.165, 74.46.431, chapter 74.46 RCW, 2004 c 276 § 913, 2001 1st sp.s. c 8. WSR 04-21-027, § 388-96-218, filed 10/13/04, effective 11/13/04. Statutory Authority: RCW 74.46.800. WSR 01-12-037, § 388-96-218, filed 5/29/01, effective 6/29/01. Statutory Authority: Chapter 74.46 RCW, 1999 c 376 § 3 amending c 309 § 207. WSR 99-24-084, § 388-96-218, filed 11/30/99, effective 12/31/99. Statutory Authority: Chapter 74.46 RCW as amended by 1998 c 322 §§ 9 and 10 and RCW 74.46.800. WSR 98-20-023, § 388-96-218, filed 9/25/98, effective 10/1/98.

Wash. Admin. Code § 388-96-310 Interest on other excess payments.

(1) Any contractor obtaining benefits or payments under the medical assistance program to which such contractor is not entitled or in an amount to which such contractor is not entitled, shall be liable for such benefits or payments received and for interest on the amount of benefits or payments from the date of receipt until repayment is made to the department at the rate of one percent per month, unless the contractor establishes the overpayment was the result of errors made by the department.

(2) Interest charged by the department or interest expense incurred by the contractor, from whatever source, in making refund to the department shall not be reimbursable by the department as an allowable cost. The contractor may, by payment of a disputed settlement in whole or in part, stop accrual of interest on the amount paid. Such payment will be without prejudice to obtain review of a settlement determination.

History

Statutory Authority: RCW 74.09.120. WSR 83-19-047 (Order 2025), § 388-96-310, filed 9/16/83.

Wash. Admin. Code § 388-96-366 Facility records and handling of resident moneys.

(1) A nursing facility may not require residents to deposit personal funds with the facility. A facility may hold a resident's personal funds only if the resident or resident's guardian provides written authorization.

(2) Once a nursing facility accepts the written authorization of the resident or resident's guardian, the facility shall hold, safeguard, and account for such personal funds under an established system in accordance with this chapter and chapter 74.46 RCW. For all resident moneys entrusted to the contractor and received by the contractor for the resident, the nursing facility shall establish and maintain a bookkeeping system incorporated into the business records and adequate for audit.

(3) The nursing facility shall maintain the resident's or guardian's written authorization in the resident's file. The facility shall deposit any resident's personal funds in excess of fifty dollars in an interest-bearing resident personal fund account or accounts, separate from any of the facility's operating accounts, and credit all interest earned on an account to the account. With respect to any other personal funds, the facility shall keep such funds in a noninterest-bearing account or petty cash fund maintained for residents.

(4) The facility shall give the resident at least a quarterly reporting of all financial transactions involving personal funds held for the resident by the facility. Also, the facility shall send the representative payee, the guardian, or other designated agents of the resident a copy of the quarterly accounting report.

(5) The nursing facility shall further maintain a written record of all personal property deposited with the facility for safekeeping by or for the resident. The facility shall issue or obtain written receipts upon taking possession or disposing of such property and retain copies and/or originals of such receipts. The facility shall maintain records adequate for audit.

(6) The facility shall purchase a surety bond, or otherwise provide assurances or security satisfactory to the department, to assure the security of all personal funds of residents deposited with the facility.

History

Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-366, filed 2/14/11, effective 2/26/11. Statutory Authority: RCW 74.46.800, 74.42.620 and 74.09.120. WSR 90-20-075 (Order 3070), § 388-96-366, filed 9/28/90, effective 10/1/90. Statutory Authority: RCW 74.46.800. WSR 87-09-058 (Order 2485), § 388-96-366, filed 4/20/87
Order 1168, § 388-96-366, filed 11/3/76
Order 1114 § 388-96-366, filed 4/21/76.

Wash. Admin. Code § 388-96-369 The nursing facility shall maintain a subsidiary ledger with an account for each resident for whom the facility holds money.

(1) The facility shall assure a full and complete separate accounting of each resident's personal funds. Each account record and related supporting information and documentation shall:

(a) Be maintained at the facility;

(b) Be kept current;

(d) Show in writing and in detail, with supporting verification, all moneys received on behalf of the individual resident and the disposition of all moneys so received.

(2) Each account shall be reasonably accessible to the resident or the resident's guardian or legal representative and shall be available for audit and inspection by a department representative. Each account shall be maintained for a minimum of four years. A medicaid provider shall notify each Title XIX medicaid recipient or guardian and the home and community services office of the department that serves the area when the amount in the account of any Title XIX medicaid recipient reaches two hundred dollars less than the applicable dollar resource limit for supplemental security income (SSI) eligibility set forth in Title XVI of the Social Security Act.

(3) When notice is given under subsection (2) of this section, the facility shall notify the recipient or guardian that if the amount in the account, in addition to the value of the recipient's other nonexempt resources, reaches the dollar resource limit determined under Title XVI, the recipient may lose eligibility for SSI medical assistance or benefits under Title XVI.

(4) After the recipient's admission to the facility, accumulation toward the Title XVI limit is permitted only from the clothing and personal incidentals allowance and other income that the department specifically designates as exempt income.

(5) No resident funds may be overdrawn (show a debit balance). If a resident wants to spend an amount greater than the facility is holding for the resident, the home may provide money from its own funds and collect the debt by installments from that portion of the resident's allowance remaining at the end of each month. No interest may be charged to residents for such loans.

(6) The facility may not impose a charge against the personal funds of a medicare or medicaid recipient for any item or service for which payment is made under the Title XVIII medicare program or the Title XIX medicaid program. In order to ensure that medicaid recipients are not charged for services provided under the Title XIX program, any charge for medical services otherwise properly made to a recipient's personal funds shall be supported by a written denial from the department.

(a) Mobility aids including walkers, wheelchairs, or crutches requested for the exclusive use by a medicaid recipient shall have a written denial from the department of social and health services before a recipient's personal funds may be charged.

(b) Requests for medically necessary services and supplies not funded under the provisions of chapter 388-96 WAC or chapter 388-86 WAC (reimbursement rate or coupon system) shall have a written denial from the department before a medicaid recipient's personal funds may be charged.

(c) A written denial from the department is not required when the pharmacist verifies that a drug is not covered by the program, e.g., items on the FDA list of ineffective or possible effective drugs, nonformulary over-the-counter (OTC) medications. The pharmacist's notation to this effect is sufficient.

History

Statutory Authority: RCW 74.46.431 (11) and (12), 74.46.800, chapter 74.46 RCW, 2004 c 276 § 913, 2001 1st sp.s. c 8. WSR 04-21-027, § 388-96-369, filed 10/13/04, effective 11/13/04. Statutory Authority: RCW 74.46.800. WSR 01-12-037, § 388-96-369, filed 5/29/01, effective 6/29/01. Statutory Authority: RCW 74.46.800, 74.42.620 and 74.09.120. WSR 90-20-075 (Order 3070), § 388-96-369, filed 9/28/90, effective 10/1/90. Statutory Authority: RCW 74.42.620 and 74.46.800. WSR 85-17-070 (Order 2275), § 388-96-369, filed 8/21/85. Statutory Authority: RCW 74.09.120. WSR 83-19-047 (Order 2025), § 388-96-369, filed 9/16/83
WSR 82-21-025 (Order 1892), § 388-96-369, filed 10/13/82
Order 1168, § 388-96-369, filed 11/3/76
Order 1114, § 388-96-369, filed 4/21/76.

Wash. Admin. Code § 388-96-372 The nursing facility may maintain a petty cash fund originating from resident personal funds of an amount reasonable and necessary for the size of the facility and the needs of the residents.

(1) This petty cash fund shall be an imprest fund limited to one thousand dollars unless the facility demonstrates good cause for the department to grant a higher limit. All moneys over and above the petty cash limit shall be deposited intact in an interest bearing account or accounts maintained for resident personal funds, separate and apart from any other bank account of the facility or other facilities. All interest earned on an account containing resident personal funds shall be credited to such account.

(2) Cash deposits of recipient allowances must be made intact to the resident personal fund account within one week from the time that payment is received from the department, Social Security Administration, or other payer.

(3) Any related bankbooks, bank statements, checkbook, check register, and all voided and cancelled checks, shall be made available for audit and inspection by a department representative, and shall be maintained by the home for not less than four years.

(4) No service charges for such checking account shall be paid by residents or deducted from resident personal funds.

(5) The resident personal fund account or accounts per bank shall be reconciled monthly to the resident personal funds per resident ledgers.

History

Statutory Authority: RCW 74.46.431 (11) and (12), 74.46.800, chapter 74.46 RCW, 2004 c 276 § 913, 2001 1st sp.s. c 8. WSR 04-21-027, § 388-96-372, filed 10/13/04, effective 11/13/04. Statutory Authority: RCW 74.46.800, 74.42.620 and 74.09.120. WSR 90-20-075 (Order 3070), § 388-96-372, filed 9/28/90, effective 10/1/90. Statutory Authority: RCW 74.09.120. WSR 83-19-047 (Order 2025), § 388-96-372, filed 9/16/83
Order 1114, § 388-96-372, filed 4/21/76.

Wash. Admin. Code § 388-96-375 Resident personal funds control/disbursement.

Personal funds shall be held and used for the benefit of the resident and are not to be turned over to anyone other than the resident or the resident's guardian without the written consent of the resident, the resident's designated agent as appointed by power of attorney, or appropriate department of social and health services personnel as designated by the CSO administrator.

(1) When money is received, a receipt shall be filled out in duplicate:

(a) One copy shall be given to the person making payment or deposit; and

(b) The other copy shall be retained in the receipt book for easy reference.

(2) Checks received by residents shall be endorsed by the resident. Schedule I-A(6e) of the agreement states in part: "Each patient receiving a check or state warrant is responsible for endorsement by his own signature. Only when the patient is incapable of signing his name may the Provider assume the responsibility of securing the patient's mark "X" followed by the name of the patient and the signature of two witnesses."

(3) If both a facility operating account and a resident personal fund account are at the same bank, the resident portion of checks which include care payments can be deposited directly to the resident account by including a resident account deposit slip for the correct amount with the checks and the operating account deposit slip.

(4) The resident's ledger sheet shall be credited with the allowance received. This shall be referenced with the receipt number and shall be supported by a copy of the deposit slip (one copy for all deposits made).

History

Statutory Authority: RCW 74.46.800, 74.42.620 and 74.09.120. WSR 90-20-075 (Order 3070), § 388-96-375, filed 9/28/90, effective 10/1/90. Statutory Authority: RCW 74.09.120. WSR 82-21-025 (Order 1892), § 388-96-375, filed 10/13/82
Order 1168, § 388-96-375, filed 11/3/76
Order 1114, § 388-96-375, filed 4/21/76.

Wash. Admin. Code § 388-96-378 Resident personal funds availability.

Funds held for any resident shall be available for the resident's personal and incidental needs when requested by the resident or one of the individuals designated in WAC 388-96-375.

History

Statutory Authority: RCW 74.46.800, 74.42.620 and 74.09.120. WSR 90-20-075 (Order 3070), § 388-96-378, filed 9/28/90, effective 10/1/90
Order 1114, § 388-96-378, filed 4/21/76.

Wash. Admin. Code § 388-96-381 Procedure for refunding resident personal funds.

(1) When a resident is discharged or transferred, the balance of the resident's personal funds shall be returned to the individual designated in WAC 388-96-375 within thirty days and a receipt obtained. In some cases it may be advisable to mail the refund to the resident's new residence.

History

Statutory Authority: RCW 74.46.431(9). WSR 15-09-025, § 388-96-381, filed 4/7/15, effective 5/8/15. Statutory Authority: RCW 74.46.800, 74.42.620 and 74.09.120. WSR 90-20-075 (Order 3070), § 388-96-381, filed 9/28/90, effective 10/1/90
Order 1114, § 388-96-381, filed 4/21/76.

Wash. Admin. Code § 388-96-384 Liquidation or transfer of resident personal funds.

(1) Upon the death of a resident, the facility shall convey within thirty days the resident's personal funds held by the facility with a final accounting of such funds to the department of social and health services office of financial recovery (or successor office) or to the individual or probate jurisdiction administering the resident's estate.

(a) When the deceased resident was a recipient of long-term care services paid for in whole or in part by the department, then the personal funds held by the facility and the final accounting shall be sent to department of social and health services office of financial recovery (or successor office).

(b) When the personal funds of the deceased resident are to be paid to the department, the facility shall:

(i) Pay with a check, money order, certified check or cashiers check made payable to the secretary, department of social and health services;

(ii) Complete a transmittal of resident personal funds form (DSHS form 18-544) for each deceased resident;

(iii) Place the name and social security number of the deceased individual from whose personal funds account the moneys are being paid on the check, money order, certified check or cashier's check and the transmittal of resident personal funds form (DSHS form 18-544); and

(iv) Mail the check or money order and the DSHS 18-544 to the office of financial recovery, estate recovery unit, P.O. Box 9501, Olympia, Washington 98507-9501, or such address as may be directed by the department in the future.

(c) The department of social and health services, office of financial recovery, estate recovery unit shall establish a release procedure for use of funds necessary for burial expenses.

(2) In situations where the resident leaves the nursing home without authorization and the resident's whereabouts is unknown:

(a) The nursing facility shall make a reasonable attempt to locate the missing resident. This includes contacting:

(i) Friends,

(ii) Relatives,

(iii) Police,

(iv) The guardian, and

(v) The home and community services office in the area.

(b) If the resident cannot be located after ninety days, the nursing facility shall notify the department of revenue of the existence of "abandoned property," outlined in chapter 63.29 RCW. The nursing facility shall deliver to the department of revenue the balance of the resident's personal funds within twenty days following such notification.

(3) Prior to the sale or other transfer of ownership of the nursing facility business, the facility operator shall:

(a) Provide each resident or resident representative with a written accounting of any personal funds held by the facility;

(b) Provide the new operator with a written accounting of all resident funds being transferred; and

History

Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-384, filed 2/14/11, effective 2/26/11. Statutory Authority: RCW 74.46.800. WSR 01-12-037, § 388-96-384, filed 5/29/01, effective 6/29/01. Statutory Authority: Chapter 74.46 RCW, 1999 c 376 § 3 amending c 309 § 207. WSR 99-24-084, § 388-96-384, filed 11/30/99, effective 12/31/99. Statutory Authority: RCW 74.46.800 and 1995 1st sp.s. c 18. WSR 95-19-037 (Order 3896), § 388-96-384, filed 9/12/95, effective 10/13/95. Statutory Authority: RCW 74.46.800, 74.42.620 and 74.09.120. WSR 90-20-075 (Order 3070), § 388-96-384, filed 9/28/90, effective 10/1/90. Statutory Authority: 1987 c 476. WSR 88-01-126 (Order 2573), § 388-96-384, filed 12/23/87. Statutory Authority: RCW 74.09.120. WSR 82-21-025 (Order 1892), § 388-96-384, filed 10/13/82
Order 1168, § 388-96-384, filed 11/3/76
Order 1114, § 388-96-384, filed 4/21/76.

Wash. Admin. Code § 388-96-499 Principles of allowable costs.

(1) The substance of a transaction will prevail over its form.

(2) All documented costs which are ordinary, necessary, related to care of medical care recipients, and not expressly unallowable under this chapter and/or chapter 74.46 RCW are to be allowable.

(3) Costs of providing therapy care are allowable, subject to any applicable limit contained in this chapter and/or chapter 74.46 RCW, provided documentation establishes the costs were incurred for medical care recipients and other sources of payment to which recipients may be legally entitled, such as private insurance or medicare, were first fully utilized.

(4) The payment for property usage is to be independent of ownership structure and financing arrangements.

(5) Allowable costs shall not include costs reported by a contractor for a prior period to the extent such costs, due to statutory exemption, will not be incurred by the nursing facility in the period to be covered by the rate.

(6) Any costs deemed allowable under this chapter are subject to the provisions of RCW 74.46.421. The allowability of a cost shall not be construed as creating a legal right or entitlement to reimbursement of the cost.

History

Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-499, filed 2/14/11, effective 2/26/11.

Wash. Admin. Code § 388-96-502 Secondary and overhead costs.

Subject to the provisions of this chapter and chapter 74.46 RCW, when a contractor provides goods or services that are not reimbursable, any secondary or overhead costs associated with their provision must be allocated to such goods or services on a reasonable basis approved by the department and must not be reported as allowable costs.

History

Statutory Authority: RCW 74.46.800, 74.46.561(1). WSR 17-22-037, § 388-96-502, filed 10/24/17, effective 11/24/17. Statutory Authority: RCW 74.46.800. WSR 98-20-023, § 388-96-502, filed 9/25/98, effective 10/1/98. Statutory Authority: 1987 c 476. WSR 88-01-126 (Order 2573), § 388-96-502, filed 12/23/87. Statutory Authority: RCW 74.46.800. WSR 86-10-055 (Order 2372), § 388-96-502, filed 5/7/86, effective 7/1/86
WSR 84-12-039 (Order 2105), § 388-96-502, filed 5/30/84.

Wash. Admin. Code § 388-96-505 Offset of miscellaneous revenues.

(1) The methodology in (a) through (d) of this subsection is effective for services provided on or before June 30, 2016.

(a) The contractor must reduce allowable costs whenever the item, service, or activity covered by such costs generates revenue or financial benefits (such as purchase discounts, refunds of allowable costs or rebates) other than through the contractor's normal billing for care services. However, the department must not deduct from the allowable costs of a nonprofit facility unrestricted grants, gifts, and endowments, and interest therefrom.

(b) The contractor must reduce allowable costs for hold-bed revenue in the support services, operations, and property rate components only. In the support services rate component, the amount of reduction must be determined by dividing a facility's allowable housekeeping costs by total adjusted patient days and multiplying the result by total hold-room days. In the operations rate component, the amount of the reduction must be determined by dividing a facility's allowable operation costs by total adjusted patient days and multiplying the result by total hold-room days. In the property rate component, the amount of reduction must be determined by dividing allowable property costs by the total adjusted patient days and multiplying the result by total hold-room days.

(c) Where goods or services are sold, the amount of the reduction is the actual cost relating to the item, service, or activity. In the absence of adequate documentation of cost, the amount of the reduction is the full amount of the revenue received. Where financial benefits such as purchase discounts, refunds of allowable costs, or rebates are received, the amount of the reduction is the amount of the discount or rebate. Financial benefits such as purchase discounts, refunds of allowable costs and rebates, including industrial insurance rebates, must be offset against allowable costs in the year the contractor actually receives the benefits.

(d) Only allowable costs may be recovered under this subsection. Costs allocable to activities or services not included in nursing facility services (such as costs of vending machines and services specified in chapter 388-86 WAC not included in nursing facility services) are nonallowable costs.

(2) The methodology in (a) through (d) of this subsection is effective for services provided on or after July 1, 2016.

(a) The contractor must reduce allowable costs whenever the item, service, or activity covered by such costs generates revenue or financial benefits (such as purchase discounts, refunds of allowable costs, or rebates) other than through the contractor's normal billing for care services. However, the department must not deduct from the allowable costs of a nonprofit facility unrestricted grants, gifts, and endowments, and interest therefrom.

(b) The contractor must reduce allowable costs for hold-bed revenue in the indirect care rate component only. The amount of reduction must be determined by dividing a facility's allowable housekeeping costs by total adjusted patient days and multiplying the result by total hold-room days.

(c) Where goods or services are sold, the amount of the reduction is the actual cost relating to the item, service, or activity. In the absence of adequate documentation of cost, the amount of the reduction is the full amount of the revenue received. Where financial benefits such as purchase discounts, refunds of allowable costs, or rebates are received, the amount of the reduction is the amount of the discount or rebate. Financial benefits such as purchase discounts, refunds of allowable costs, and rebates, including industrial insurance rebates, must be offset against allowable costs in the year the contractor actually receives the benefits.

History

Statutory Authority: RCW 74.46.800, 74.46.561(1). WSR 17-22-037, § 388-96-505, filed 10/24/17, effective 11/24/17. Statutory Authority: RCW 74.46.800. WSR 98-20-023, § 388-96-505, filed 9/25/98, effective 10/1/98. Statutory Authority: RCW 74.46.200 and 74.46.800. WSR 97-17-040, § 388-96-505, filed 8/14/97, effective 9/14/97. Statutory Authority: RCW 74.46.800 and 74.09.120. WSR 93-19-074 (Order 3634), § 388-96-505, filed 9/14/93, effective 10/15/93. Statutory Authority: RCW 74.46.800. WSR 92-16-013 (Order 3424), § 388-96-505, filed 7/23/92, effective 8/23/92. Statutory Authority: 1987 c 476. WSR 88-01-126 (Order 2573), § 388-96-505, filed 12/23/87. Statutory Authority: RCW 74.09.120. WSR 84-24-050 (Order 2172), § 388-96-505, filed 12/4/84
WSR 82-21-025 (Order 1892), § 388-96-505, filed 10/13/82. Statutory Authority: RCW 74.09.120 and 74.46.800. WSR 81-06-024 (Order 1613), § 388-96-505, filed 2/25/81. Statutory Authority: RCW 74.08.090 and 74.09.120. WSR 78-06-080 (Order 1300), § 388-96-505, filed 6/1/78
Order 1262, § 388-96-505, filed 12/30/77.

Wash. Admin. Code § 388-96-525 Education and training.

(1) Necessary and ordinary expenses of on-the-job training and in-service training required for employee orientation and certification training directly related to the performance of duties assigned will be allowable costs. Cost of training for which the nursing facility is reimbursed outside the payment rate is an unallowable cost.

(2) Necessary and ordinary expenses of recreational and social activity training conducted by the contractor for volunteers will be allowable costs. Expenses of training programs for other nonemployees will not be allowable costs.

(3) Expenses for travel, lodging, and meals associated with education and training are allowable if the expenses meet the requirements of this chapter.

(4) Costs designated by this section as allowable are subject to any applicable cost center limit established by this chapter.

History

Statutory Authority: RCW 74.46.800, 74.46.561(1). WSR 17-22-037, § 388-96-525, filed 10/24/17, effective 11/24/17. Statutory Authority: RCW 74.46.800. WSR 98-20-023, § 388-96-525, filed 9/25/98, effective 10/1/98
WSR 94-12-043 (Order 3737), § 388-96-525, filed 5/26/94, effective 6/26/94. Statutory Authority: RCW 74.46.800 and 74.09.120. WSR 93-19-074 (Order 3634), § 388-96-525, filed 9/14/93, effective 10/15/93. Statutory Authority: RCW 74.46.800. WSR 84-12-039 (Order 2105), § 388-96-525, filed 5/30/84. Statutory Authority: RCW 74.09.120. WSR 81-22-081 (Order 1712), § 388-96-525, filed 11/4/81. Statutory Authority: RCW 74.09.120 and 74.46.800. WSR 81-06-024 (Order 1613), § 388-96-525, filed 2/25/81. Statutory Authority: RCW 74.09.120. WSR 80-06-122 (Order 1510), § 388-96-525, filed 5/30/80, effective 7/1/80
Order 1262, § 388-96-525, filed 12/30/77.

Wash. Admin. Code § 388-96-528 Payments to related organizations—Limits—Documentation.

(1) Costs applicable to services, facilities, and supplies furnished by a related organization to the contractor shall be allowable only to the extent they do not exceed the lower of the cost to the related organization or the price of comparable services, facilities, or supplies purchased elsewhere.

(2) Documentation of costs to the related organization shall be made available to the department. Payments to or for the benefit of the related organization will be disallowed where the cost to the related organization cannot be documented.

History

Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-528, filed 2/14/11, effective 2/26/11.

Wash. Admin. Code § 388-96-530 What will be allowable compensation for owners, relatives, licensed administrator, assistant administrator, and/or administrator-in-training?

Subject to any applicable cost center limit established by chapter 74.46 RCW, total allowable compensation shall be:

(1) As provided in the employment contract, including benefits, whether such contract is written, verbal, or inferred from the acts of the parties; or

(2) In the absence of a contract, gross salary or wages excluding payroll taxes and benefits made available to all employees, e.g., health insurance.

History

Statutory Authority: RCW 74.46.800. WSR 98-20-023, § 388-96-530, filed 9/25/98, effective 10/1/98.

Wash. Admin. Code § 388-96-532 Does the contractor have to maintain time records?

(1) The contractor shall maintain time records that are adequate for audit for owners, relatives, the licensed administrator, assistant administrator, and/or administrator-in-training. The contractor shall include in such records verification of the actual hours of service performed for the nursing home and shall document compensated time was spent in provision of necessary services actually performed.

(2) If the contractor has no or inadequate time records, the undocumented cost of compensation shall be unallowable.

History

Statutory Authority: RCW 74.46.800. WSR 98-20-023, § 388-96-532, filed 9/25/98, effective 10/1/98.

Wash. Admin. Code § 388-96-535 Management agreements, management fees, and central office services.

(1) The contractor shall disclose to the department the nature and purpose of all management agreements, including an organizational chart showing the relationship among the contractor, management company and all related organizations. The department may request additional information or clarification.

(2) A copy of the agreement must be received by the department at least sixty days before it is to become effective. A copy of any amendment to a management agreement must be received by the department at least thirty days in advance of the date it is to become effective. Failure to meet these deadlines will result in the unallowability of cost incurred more than sixty days prior to submitting a management agreement and more than thirty days prior to submitting an amendment.

(3) Management fees will be allowed only when:

(a) A written management agreement both creates a principal/agent relationship between the contractor and the manager, and sets forth the items, services, and activities to be provided by the manager; and

(b) Documentation demonstrates that the service contracted for were actually delivered; and

(c) The scope of services performed under a management agreement are not so extensive that the manager or managing entity is substituted for the contractor in fact, substantially relieving the contractor/licensee of responsibility for operating the facility.

(4) Acceptance of a management agreement shall not be construed as a determination that all management fees or costs are allowable in whole or in part. Management fees or costs not disclosed or approved in conformity with chapter 74.46 RCW and this section are unallowable. When necessary for the health and safety of medical care recipients, in writing, the department may waive the sixty-day or thirty-day advance notice requirement of subsection (2) of this section.

(5)(a) Management fees are allowable only for necessary, nonduplicative services that are of the nature and magnitude that prudent and cost-conscious management would pay; and

(b) Management fees paid to or for the benefit of a related organization will be allowable to the extent they not exceed the lower of the:

(i) Actual cost to the related organization of providing necessary services related to patient care under the agreement; or

(ii) The cost of comparable services purchased elsewhere. Where costs to the related organization represent joint facility costs, the measurement of such costs shall comply with WAC 388-96-534.

(6) Allowable fees for all general management services of any kind referenced in this section, including corporate or business entity management and management fees not allocated to specific services, are subject to any applicable cost center limit established in chapter 74.46 RCW and this chapter.

(7) Central office costs, owner's compensation, and other fees or compensation, including joint facility costs for general administrative and management services, and management expense not allocated to specific services shall be subject to any cost center limit established by chapter 74.46 RCW and chapter 388-96 WAC.

(8) Necessary travel and housing expenses of nonresident staff working at a contractor's nursing facility shall be considered allowable costs if the visit does not exceed three weeks.

(9) Bonuses paid to employees at a contractor's nursing facility or management company shall be considered compensation.

History

Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-535, filed 2/14/11, effective 2/26/11. Statutory Authority: RCW 74.46.800. WSR 98-20-023, § 388-96-535, filed 9/25/98, effective 10/1/98. Statutory Authority: RCW 74.46.800 and 74.09.120. WSR 93-19-074 (Order 3634), § 388-96-535, filed 9/14/93, effective 10/15/93. Statutory Authority: 1987 c 476. WSR 88-01-126 (Order 2573), § 388-96-535, filed 12/23/87. Statutory Authority: RCW 74.46.800. WSR 86-10-055 (Order 2372), § 388-96-535, filed 5/7/86, effective 7/1/86. Statutory Authority: RCW 74.09.120. WSR 83-19-047 (Order 2025), § 388-96-535, filed 9/16/83
WSR 81-22-081 (Order 1712), § 388-96-535, filed 11/4/81. Statutory Authority: RCW 74.09.120 and 74.46.800. WSR 81-06-024 (Order 1613), § 388-96-535, filed 2/25/81. Statutory Authority: RCW 74.09.120. WSR 80-09-083 (Order 1527), § 388-96-535, filed 7/22/80
WSR 79-03-020 (Order 1371), § 388-96-535, filed 2/21/79
Order 1262, § 388-96-535, filed 12/30/77.

Wash. Admin. Code § 388-96-536 Does the department limit the allowable compensation for an owner or relative of an owner?

(1) Total compensation including compensation received from a related or unrelated organization or company paid to an owner or relative of an owner shall be limited to ordinary compensation for necessary services actually performed.

(a) Compensation is ordinary if it is the amount usually paid for comparable services in a comparable facility to an unrelated employee, and does not exceed any applicable limits set out in chapter 74.46 RCW and this chapter.

(b) A service is necessary if it is related to patient care and would have had to be performed by another person if the owner or relative had not done it.

(2) If the service provided would require licensed staff, e.g., RN, then the same license standard must be met when performed by an owner, relative or other administrative personnel.

(3) The contractor, in maintaining customary time records adequate for audit, shall include such records for owners and relatives who receive compensation.

History

Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-536, filed 2/14/11, effective 2/26/11. Statutory Authority: RCW 74.46.800. WSR 98-20-023, § 388-96-536, filed 9/25/98, effective 10/1/98.

Wash. Admin. Code § 388-96-542 Home office or central office.

(1) The department will include all allowable reported home or central office costs including all costs that are documented, ordinary, necessary, and related to the provision of medical and personal care services to authorized patients.

Allocated costs may be included in the cost of services in such cost centers where such services and related costs are appropriately reported.

(2) Home office or central office costs must be allocated and reported.

History

Statutory Authority: RCW 74.46.800, 74.46.561(1). WSR 17-22-037, § 388-96-542, filed 10/24/17, effective 11/24/17. Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-542, filed 2/14/11, effective 2/26/11. Statutory Authority: Chapter 74.46 RCW as amended by 1998 c 322 § 19(11), RCW 74.46.270 and 74.46.800. WSR 98-20-023, § 388-96-542, filed 9/25/98, effective 10/1/98.

Wash. Admin. Code § 388-96-554 Equipment.

(1) The contractor must expense the following equipment costs to indirect care:

(a) Expenditures for equipment with a historical cost of seven hundred fifty dollars or less per unit and a useful life of one year or less from the date of purchase; and

(b) Expenditures for and costs of repairs necessary to maintain the useful life of equipment including furniture and furnishings and real property items, components, or improvements that cost less than seven hundred fifty dollars.

(2) Subsection (1) of this section does not apply if:

(a) The equipment was acquired in a group purchase where the total cost exceeded seven hundred fifty dollars; or

(b) The equipment was part of the initial equipment or stock of the nursing home.

History

Statutory Authority: RCW 74.46.800, 74.46.561(1). WSR 17-22-037, § 388-96-554, filed 10/24/17, effective 11/24/17. Statutory Authority: RCW 74.46.310, [74.46.]320 and [74.46.]330. WSR 97-17-040, § 388-96-554, filed 8/14/97, effective 9/14/97. Statutory Authority: RCW 74.09.120. WSR 83-19-047 (Order 2025), § 388-96-554, filed 9/16/83
WSR 83-05-007 (Order 1944), § 388-96-554, filed 2/4/83.

Wash. Admin. Code § 388-96-556 Initial cost of operation.

(1) The necessary and ordinary one-time expenses directly incident to the preparation of a newly constructed or purchased building by a contractor for operation as a licensed facility are allowable costs. These expenses are limited to start-up and organizational costs incurred prior to the admission of the first patient.

(2) Start-up costs include, but are not limited to, administrative and nursing salaries, utility costs, taxes, insurance, repairs and maintenance, and training. Start-up costs do not include expenditures for capital assets. Start-up costs are allowable in the indirect care cost center if they are amortized over a period of not less than sixty months beginning with the month in which the first patient is admitted for care.

(3) Organizational costs are those necessary, ordinary, and directly incident to the creation of a corporation or other form of business of the contractor including, but not limited to, legal fees incurred in establishing the corporation or other organization and fees paid to states for incorporation. However, organizational costs do not include costs relating to the issuance and sale of shares of capital stock or other securities. Such organizational costs will be allowable in the indirect care cost center if they are amortized over a period of not less than sixty months beginning with the month in which the first patient is admitted for care.

History

Statutory Authority: RCW 74.46.800, 74.46.561(1). WSR 17-22-037, § 388-96-556, filed 10/24/17, effective 11/24/17. Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-556, filed 2/14/11, effective 2/26/11.

Wash. Admin. Code § 388-96-560 Land.

Land includes but is not limited to, off-site sewer and water lines, public utility charges necessary to service the land, governmental assessments for street paving and sewers, the cost of permanent roadways and grading, and the cost of curbs and sidewalks, replacement of which is not the responsibility of the contractor.

History

Statutory Authority: RCW 74.46.800, 74.46.561(1). WSR 17-22-037, § 388-96-560, filed 10/24/17, effective 11/24/17. Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-560, filed 2/14/11, effective 2/26/11.

Wash. Admin. Code § 388-96-580 Operating leases of office equipment.

(1) Rental costs of office equipment under arm's-length operating leases are allowable to the extent such costs are necessary, ordinary, and related to patient care.

(2) The department must pay office equipment rental costs in the indirect component rate allocation. Office equipment may include items typically used in administrative or clerical functions such as telephones, copy machines, desks and chairs, calculators and adding machines, file cabinets, typewriters, and computers.

History

Statutory Authority: RCW 74.46.800, 74.46.561(1). WSR 17-22-037, § 388-96-580, filed 10/24/17, effective 11/24/17. Statutory Authority: RCW 74.46.800. WSR 98-20-023, § 388-96-580, filed 9/25/98, effective 10/1/98. Statutory Authority: RCW 74.46.800 and 74.09.120. WSR 93-19-074 (Order 3634), § 388-96-580, filed 9/14/93, effective 10/15/93. Statutory Authority: RCW 74.09.120, 74.46.840 and 74.46.800. WSR 85-17-052 (Order 2270), § 388-96-580, filed 8/19/85. Statutory Authority: RCW 74.09.120. WSR 84-24-050 (Order 2172), § 388-96-580, filed 12/4/84. Statutory Authority: RCW 74.46.800. WSR 84-12-039 (Order 2105), § 388-96-580, filed 5/30/84.

Wash. Admin. Code § 388-96-585 Unallowable costs.

(1) Unallowable costs listed in subsection (2) of this section represent a partial summary of such costs, in addition to those unallowable under chapter 74.46 RCW and this chapter.

(2) Unallowable costs include but are not limited to the following:

(a) Costs of items or services not covered by the medical care program. Costs of such items or services are unallowable even if they are indirectly reimbursed by the department as the result of an authorized reduction in patient contribution.

(b) Costs of services and items provided to recipients covered by the medical care program but not included in the medicaid per-resident day payment rate established under this chapter and chapter 74.46 RCW.

(c) Costs associated with a capital expenditure if the department found it was not consistent with applicable standards, criteria, or plans. If the department was not given timely notice of a proposed capital expenditure, all associated costs will be unallowable up to the date they are determined to be reimbursable under applicable federal regulations.

(d) Costs associated with a construction or acquisition project requiring certificate of need approval or exemption from the requirements for certificate of need for the replacement of existing nursing home beds, pursuant to chapter 70.38 RCW if such approval or exemption was not obtained.

(e) Interest costs other than those provided by WAC 388-96-556(4) on and after January 1, 1985.

(f) Salaries or other compensation of owners, officers, directors, stockholders, partners, principals, participants, and others associated with the contractor or its home office, including all board of directors' fees for any purpose, except reasonable compensation paid for service related to patient care.

(g) Costs in excess of limits or in violation of principles set forth in this chapter.

(h) Costs resulting from transactions or the application of accounting methods that circumvent the principles of the payment system set forth in this chapter and chapter 74.46 RCW.

(i) Costs applicable to services, facilities, and supplies furnished by a related organization in excess of the lower of the cost to the related organization or the price of comparable services, facilities, or supplies purchased elsewhere.

(j) Bad debts of Title XIX recipients are unallowable unless all the following applies:

(i) The debt is related to covered services.

(ii) The debt arises from the recipient's required contribution toward the cost of care.

(iii) The provider can establish reasonable collection efforts were made. Reasonable collection efforts consist of at least three documented attempts by the contractor to obtain payment demonstrating that the effort devoted to collecting the bad debts of Title XIX recipients is the same devoted by the contractor to collect the bad debts of non-Title XIX recipients.

(iv) The debt was actually uncollectible when claimed as worthless.

(v) Sound business judgment established there was no likelihood of recovery at any time in the future.

(k) Charity and courtesy allowances.

(l) Cash, assessments, or other contributions to charitable organizations, professional organizations, trade associations, or political parties, and costs incurred to improve community or public relations.

(m) Vending machine expenses. This does not include membership dues.

(n) Expenses for barber or beautician services not included in routine care.

(o) Funeral and burial expenses.

(p) Costs of gift shop operations and inventory.

(q) Personal items such as cosmetics, smoking materials, newspapers and magazines, and clothing, except those used in patient activity programs.

(r) Fund-raising expenses, except those directly related to the patient activity program.

(s) Penalties and fines.

(t) Expenses related to telephones, radios, and similar appliances in patients' private accommodations.

(u) Federal, state, and other income taxes.

(v) Costs of special care services except where authorized by the department;

(w) Expenses of an employee benefit not in fact made available to all employees on an equal or fair basis. For example, key-man insurance and other insurance or retirement plans.

(x) Expenses of profit-sharing plans.

(y) Expenses related to the purchase or use of private or commercial airplanes that are in excess of what a prudent contractor would expend for the ordinary and economic provision of such a transportation need related to patient care.

(z) Personal expenses and allowances of any nursing home employees or owners or relatives of any nursing home employees or owners.

(aa) All expenses of maintaining professional licenses or membership in professional organizations.

(bb) Costs related to agreements not to compete.

(cc) Amortization of goodwill, lease acquisition, or any other intangible asset, whether related to resident care or not and whether recognized under generally accepted accounting principles or not.

(dd) Legal and consultant fees in connection with a fair hearing against the department when the department's board of appeals upholds the department's actions in an administrative review decision. When the administrative review decision is pending, reported legal and consultant fees are unallowable. To be allowable, the contractor must report legal and consultant fees related to an administrative review decision issued in the contractor's favor in the cost report period in which the board of appeals issues its decision irrespective of when the legal and consultant fees related to the administrative review were incurred.

(ee) Legal and consultant fees of a contractor or contractors in connection with a lawsuit against the department. Judicial review is a lawsuit against the department.

(ff) Lease acquisition costs, goodwill, the cost of bed rights, or any other intangible assets.

(gg) All rental or lease costs other than those provided for in WAC 388-96-580.

(hh) Post-survey charges incurred by the facility under RCW 18.51.060.

(ii) Compensation paid for any purchased nursing care services, including registered nurse, licensed practical nurse, and nurse assistant services, obtained through a service contract arrangement in excess of the amount of compensation paid for such hours of nursing care service had the purchased nursing care staff been paid at the average hourly wage for in-house nursing care staff of like classification at the same nursing facility, including related taxes and benefits, as reported in the most recent cost report period.

(jj) Costs reported by the contractor for a prior period to the extent such costs, due to statutory exemption, will not be incurred by the contractor in the period to be covered by the rate.

(kk) Costs of outside activities, for example, costs allocated to the use of a vehicle for personal purposes or related to the part of a facility leased out for office space.

(ll) Travel expenses that are not necessary, ordinary, and related to resident care.

(mm) Moving expenses of employees in the absence a of demonstrated, good-faith effort to recruit within the states of Idaho, Oregon, and Washington, and the province of British Columbia.

(nn) Costs for temporary health care personnel from a nursing pool not registered with the secretary of the department of health.

(oo) Payroll taxes associated with compensation in excess of allowable compensation of owners, relatives, and administrative personnel.

(pp) Costs and fees associated with filing a petition for bankruptcy.

(qq) All advertising or promotional costs, except reasonable costs of help wanted advertising.

(rr) Interest charges assessed by any department or agency of this state for failure to make a timely refund of overpayments and interest expenses incurred for loans obtained to make the refunds.

(ss) Tax expenses that a nursing facility has never incurred.

(tt) Any portion of trade association dues attributable to legal and consultant fees and costs in connection with lawsuits against the department.

(uu) Increased costs resulting from a series of transactions between the same parties and involving the same assets (such as sale and lease back and successive sales or leases of a single facility or piece of equipment).

(vv) Costs related to a nursing assistant certified training program.

(ww) Effective July 1, 2012, payments made relating to the safety net assessment.

(xx) Building renovations, building improvements, or leasehold improvements that require preapproval from the department of health and were not preapproved.

History

Statutory Authority: RCW 74.46.800, 74.46.561(1). WSR 17-22-037, § 388-96-585, filed 10/24/17, effective 11/24/17. Statutory Authority: RCW 74.46.431(9). WSR 15-09-025, § 388-96-585, filed 4/7/15, effective 5/8/15. Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-585, filed 2/14/11, effective 2/26/11. Statutory Authority: Chapter 74.46 RCW, 1999 c 376 § 3 amending c 309 § 207. WSR 99-24-084, § 388-96-585, filed 11/30/99, effective 12/31/99. Statutory Authority: RCW 74.46.800. WSR 98-20-023, § 388-96-585, filed 9/25/98, effective 10/1/98. Statutory Authority: RCW 74.46.190, [74.46.]460 and [74.46.]800. WSR 97-17-040, § 388-96-585, filed 8/14/97, effective 9/14/97. Statutory Authority: RCW 74.46.800. WSR 96-15-056, § 388-96-585, filed 7/16/96, effective 8/16/96. Statutory Authority: RCW 74.46.800 and 1995 1st sp.s. c 18. WSR 95-19-037 (Order 3896), § 388-96-585, filed 9/12/95, effective 10/13/95. Statutory Authority: RCW 74.46.800. WSR 94-12-043 (Order 3737), § 388-96-585, filed 5/26/94, effective 6/26/94
WSR 93-17-033 (Order 3615), § 388-96-585, filed 8/11/93, effective 9/11/93. Statutory Authority: RCW 74.46.800, 74.46.450 and 74.09.120. WSR 93-12-051 (Order 3555), § 388-96-585, filed 5/26/93, effective 6/26/93. Statutory Authority: RCW 74.09.120. WSR 91-22-025 (Order 3270), § 388-96-585, filed 10/29/91, effective 11/29/91. Statutory Authority: RCW 74.09.120 and 74.46.800. WSR 90-09-061 (Order 2970), § 388-96-585, filed 4/17/90, effective 5/18/90. Statutory Authority: RCW 74.46.800. WSR 89-17-030 (Order 2847), § 388-96-585, filed 8/8/89, effective 9/8/89. Statutory Authority: RCW 74.09.180 and 74.46.800. WSR 89-01-095 (Order 2742), § 388-96-585, filed 12/21/88. Statutory Authority: RCW 74.46.800. WSR 87-09-058 (Order 2485), § 388-96-585, filed 4/20/87
WSR 86-10-055 (Order 2372), § 388-96-585, filed 5/7/86, effective 7/1/86
WSR 84-12-039 (Order 2105), § 388-96-585, filed 5/30/84. Statutory Authority: RCW 74.09.120. WSR 83-19-047 (Order 2025), § 388-96-585, filed 9/16/83
WSR 82-21-025 (Order 1892), § 388-96-585, filed 10/13/82
WSR 82-11-065 (Order 1808), § 388-96-585, filed 5/14/82
WSR 81-22-081 (Order 1712), § 388-96-585, filed 11/4/81. Statutory Authority: RCW 74.09.120 and 74.46.800. WSR 81-06-024 (Order 1613), § 388-96-585, filed 2/25/81. Statutory Authority: RCW 74.09.120. WSR 79-04-102 (Order 1387), § 388-96-585, filed 4/4/79. Statutory Authority: RCW 74.08.090 and 74.09.120. WSR 78-06-080 (Order 1300), § 388-96-585, filed 6/1/78
Order 1262, § 388-96-585, filed 12/30/77.

Wash. Admin. Code § 388-96-704 Prospective payment rates.

The department, as provided in chapter 74.46 RCW and this chapter, shall determine, adjust, or update prospective medicaid payment rates for nursing facility services provided to medical care recipients. Each rate, subject to the principles of this chapter and chapter 74.46 RCW, represents a nursing facility's maximum compensation for one resident day of care provided a medical care recipient determined by the department to both require and be eligible to receive nursing facility care.

History

Statutory Authority: Chapter 74.46 RCW as amended by 1998 c 322. WSR 98-20-023, § 388-96-704, filed 9/25/98, effective 10/1/98. Statutory Authority: RCW 74.46.800 and 1995 1st sp.s. c 18. WSR 95-19-037 (Order 3896), § 388-96-704, filed 9/12/95, effective 10/13/95. Statutory Authority: RCW 74.46.800. WSR 94-12-043 (Order 3737), § 388-96-704, filed 5/26/94, effective 6/26/94. Statutory Authority: RCW 74.09.120. WSR 82-21-025 (Order 1892), § 388-96-704, filed 10/13/82. Statutory Authority: RCW 74.08.090 and 74.09.120. WSR 78-06-080 (Order 1300), § 388-96-704, filed 6/1/78. Statutory Authority: RCW 74.09.120. WSR 78-02-013 (Order 1264), § 388-96-704, filed 1/9/78.

Wash. Admin. Code § 388-96-705 Payment for services after settlement.

When payment for services is first made following preliminary or final settlement for the period during which the services were provided, payment will be at the most recent available settlement rate.

History

Statutory Authority: RCW 74.09.120. WSR 81-22-081 (Order 1712), § 388-96-705, filed 11/4/81.

Wash. Admin. Code § 388-96-710 Prospective payment rate for new contractors.

(1) The department will establish an initial prospective medicaid payment rate for a new contractor as defined under WAC 388-96-026 within sixty days following the new contractor's application and approval for a license to operate the facility under chapter 18.51 RCW. The rate will take effect as of the effective date of the contract, except as provided in this section, and will comply with all the provisions of rate setting contained in chapter 74.46 RCW and in this chapter, including all lids and maximums set forth.

(2) To set the initial prospective medicaid payment rate for a new contractor as defined in WAC 388-96-026 (1)(a) and (b), the department will:

(a) Determine the direct care rate by multiplying the current direct care industry median per RCW 74.46.561(8) by the appropriate county wage index by the appropriate industry medicaid average case mix index (MACMI);

(b) Assign the new provider the indirect price based rate per RCW 74.46.561(8);

(c) Determine a capital rate once the facility has submitted square footage and facility age information per RCW 74.46.561(5) and the department accepts it; and

(d) Use the facility's available centers for medicare and medicaid date for at least the three quarter period currently being measured by the department to calculate a quality enhancement rate and if no data is available, the department will not pay a quality enhancement.

(3) A prospective payment rate set for all new contractors will be subject to adjustments for economic trends and conditions as authorized and provided in this chapter and in chapter 74.46 RCW.

History

Statutory Authority: RCW 74.46.800, 74.46.561(1). WSR 17-22-037, § 388-96-710, filed 10/24/17, effective 11/24/17. Statutory Authority: RCW 74.46.800. WSR 01-12-037, § 388-96-710, filed 5/29/01, effective 6/29/01. Statutory Authority: Chapter 74.46 RCW, 1999 c 376 § 3 amending c 309 § 207. WSR 99-24-084, § 388-96-710, filed 11/30/99, effective 12/31/99. Statutory Authority: Chapter 74.46 RCW as amended by 1998 c 322 § 19(11) and RCW 74.46.800. WSR 98-20-023, § 388-96-710, filed 9/25/98, effective 10/1/98. Statutory Authority: RCW 74.46.800 and 1995 1st sp.s. c 18. WSR 95-19-037 (Order 3896), § 388-96-710, filed 9/12/95, effective 10/13/95. Statutory Authority: RCW 74.46.800. WSR 94-12-043 (Order 3737), § 388-96-710, filed 5/26/94, effective 6/26/94
WSR 93-17-033 (Order 3615), § 388-96-710, filed 8/11/93, effective 9/11/93. Statutory Authority: RCW 74.46.800, 74.46.450 and 74.09.120. WSR 93-12-051 (Order 3555), § 388-96-710, filed 5/26/93, effective 6/26/93. Statutory Authority: RCW 74.46.800. WSR 92-16-013 (Order 3424), § 388-96-710, filed 7/23/92, effective 8/23/92. Statutory Authority: 1987 c 476. WSR 88-01-126 (Order 2573), § 388-96-710, filed 12/23/87. Statutory Authority: RCW 74.46.800. WSR 87-09-058 (Order 2485), § 388-96-710, filed 4/20/87. Statutory Authority: RCW 74.09.120. WSR 83-19-047 (Order 2025), § 388-96-710, filed 9/16/83
WSR 78-02-013 (Order 1264), § 388-96-710, filed 1/9/78.

Wash. Admin. Code § 388-96-713 Rate determination.

(1) Each nursing facility's medicaid payment rate for services provided to medical care recipients will be determined, adjusted, and updated prospectively as provided in this chapter and in chapter 74.46 RCW. The department will calculate any limit, median, or both only when it rebases each nursing facility's July 1st medicaid payment rate in accordance with chapter 74.46 RCW and this chapter.

(2) If the contractor participated in the program for less than six months of the prior calendar year, its rates will be determined by procedures set forth in WAC 388-96-710.

(3) Contractors that submit correct and complete cost reports by March 31st, must be notified of their rates by July 1st, unless circumstances beyond the control of the department interfere.

(4) In setting rates, the department will use the greater of actual days from the cost report period on which the rate is based or days calculated at minimum occupancy pursuant to chapter 74.46 RCW.

History

Statutory Authority: RCW 74.46.800, 74.46.561(1). WSR 17-22-037, § 388-96-713, filed 10/24/17, effective 11/24/17. Statutory Authority: RCW 74.46.431, chapter 74.46 RCW, 2004 c 276 § 913, 2001 1st sp.s. c 8. WSR 04-21-027, § 388-96-713, filed 10/13/04, effective 11/13/04. Statutory Authority: RCW 74.46.800. WSR 01-12-037, § 388-96-713, filed 5/29/01, effective 6/29/01
WSR 98-20-023, § 388-96-713, filed 9/25/98, effective 10/1/98. Statutory Authority: RCW 74.46.800 and 1995 1st sp.s. c 18. WSR 95-19-037 (Order 3896), § 388-96-713, filed 9/12/95, effective 10/13/95. Statutory Authority: RCW 74.46.800 and 74.09.120. WSR 93-19-074 (Order 3634), § 388-96-713, filed 9/14/93, effective 10/15/93
WSR 90-09-061 (Order 2970), § 388-96-713, filed 4/17/90, effective 5/18/90. Statutory Authority: RCW 74.09.120. WSR 83-19-047 (Order 2025), § 388-96-713, filed 9/16/83
WSR 81-15-049 (Order 1669), § 388-96-713, filed 7/15/81
WSR 80-06-122 (Order 1510), § 388-96-713, filed 5/30/80, effective 7/1/80
WSR 78-02-013 (Order 1264), § 388-96-713, filed 1/9/78.

Wash. Admin. Code § 388-96-718 Public process for determination of rates.

(1) The purpose of this section is to describe the manner in which the department will comply with the federal Balanced Budget Act of 1997, Section 4711 (a)(1), codified at 42 U.S.C. 1396a (a)(13)(A).

(2) For all material changes to the methodology for determining nursing facility medicaid payment rates occurring after October 1, 1997, and requiring a Title XIX state plan amendment to be submitted to and approved by the Health Care Financing Administration under applicable federal laws, the department shall follow the following public process:

(a) The proposed estimated initial payment rates, the proposed new methodologies for determining the payment rates, and the underlying justifications shall be published. Publication shall be:

(i) In the Washington State Register; or

(ii) In the Seattle Times and Spokane Spokesman Review newspapers.

(b) The department shall maintain and update as needed a mailing list of all individuals and organizations wishing to receive notice of changes to the nursing facility medicaid payment rate methodology, and all materials submitted for publication shall be sent either postage prepaid by regular mail to such individuals and organizations or by email. Individuals and organizations wishing to receive notice shall notify the department in writing.

(c) Nursing facility contractors, their associations, nursing facility medicaid beneficiaries, representatives of contractors or beneficiaries, and other concerned members of the public shall be given a reasonable opportunity to review and comment on the proposed estimated rates, methodologies and justifications. The period allowed for review and comment shall not be less than fourteen calendar days after the date of the Washington State Register containing the published material or the date the published material has appeared in both the Seattle Times and the Spokane Spokesman Review.

(d) If, after receiving and considering all comments, the department decides to move ahead with any change to its nursing facility medicaid payment rate methodology, it shall adopt needed further changes in response to comments, if any, and shall publish the final estimated initial rates, final rate determination methodologies and justifications. Publication shall be:

(i) In the Washington State Register; or

(ii) In the Seattle Times and Spokane Spokesman Review newspapers.

(e) Unless an earlier effective date is required by state or federal law, implementation of final changes in methodologies and commencement of the new rates shall not occur until final publication has occurred in the Register or in both designated newspapers. The department shall not be authorized to delay implementation of, or to alter, ignore or violate requirements of, state or federal laws in response to public process comments.

(f) Publication of proposed estimated initial payment rates and final estimated initial payment rates shall be deemed complete once the department has published:

(i) The statewide average proposed estimated initial payment rate weighted by adjusted medicaid resident days for all medicaid facilities from the most recent cost report year, including the change from the existing statewide average payment rate weighted by adjusted medicaid resident days for all medicaid facilities from the most recent cost report year; and

(ii) The statewide average final estimated initial payment rate weighted by adjusted medicaid resident days for all medicaid facilities from the most recent cost report year, including the change from the existing statewide average payment rate weighted by adjusted medicaid resident days for all medicaid facilities from the most recent cost report year.

(3) Nothing in this section shall be construed to prevent the department from commencing or completing the public process authorized by this section even though the proposed changes to the methodology for determining nursing facility medicaid payment rates are awaiting federal approval, or are the subject of pending legislative, gubernatorial or rule-making action and are yet to be finalized in statute and/or regulation.

(4)(a) Neither a contractor nor any other interested person or organization shall challenge, in any administrative appeals or exception procedure established in rule by the department under the provisions of chapter 74.46 RCW, the adequacy or validity of the public process followed by the department in proposing or implementing a change to the payment rate methodology, regardless of whether the challenge is brought to obtain a ruling on the merits or simply to make a record for subsequent judicial or other review. Such challenges shall be pursued only in courts of proper jurisdiction as may be provided by law.

(b) Any challenge to the public process followed by the department that is brought in the course of an administrative appeals or exception procedure shall be dismissed by the department or presiding officer, with prejudice to further administrative review and record-making, but without prejudice to judicial or other review as may be provided by law.

(5) The public process required and authorized by this section shall not apply to any change in the payment rate methodology that does not require a Title XIX state plan amendment under applicable federal laws, including but not limited to:

(a) Prospective or retrospective changes to nursing facility payment rates or to methodologies for establishing such rates ordered by a court or administrative tribunal, after exhaustion of all appeals by either party as may be authorized by law, or the expiration of time to appeal; or

(b) Changes to nursing facility payment rates for one or more facilities resulting from the application of authorized payment rate methodologies, principles or adjustments, including but not limited to: Partial or phased-in termination or implementation of rate methodologies; scheduled cost rebasing; quarterly or other updates to reflect changes in case mix or other private or public source data used to establish rates; adjustments for inflation or economic trends and conditions; rate funding for capital improvements or new requirements imposed by the department; changes to resident-specific or exceptional care rates; and changes to correct errors or omissions by the contractor or the department.

History

Statutory Authority: RCW 74.46.431(9). WSR 15-09-025, § 388-96-718, filed 4/7/15, effective 5/8/15. Statutory Authority: Chapter 74.46 RCW, 1999 c 376 § 3 amending c 309 § 207. WSR 99-24-084, § 388-96-718, filed 11/30/99, effective 12/31/99. Statutory Authority: RCW 74.46.800, 74.09.500 and 74.08.090. WSR 98-19-062, § 388-96-718, filed 9/16/98, effective 10/17/98.

Wash. Admin. Code § 388-96-723 Comparison of the statewide weighted average payment rate for all nursing facilities with the weighted average payment rate identified in the Biennial Appropriations Act.

(1) On a quarterly basis, the department will compare the statewide weighted average payment rate for all nursing facilities with the weighted average payment rate identified in the Biennial Appropriations Act.

(2) To determine the statewide weighted average payment rate, the department will use total billed medicaid days incurred in the calendar year immediately preceding the current fiscal year for the purpose of weighting the July 1 nursing facilities' rates that have been adjusted, or updated pursuant to chapter 74.46 RCW and this chapter.

History

Statutory Authority: RCW 74.46.431 (11) and (12), 74.46.800, chapter 74.46 RCW, 2004 c 276 § 913, 2001 1st sp.s. c 8. WSR 04-21-027, § 388-96-723, filed 10/13/04, effective 11/13/04. Statutory Authority: RCW 74.46.800. WSR 01-12-037, § 388-96-723, filed 5/29/01, effective 6/29/01. Statutory Authority: Chapter 74.46 RCW, 1999 c 376 § 3 amending c 309 § 207. WSR 99-24-084, § 388-96-723, filed 11/30/99, effective 12/31/99. Statutory Authority: RCW 74.46.421 and 74.46.800. WSR 98-20-023, § 388-96-723, filed 9/25/98, effective 10/1/98.

Wash. Admin. Code § 388-96-724 Advance notice—Nursing facility component rate reduction taken under RCW 74.46.421.

(1) The department will notify the nursing facility at least twenty-eight calendar days in advance of the effective date of a reduction taken under RCW 74.46.421.

(2) A rate reduction taken under RCW 74.46.421 will be effective the first day of the month following the twenty-eight calendar day advance notice.

History

Statutory Authority: RCW 74.46.431 (11) and (12), 74.46.800, chapter 74.46 RCW, 2004 c 276 § 913, 2001 1st sp.s. c 8. WSR 04-21-027, § 388-96-724, filed 10/13/04, effective 11/13/04. Statutory Authority: Chapter 74.46 RCW, 1999 c 376 § 3 amending c 309 § 207. WSR 99-24-084, § 388-96-724, filed 11/30/99, effective 12/31/99. Statutory Authority: RCW 74.46.421 and 74.46.800. WSR 98-20-023, § 388-96-724, filed 9/25/98, effective 10/1/98.

Wash. Admin. Code § 388-96-725 RCW 74.46.421 rate reduction—A nursing facility's rates.

(1) The department will not reverse any rate reductions taken in accordance with RCW 74.46.421.

(2) If after a reduction a nursing facility is eligible to receive an increase in a component rate for some unrelated change (e.g., a change in the medicaid case mix index causes the direct care rate to increase), the department will apply the increase to the rate reduced by application of RCW 74.46.421.

(3) Reductions made under RCW 74.46.421 are cumulative. The department will reduce the component rates for all nursing facilities without reversing any previous reductions.

History

Statutory Authority: RCW 74.46.431 (11) and (12), 74.46.800, chapter 74.46 RCW, 2004 c 276 § 913, 2001 1st sp.s. c 8. WSR 04-21-027, § 388-96-725, filed 10/13/04, effective 11/13/04. Statutory Authority: Chapter 74.46 RCW, 1999 c 376 § 3 amending c 309 § 207. WSR 99-24-084, § 388-96-725, filed 11/30/99, effective 12/31/99. Statutory Authority: RCW 74.46.421 and 74.46.800. WSR 98-20-023, § 388-96-725, filed 9/25/98, effective 10/1/98.

Wash. Admin. Code § 388-96-726 RCW 74.46.421 nursing facility component rates below the statewide weighted average payment rate identified in the Biennial Appropriations Act.

(1) Even if an individual nursing facility's component rates are below the statewide weighted average payment rate identified in the Biennial Appropriations Act, the department will reduce the nursing facility's rates as required under RCW 74.46.421.

(2) The department will not exempt any nursing facility from a component rates reduction required by RCW 74.46.421 for any circumstance, e.g., billed medicaid days, under-spending of the biennial appropriation for nursing facility rates, etc.

History

Statutory Authority: RCW 74.46.431 (11) and (12), 74.46.800, chapter 74.46 RCW, 2004 c 276 § 913, 2001 1st sp.s. c 8. WSR 04-21-027, § 388-96-726, filed 10/13/04, effective 11/13/04. Statutory Authority: Chapter 74.46 RCW, 1999 c 376 § 3 amending c 309 § 207. WSR 99-24-084, § 388-96-726, filed 11/30/99, effective 12/31/99. Statutory Authority: RCW 74.46.421 and 74.46.800. WSR 98-20-023, § 388-96-726, filed 9/25/98, effective 10/1/98.

Wash. Admin. Code § 388-96-730 Methodology for reducing a nursing facility's medicaid payment rate in order to reduce the statewide weighted average nursing facility medicaid payment rate to equal or be less than the weighted average payment rate identified in the Biennial Appropriations Act.

(1) The department will determine a percentage reduction factor (PRF) that, when applied to all nursing facilities' rates will result in a statewide weighted average payment rate that is equal to or less than the weighted average payment rate identified in the Biennial Appropriations Act.

(2) By applying various percentages to the rates for all nursing facilities, the department will identify a percentage that reduces the statewide weighted average payment rate equal to or less than the weighted average payment rate identified in the Biennial Appropriations Act.

(3) The percentage identified in subsection (2) of this section will be the PRF. To reduce the statewide average payment rate to less than or equal to the weighted average payment rate identified in the Biennial Appropriations Act, the department will apply the PRF equally to all rate component allocations of each nursing facility's rate.

History

Statutory Authority: RCW 74.46.431 (11) and (12), 74.46.800, chapter 74.46 RCW, 2004 c 276 § 913, 2001 1st sp.s. c 8. WSR 04-21-027, § 388-96-730, filed 10/13/04, effective 11/13/04. Statutory Authority: Chapter 74.46 RCW, 1999 c 376 § 3 amending c 309 § 207. WSR 99-24-084, § 388-96-730, filed 11/30/99, effective 12/31/99.

Wash. Admin. Code § 388-96-731 Nursing facilities' rate reductions pursuant to RCW 74.46.421.

Under RCW 74.46.421, the department will reduce the rate for each nursing facility when the statewide weighted average payment rate for all nursing facilities exceeds or is likely to exceed the weighted average payment rate identified in the Biennial Appropriations Act.

History

Statutory Authority: RCW 74.46.431 (11) and (12), 74.46.800, chapter 74.46 RCW, 2004 c 276 § 913, 2001 1st sp.s. c 8. WSR 04-21-027, § 388-96-731, filed 10/13/04, effective 11/13/04. Statutory Authority: Chapter 74.46 RCW, 1999 c 376 § 3 amending c 309 § 207. WSR 99-24-084, § 388-96-731, filed 11/30/99, effective 12/31/99.

Wash. Admin. Code § 388-96-738 What default case mix group and weight must the department use for case mix grouping when there is no minimum data set resident assessment for a nursing facility resident?

(1) When a resident:

(a) Expires before the facility completes the resident's initial assessment, the department must assign the assessment to the special care case mix group - HD2. The department must use the case mix weight assigned to the special care case mix group - HD2. The department will count the case as a medicaid resident;

(b) Is discharged to an acute care facility before the nursing facility completes the resident's initial assessment, the department must assign the assessment to the special care case mix group - HD2. The department must use the case mix weight assigned to the special care case mix group - HD2. The department will count the case as a medicaid resident; or

(c) Is discharged for a reason other than those noted above before the facility completes the resident's initial assessment, the department must assign the assessment to the case mix group BC1. The department will count the case as a medicaid resident.

(2) If the resident assessment is untimely as defined in RCW 74.46.501 and as defined by federal regulations, then the department must assign the case to the default case mix group of BC1. The department will count the case a medicaid resident.

History

Statutory Authority: RCW 74.46.431(9). WSR 15-09-025, § 388-96-738, filed 4/7/15, effective 5/8/15. Statutory Authority: Chapter 74.46 RCW as amended by 1998 c 322 §§ 22, 24 and 25 and RCW 74.46.800. WSR 98-20-023, § 388-96-738, filed 9/25/98, effective 10/1/98.

Wash. Admin. Code § 388-96-739 How will the department determine which resident assessments are medicaid resident assessments?

The department must identify a medicaid resident assessment through the review of the minimum data set (MDS) medicaid number field. If the nursing facility completes the MDS medicaid number field with a valid medicaid number or the appropriate code for medicaid pending, then the department will count the case as a medicaid resident assessment.

History

Statutory Authority: RCW 74.46.431(9). WSR 15-09-025, § 388-96-739, filed 4/7/15, effective 5/8/15. Statutory Authority: Chapter 74.46 RCW as amended by 1998 c 322 §§ 22, 24 and 25 and RCW 74.46.800. WSR 98-20-023, § 388-96-739, filed 9/25/98, effective 10/1/98.

Wash. Admin. Code § 388-96-757 Payment for veterans' homes.

Payment rates to nursing facilities operated by the state of Washington, department of veterans' affairs shall be determined in accordance with chapter 74.46 RCW and this chapter as for all other facilities.

History

Statutory Authority: RCW 74.09.120 and 74.46.800. WSR 98-20-023, § 388-96-757, filed 9/25/98, effective 10/1/98
WSR 93-19-074 (Order 3634), § 388-96-757, filed 9/14/93, effective 10/15/93.

Wash. Admin. Code § 388-96-758 Add-on for low-wage workers.

(1) A nursing home may use the low-wage worker add-on only for in-house staff and not for allocated, home office, or purchased service increases. A nursing home may use the add-on to:

(a) Increase wages, benefits, or staffing levels for certified nurse aides;

(b) Increase wages or benefits but not staffing levels for dietary aides, housekeepers, laundry aides, or any other category of worker whose statewide average dollars-per-hour wage was less than fifteen dollars in calendar year 2008, according to cost report data, including:

(i) Activities directors and assistants;

(ii) Patient choices coordinators;

(iii) Central supply/ward clerks;

(iv) Expanded community service workers; and

(v) Social workers; and

(2) A nursing home that receives a low-wage add-on must report to the department its expenditure of that add-on by:

(a) Completing cost report schedule L 1; and

(b) Returning it to the department by January 31st.

(3) By examining cost report schedule L 1, the department will determine whether the nursing home complied with the statutory requirements for distribution of the low wage add-on. When the department is unable to determine or unsure that the statutory requirements have been met, it will conduct an on-site audit.

(4) When the department determines that the statutory requirements have been met, the low wage add-on will be reconciled at the same time as the regular settlement process but as a separate reconciliation. The reconciliation process will compare gross dollars received in the add-on to gross dollars spent.

(5) When the department determines that the low wage add-on has not been spent in compliance with the statutory requirements, then it will recoup the noncomplying amount as an overpayment.

(6) The department also will require the completing of cost report schedule L 1 for any calendar year in which the low wage add-on is paid for six months or more. Subsections (1) through (5) of this section will apply to all completions of cost report schedule L 1 irrespective of the calendar year in which it is paid.

History

Statutory Authority: RCW 74.46.800, 74.46.561(1). WSR 17-22-037, § 388-96-758, filed 10/24/17, effective 11/24/17. Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-758, filed 2/14/11, effective 2/26/11. Statutory Authority: 2008 c 329 § 206(9). WSR 09-08-081, § 388-96-758, filed 3/30/09, effective 4/30/09.

Wash. Admin. Code § 388-96-759 Standards for low-wage worker add-on.

(1) In accordance with WAC 388-96-758, the low-wage worker add-on must be used to provide increases in wages or benefits, or to address resulting wage compression beginning on or after the date on which the add-on is first included in the rate. The low-wage worker add-on may be used to increase staffing levels for certified nurse aides only. Nursing home contractors receiving the low-wage add-on may not use it to pay for increases for time periods that they were not receiving the low wage worker add-on.

(2) Any type of traditional employee benefit is allowable. Such benefits typically fall in one of two categories: Retirement and life or health insurance. However, nontraditional benefits are also allowable (for example, wellness benefits, subsidized meals, or assistance with daycare).

(3) The employer's share of payroll taxes associated with wages and benefits may be covered with the add-on.

(4) For purposes of wage compression, an "immediately affected" job class is one that is related to the low-wage worker category, either in the organizational structure (for example, it supervises the low-wage worker category) or by existing practice (for example, the facility has a benchmark of paying that job class a certain percentage more than the low-wage worker category). Facilities must be able to explain the basis of the relationship if requested. Because the statute refers to "resulting wage compression," a facility must use a portion of the add-on to increase wages or benefits before it may use any of the add-on to address any wage compression caused by such increase.

(5) A facility may use the add-on in relation to any of the job categories listed in WAC 388-96-758, regardless of whether the average wage it pays to its own employees is above fifteen dollars per hour, either before or after including the additional wages funded by the add-on.

(6) Wages or benefits, including employee bonuses, otherwise properly paid with the add on will not be considered as unallowable costs under RCW 74.46.410 (2)(x).

(7) The low-wage worker add-on payments calculated in accordance with WAC 388-96-758 and this section must be adjusted to the extent necessary to comply with RCW 74.46.421.

History

Statutory Authority: RCW 74.46.800, 74.46.561(1). WSR 17-22-037, § 388-96-759, filed 10/24/17, effective 11/24/17. Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-759, filed 2/14/11, effective 2/26/11. Statutory Authority: 2008 c 329 § 206(9). WSR 09-08-081, § 388-96-759, filed 3/30/09, effective 4/30/09.

Wash. Admin. Code § 388-96-760 Upper limits to the payment rate.

The average payment rate for the cost report year shall not exceed the contractor's average customary charges to the general public for the services covered by the payment rate for the same time period. The department will pay public facilities rendering such services free of charge or at a nominal charge according to the methods and standards set out in this chapter. The contractor shall provide as part of the annual cost report a statement of the average charges for the cost report year for services covered by the payment rate and supporting computations and documentation. The contractor shall immediately inform the department if its payment rate does exceed customary charges for comparable services. If necessary, the department will adjust the payment rate in accordance with RCW 74.46.531.

History

Statutory Authority: Chapter 74.46 RCW as amended by 1998 c 322, RCW 74.46.800 and 74.09.120. WSR 98-20-023, § 388-96-760, filed 9/25/98, effective 10/1/98. Statutory Authority: RCW 74.46.800 and 74.09.120. WSR 91-12-026 (Order 3185), § 388-96-760, filed 5/31/91, effective 7/1/91. Statutory Authority: RCW 74.09.120. WSR 84-24-050 (Order 2172), § 388-96-760, filed 12/4/84
WSR 83-19-047 (Order 2025), § 388-96-760, filed 9/16/83
WSR 81-22-081 (Order 1712), § 388-96-760, filed 11/4/81. Statutory Authority: RCW 74.08.090 and 74.09.120. WSR 78-06-080 (Order 1300), § 388-96-760, filed 6/1/78. Statutory Authority: RCW 74.09.120. WSR 78-02-013 (Order 1264), § 388-96-760, filed 1/9/78.

Wash. Admin. Code § 388-96-766 Notification.

(1)(a) The contractor must inform the department of its current electronic mail (email) address at which it wants to receive rate notifications. It is the responsibility of the contractor to inform the department of any changes to the email address at which it wants to receive notice of the department's actions. The department may notify each contractor by email using the contractor's supplied email address of its prospective medicaid payment rate allocation and/or any actions that result in a change to the contractor's prospective medicaid payment rate allocation. The date of the department's notification email will be used to determine whether the notification and the contractor's response met any legal requirements, irrespective of when the contractor read the email.

(b) When the contractor seeks to appeal or take exception to a department action taken under authority of this chapter or chapter 74.46 RCW and eligible for administrative review under WAC 388-96-901, it shall comply with WAC 388-96-904 when requesting an administrative review conference.

(2)(a) Unless otherwise specified at the time it is issued, the medicaid payment rate allocation and/or component rate allocation(s) will be effective from the first day of the month in which it (they) is (are) issued. When the department amends a medicaid payment rate allocation and/or component rate allocation(s) as the result of an appeal in accordance with WAC 388-96-904, the amended rate will have the same effective date as the appealed rate.

(b) When a total medicaid component payment rate allocation and/or rate allocation(s) is (are) adjusted, updated or amended after the calendar year in which the adjustment or update was effective, then the department will account for any amounts owed through the settlement process.

(3)(a) When the department has sent written notice by post, it shall deem the contractor to have received the department's notice five calendar days after the date of the notification letter, unless proof of the date of receipt of the department's notification letter exists, in which case the actual date of receipt shall be used. Proof of date of receipt of department's notification must be from an independent source that has no stake in the outcome.

(b) When the department has sent notice by certified letter, the department shall deem the contractor to have received the department's notice five calendar days after the date the U.S. Post Office first attempts to deliver the certified letter containing the notice of the department's action(s).

History

Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-766, filed 2/14/11, effective 2/26/11. Statutory Authority: RCW 74.46.431 (11) and (12), 74.46.800, chapter 74.46 RCW, 2004 c 276 § 913, 2001 1st sp.s. c 8. WSR 04-21-027, § 388-96-766, filed 10/13/04, effective 11/13/04. Statutory Authority: Chapter 74.46 RCW, 1999 c 376 § 3 amending c 309 § 207. WSR 99-24-084, § 388-96-766, filed 11/30/99, effective 12/31/99. Statutory Authority: RCW 74.09.120. WSR 78-02-013 (Order 1264), § 388-96-766, filed 1/9/78.

Wash. Admin. Code § 388-96-771 Receivership.

(1) If the nursing home is providing care to recipients of state medical assistance, the receiver shall:

(a) Become the medicaid contractor for the duration of the receivership period;

(b) Assume all reporting responsibilities for new contractors;

(d) Be responsible for the refund of medicaid rate payments in excess of costs during the period of receivership.

(2) In establishing the prospective rate during receivership the department shall consider:

(a) Compensation, if any, ordered by the court for the receiver. Such compensation may already be available to the receiver through the rate as follows:

(i) Financing allowance and variable return component rate allocations, or

(ii) The administrator's salary in the case of facilities where the receiver is also the administrator.

If these existing sources of compensation are less than what was ordered by the court, additional costs may be allowed in the rate up to the compensation amount ordered by the court.

(b) Start up costs and costs of repairs, replacements, and additional staff needed for patient health, security, and welfare. To the extent such costs can be covered through the financing allowance and the variable return component rate allocations, no additional moneys will be added to the rate;

(3)(a) Upon order of the court, the department shall provide emergency or transitional financial assistance to a receiver not to exceed thirty thousand dollars.

(b) The department shall recover any emergency or transitional expenditure made by the department on behalf of a nursing home not certified to participate in the medicaid Title XIX program from revenue generated by the facility which is not obligated to the operation of the facility.

(c) In order to help recover an emergency or transitional expenditure, regardless of whether the facility is certified to participate in the medicaid Title XIX program or not, the department may:

(i) File an action against the former licensee or owner at the time the expenditure is made to recover such expenditure; or

(ii) File a lien on the facility or on the proceeds of the sale of the facility.

(4) If recommendations on receiver's compensation are solicited from the department by the court, the department shall consider the following:

(a) The range of compensation for nursing home managers;

(b) Experience and training of the receiver;

(d) Any additional factors deemed appropriate by the department.

(5) When the receivership terminates, the department may revise the nursing home's medicaid reimbursement. The medicaid reimbursement rate for:

(a) The former owner or licensee shall be what it was before receivership, unless the former owner or licensee requests prospective rate revisions from the department as set forth in this chapter; and

(b) Licensed replacement operators shall be determined consistent with rules governing prospective reimbursement rates for new contractors as set forth in this chapter.

History

Statutory Authority: Chapter 74.46 RCW, 1999 c 376 § 3 amending c 309 § 207. WSR 99-24-084, § 388-96-771, filed 11/30/99, effective 12/31/99. Statutory Authority: RCW 79.09.120 [74.09.120] and 74.46.800. WSR 90-09-061 (Order 2970), § 388-96-771, filed 4/17/90, effective 5/18/90. Statutory Authority: RCW 74.09.120. WSR 88-06-085 (Order 2602), § 388-96-771, filed 3/2/88.

Wash. Admin. Code § 388-96-777 Add-ons to the prospective rate—Initiated by the department.

(1) The department shall initiate all rate add-ons granted under this section. Contractors may not request and be approved a rate add-on under this section.

(2) Rate add-ons the department grants under the authority of this section shall be for costs to implement:

(a) Program changes that the director of residential care services, aging and adult services administration determines a rate add-on is necessary to accomplish the purpose of the change and announces same in a written directive to the chief of the office of rates management; or

(b) Changes in either the state or federal statutes or regulations or directives that the director of management services, aging and adult services administration determines requires a rate add-on to implement and directs in writing the chief of the office of rates management to implement.

(3) Changes made under this section are subject to review under WAC 388-96-901 and 388-96-904; provided, the issue is not whether a rate add-on should have been granted.

(4) If the contractor does not use the funds for the purpose for which they were granted, the department shall immediately recoup the misspent or unused funds.

History

Statutory Authority: RCW 74.46.800. WSR 01-12-037, § 388-96-777, filed 5/29/01, effective 6/29/01
WSR 94-12-043 (Order 3737), § 388-96-777, filed 5/26/94, effective 6/26/94.

Wash. Admin. Code § 388-96-781 Exceptional care rate add-on—Covered medicaid residents.

A nursing facility (NF) may receive an increase in its direct care rate allocations for providing exceptional care to a medicaid resident who:

(1) Receives specialized services to meet chronic complex medical conditions and neurodevelopment needs of medically fragile children and resides in a NF where all residents are under age twenty-one with at least fifty percent of the residents entering the facility before the age of fourteen;

(2) Receives expanded community services (ECS);

(3) Is admitted to a NF as an extraordinary medical placement (EMP) and the department of corrections (DOC) has approved the exceptional direct care;

(4) Is ventilator or tracheotomy (VT) dependent and resides in a NF that the department has designated as active ventilator-weaning center;

(5) Has a traumatic brain injury (TBI) established by a comprehensive assessment reporting evaluation (CARE) assessment administered by department staff and resides in a NF that the department has designated as capable for TBI patients;

(6) Has a TBI and currently resides in nursing facility specializing in the care of TBI residents where more than fifty percent of residents are classified with TBIs based on the federal minimum data set assessment (MDS 3.0 or its successor); or

(7) Is admitted to a NF from a hospital with an exceptional care need and medicaid purchasing administration (MPA) or a successor administration has approved the exceptional direct care payment.

History

Statutory Authority: RCW 74.46.800, 74.46.561(1). WSR 17-22-037, § 388-96-781, filed 10/24/17, effective 11/24/17. Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-781, filed 2/14/11, effective 2/26/11. Statutory Authority: RCW 74.46.800, 74.46.508. WSR 00-12-098, § 388-96-781, filed 6/7/00, effective 7/8/00.

Wash. Admin. Code § 388-96-782 Exceptional direct care—Payment.

(1) For WAC 388-96-781(1) residents, the department will pay the Oregon medicaid rate.

(2) For WAC 388-96-781 (4), (5), (6), and (7) residents, the department may establish a rate add-on that when added to the nursing facility's per diem medicaid rate does not exceed the cost of caring for the client in a hospital.

(3) Costs related to payments resulting from increases in direct care component rates under subsection (2) of this section must be offset against the facility's examined, allowable direct care costs, for each report year or partial period such increases are paid. Such reductions in allowable direct care must be for rate setting, settlement, and other purposes deemed appropriate by the department.

History

Statutory Authority: RCW 74.46.800, 74.46.561(1). WSR 17-22-037, § 388-96-782, filed 10/24/17, effective 11/24/17. Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-782, filed 2/14/11, effective 2/26/11. Statutory Authority: RCW 74.46.431 (11) and (12), 74.46.800, chapter 74.46 RCW, 2004 c 276 § 913, 2001 1st sp.s. c 8. WSR 04-21-027, § 388-96-782, filed 10/13/04, effective 11/13/04. Statutory Authority: RCW 74.46.800, 74.46.508. WSR 00-12-098, § 388-96-782, filed 6/7/00, effective 7/8/00.

Wash. Admin. Code § 388-96-785 Supplemental payments.

To the extent the federal government approves such payments under the state's plan for medical assistance, and only to the extent that funds are specifically appropriated for this purpose in the biennial appropriations act, the department shall make supplemental payments to nursing facilities operated by public hospital districts. The payments shall be calculated and distributed in accordance with the terms and conditions specified in the biennial appropriations act. The payments shall be supplemental to the component rate allocations calculated in accordance with Part E of chapter 74.46 RCW and the related sections of this chapter neither the provisions of Part E of chapter 74.46 RCW nor the settlement provisions of this chapter apply to these supplemental payments.

History

Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-785, filed 2/14/11, effective 2/26/11.

Wash. Admin. Code § 388-96-802 Billing/payment.

(1) The department will pay nursing facility (NF) contractors for the first day of a medicaid resident's stay but not the last day.

(2) The department will pay a contractor for service rendered under the facility contract and billed in accordance with the department's billing procedure. The amount paid will be computed using the appropriate rates assigned to the contractor. For each recipient, the department will pay an amount equal to the appropriate rates, multiplied by the number of medicaid resident days each rate was in effect, less the amount the recipient is required to pay for his or her care as set forth by WAC 388-96-803.

(3) A NF contractor shall not bill the department for service provided to a medicaid recipient until an award letter of eligibility for the recipient under rules established under the authority of chapter 74.09 RCW has been received by the facility. However a facility may bill and shall be reimbursed for all medical care recipients referred to the facility by the department prior to the receipt of the award letter of eligibility or the denial of such eligibility.

History

Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-802, filed 2/14/11, effective 2/26/11. Statutory Authority: RCW 74.46.800. WSR 01-12-037, § 388-96-802, filed 5/29/01, effective 6/29/01.

Wash. Admin. Code § 388-96-803 Notification of participation—Responsibility to collect—Reporting medicaid recipient's changes in income/resources—Rate payment in full for services.

(1) The department will notify a contractor of the amount each medical recipient is required to participate in the cost of his or her care and the effective date of the required participation. The contractor must collect the participation from the patient and to account for any authorized reductions from the participation.

(2) Within seventy-two hours of becoming aware of a change in the medicaid resident's income and/or resources, the NF contractor will report the change in writing to the home and community services office serving the area in which the NF is located. When reporting the change, the NF contractor will include copies of any available documentation of the change in the medicaid resident's income and/or resources.

(3) For each medicaid resident, the contractor shall accept the payment rates established by the department multiplied by the number of medicaid resident days each rate was in effect, less the amount the recipient is required to pay for his or her care as set forth in WAC 388-96-803(1) as full compensation for all services provided under the contract, certification as specified by Title XIX, and licensure under chapter 18.51 RCW. The contractor shall not seek or accept additional compensation from or on behalf of a recipient for any or all such services.

History

Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-803, filed 2/14/11, effective 2/26/11. Statutory Authority: RCW 74.46.800. WSR 01-12-037, § 388-96-803, filed 5/29/01, effective 6/29/01.

Wash. Admin. Code § 388-96-805 Suspension of payments.

(1) The department may withhold payments to a contractor in each of the following circumstances:

(a) A required report is not properly completed and filed by the contractor within the appropriate time period, including any approved extension. Payments will be released as soon as a properly completed report is received;

(b) State auditors, department auditors, or authorized personnel in the course of their duties are refused access to a nursing facility or are not provided with existing appropriate records. Payments will be released as soon as such access or records are provided;

(c) A refund in connection with a settlement or rate adjustment is not paid by the contractor when due. The amount withheld will be limited to the unpaid amount of the refund and any accumulated interest owed to the department as authorized by this chapter;

(d) Payment for the final sixty days of service prior to termination or assignment of a contract will be held in the absence of adequate alternate security acceptable to the department pending settlement of all periods when the contract is terminated or assigned; and

(e) Payment for services at any time during the contract period in the absence of adequate alternate security acceptable to the department, when a contractor's net medicaid overpayment liability for one or more nursing facilities or other debt to the department, as determined by settlement, civil fines imposed by the department, third-party liabilities or other source, reaches or exceeds fifty thousand dollars, whether subject to good faith dispute or not, and for each subsequent increase in liability reaching or exceeding twenty-five thousand dollars. Payments will be released as soon as practicable after acceptable security is provided or refund to the department is made.

(2) No payment will be withheld until written notification of the suspension is provided to the contractor, stating the reason for the withholding. Neither a timely filed request to pursue any administrative appeals or exception procedure that the department may establish by rule nor commencement of judicial review, as may be available to the contractor in law, shall delay suspension of payment.

History

Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-805, filed 2/14/11, effective 2/26/11.

Wash. Admin. Code § 388-96-808 Change of ownership—Assignment of department's contract.

(1) On the effective date of a change of ownership the department's contract with the old owner shall be automatically assigned to the new owner, unless:

(a) The new owner does not desire to participate in medicaid as a nursing facility provider;

(b) The department elects not to continue the contract with the new owner; or

(c) The new owner elects not to accept assignment and requests certification and a new contract. The old owner shall give the department sixty days' written notice of such intent to change ownership and assign. When certificate of need and/or section 1122 approval is required pursuant to chapter 70.38 RCW and Part 100, Title 42 C.F.R., for the new owner to acquire the facility, and the new owner wishes to continue to provide service to recipients without interruption, certificate of need and/or section 1122 approval shall be obtained before the old owner submits a notice of intent to change ownership and assign.

(2) If the new owner desires to participate in the nursing facility medicaid payment system, it shall meet the conditions specified in WAC 388-96-011. The facility contract with the new owner shall be effective as of the date of the change of ownership.

History

Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-808, filed 2/14/11, effective 2/26/11.

Wash. Admin. Code § 388-96-809 Change of ownership—Final reports—Settlement securities.

(1) When there is a change of ownership for any reason, final reports shall be submitted as required by WAC 388-96-022.

(2) Upon a notification of intent to change ownership, the department shall determine by settlement or reconciliation the amount of any overpayments made to the assigning or terminating contractor, including overpayments disputed by the assigning or terminating contractor. If settlements are unavailable for any period up to the date of assignment or termination, the department shall make a reasonable estimate of any overpayment or underpayments for such periods. The reasonable estimate shall be based upon prior period settlements, available audit findings, the projected impact of prospective rates, and other information available to the department. The department shall also determine and add in the total of all other debts and potential debts owed to the department regardless of source, including, but not limited to, interest owed to the department as authorized by this chapter, civil fines imposed by the department, or third-party liabilities.

(3) For all cost reports, the assigning or terminating contractor shall provide security, in a form deemed adequate by the department, equal to the total amount of determined and estimated overpayments and all debts and potential debts from any source, whether or not the overpayments are the subject of good faith dispute including but not limited to, interest owed to the department, civil fines imposed by the department, and third-party liabilities. Security shall consist of one or more of the following:

(a) Withheld payments due the assigning or terminating contractor under the contract being assigned or terminated;

(b) An assignment of funds to the department;

(d) An authorization to withhold payments from one or more medicaid nursing facilities that continue to be operated by the assigning or terminating contractor;

(e) A promissory note secured by a deed of trust; or

(f) Other collateral or security acceptable to the department.

(4) An assignment of funds shall:

(a) Be at least equal to the amount of determined or estimated debt or potential debt minus withheld payments or other security provided; and

(b) Provide that an amount equal to any recovery the department determines is due from the contractor from any source of debt to the department, but not exceeding the amount of the assigned funds, shall be paid to the department if the contractor does not pay the debt within sixty days following receipt of written demand for payment from the department to the contractor.

(5) The department shall release any payment withheld as security if alternate security is provided under subsection (3) of this section in an amount equivalent to the determined and estimated debt.

(6) If the total of withheld payments and assigned funds is less than the total of determined and estimated debt, the unsecured amount of such debt shall be a debt due the state and shall become a lien against the real and personal property of the contractor from the time of filing by the department with the county auditor of the county where the contractor resides or owns property, and the lien claim has preference over the claims of all unsecured creditors.

(7) A properly completed final cost report shall be filed in accordance with WAC 388-96-022, which shall be examined by the department in accordance with WAC 388-96-205.

(8) Security held pursuant to this section shall be released to the contractor after all debts, including accumulated interest owed the department, have been paid by the old owner.

(9) Security held pursuant to this section shall be released to the contractor if the new contractor assumes all liability.

(10) If, after calculation of settlements for any periods, it is determined that overpayments exist in excess of the value of security held by the state, the department may seek recovery of these additional overpayments as provided by law.

(11) Regardless of whether a contractor intends to change ownership, if a contractor's net medicaid overpayments and erroneous payments for one or more settlement periods, and for one or more nursing facilities, combined with debts due the department, reaches or exceeds a total of fifty thousand dollars, as determined by settlement, civil fines imposed by the department, third-party liabilities or by any other source, whether such amounts are subject to good faith dispute or not, the department shall demand and obtain security equivalent to the total of such overpayments, erroneous payments, and debts and shall obtain security for each subsequent increase in liability reaching or exceeding twenty-five thousand dollars. Such security shall meet the criteria in subsections (3) and (4) of this section, except that the department shall not accept an assumption of liability. The department shall withhold all or portions of a contractor's current contract payments or impose liens, or both, if security acceptable to the department is not forthcoming. The department shall release a contractor's withheld payments or lift liens, or both, if the contractor subsequently provides security acceptable to the department.

(12) Notwithstanding the application of security measures authorized by this section, if the department determines that any remaining debt of the old owner is uncollectible from the old owner, the new owner is liable for the unsatisfied debt in all respects. If the new owner does not accept assignment of the contract and the contingent liability for all debt of the prior owner, a new certification survey shall be done and no payments shall be made to the new owner until the department determines the facility is in substantial compliance for the purposes of certification.

(13) Medicaid provider contracts shall only be assigned if there is a change of ownership, and with approval by the department.

History

Statutory Authority: RCW 74.46.431(9). WSR 15-09-025, § 388-96-809, filed 4/7/15, effective 5/8/15. Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-809, filed 2/14/11, effective 2/26/11.

Wash. Admin. Code § 388-96-901 Disputes.

(1) When a contractor wishes to contest the way in which the department applied a statute or department rule to the contractor's circumstances, the contractor must pursue the administrative review process prescribed in WAC 388-96-904.

(a) Adverse actions taken under the authority of this chapter or chapter 74.46 RCW subject to administrative review under WAC 388-96-904 include but are not limited to the following:

(i) Determining a nursing facility payment rate;

(ii) Calculating a nursing facility settlement;

(iii) Imposing a civil fine on the nursing facility;

(iv) Suspending payment to a nursing facility; and

(v) Conducting trust fund and accounts receivable audits.

(b) Adverse actions taken under the authority of this chapter or chapter 74.46 RCW not subject to administrative review under WAC 388-96-904 include but are not limited to:

(i) Actions taken under the authority of RCW 74.46.421 and sections of this chapter implementing RCW 74.46.421;

(ii) Case mix accuracy review of minimum data set (MDS) nursing facility resident assessments that are limited to separate administrative review under WAC 388-96-905;

(iii) Semiannual rate updates to reflect changes in a facility's resident case mix including contractor errors made in the MDSs used to update the facility's resident case mix;

(iv) Actions taken under the exceptional direct care program codified at WAC 388-96-781 and 388-96-782; and

(v) Actions taken under WAC 388-96-218 (2)(c).

(2) The administrative review process prescribed in WAC 388-96-904 must not be used to contest or review unrelated or ancillary department actions, whether review is sought to obtain a ruling on the merits, make a record for subsequent judicial review, or other purpose. If an issue is raised that is not subject to review under WAC 388-96-904, the presiding officer must dismiss such issue with prejudice to further review under the provisions of WAC 388-96-904, but without prejudice to other administrative or judicial review as may be provided by law. Unrelated or ancillary actions not eligible for administrative review under WAC 388-96-904 include but are not limited to:

(a) Challenges to the adequacy or validity of the public process followed by the department in proposing or making a change to the nursing facility medicaid payment rate methodology, as required by Title 42 U.S.C. Sec. 1396a (a)(13)(A) and WAC 388-96-718;

(b) Challenges to the nursing facility medicaid payment system that are based in whole or in part on federal laws, regulations, or policies;

(d) Challenges to the legal validity of a statute or regulation; and

(e) Actions of the department affecting a medicaid beneficiary or provider that were not commenced by the office of rates management, aging and long-term support administration.

(3) If a contractor wishes to challenge the legal validity of a statute, rule, or contract provision relating to the nursing facility medicaid payment system or bring a challenge based in whole or in part on federal law, it must bring such action de novo in a court of proper jurisdiction as may be provided by law. The contractor must not use this section or WAC 388-96-904 for such purposes. This prohibition applies irrespective of whether the contractor wishes to obtain a decision or ruling on an issue of validity or federal compliance or wishes only to make a record for the purpose of subsequent judicial review.

History

Statutory Authority: RCW 74.46.800, 74.46.561(1). WSR 17-22-037, § 388-96-901, filed 10/24/17, effective 11/24/17. Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-901, filed 2/14/11, effective 2/26/11. Statutory Authority: RCW 74.46.431 (11) and (12), 74.46.800, chapter 74.46 RCW, 2004 c 276 § 913, 2001 1st sp.s. c 8. WSR 04-21-027, § 388-96-901, filed 10/13/04, effective 11/13/04. Statutory Authority: RCW 74.46.800. WSR 01-12-037, § 388-96-901, filed 5/29/01, effective 6/29/01. Statutory Authority: RCW 74.46.800, 74.46.508. WSR 00-12-098, § 388-96-901, filed 6/7/00, effective 7/8/00. Statutory Authority: RCW 74.46.780 as amended by 1998 c 322 § 41. WSR 98-20-023, § 388-96-901, filed 9/25/98, effective 10/1/98. Statutory Authority: RCW 74.46.800 and 1995 1st sp.s. c 18. WSR 95-19-037 (Order 3896), § 388-96-901, filed 9/12/95, effective 10/13/95. Statutory Authority: RCW 74.46.800 and 74.09.120. WSR 91-12-026 (Order 3185), § 388-96-901, filed 5/31/91, effective 7/1/91. Statutory Authority: RCW 74.09.120. WSR 82-21-025 (Order 1892), § 388-96-901, filed 10/13/82
Order 1262, § 388-96-901, filed 12/30/77.

Wash. Admin. Code § 388-96-904 Administrative review—Adjudicative proceeding.

(1)(a) A contractor seeking an administrative review of an adverse action or determination of the department taken under authority of this chapter or chapter 74.46 RCW and eligible for administrative review under WAC 388-96-901, shall file a written request for an administrative review conference with the office of rates management within twenty-eight calendar days after receiving notice of the department's action or determination.

(b) When the department has sent written notice by United States mail, it shall deem the contractor to have received the department's notice five calendar days after the date of the notification letter, unless proof of the date of receipt of the department's notification letter exists, in which case the actual date of receipt shall be used to determine timeliness of the contractor's request for an administrative review conference. When the department has electronically mailed (email) written notice, the date of the department's notification email will be the date of receipt by the contractor irrespective of when the contractor reads the email.

(i) Be signed by the contractor or by a partner, officer, or authorized employee of the contractor;

(ii) State the particular issues raised; and

(iii) Include all necessary supporting documentation or other information.

(2) After receiving a request for administrative review conference that meets the criteria in subsection (1) of this section, the department shall schedule an administrative review conference. The conference may be conducted by telephone.

(3) At least fourteen calendar days prior to the scheduled date of the administrative review conference, the contractor must supply any additional or supporting documentation or information upon which the contractor intends to rely in presenting its case. In addition, the department may request at any time prior to issuing a determination any documentation or information needed to decide the issues raised, and the contractor must comply with such a request within fourteen calendar days after it is received. The department may extend this period up to fourteen additional calendar days for good cause shown if the contractor requests an extension in writing received by the department before expiration of the initial fourteen-day period. The department shall dismiss issues that cannot be decided or resolved due to a contractor's failure to provide requested documentation or information within the required period.

(4) The department shall, within sixty calendar days after conclusion of the conference, render a determination in writing addressing the issues raised. If the department is waiting for additional documentation or information promised by or requested from the contractor pursuant to subsection (3) of this section, the sixty-day period shall not commence until the department's receipt of such documentation or information or until expiration of the time allowed to provide it. The determination letter shall include a notice of dismissal of all issues which cannot be decided due to a contractor's failure to provide documentation or information promised or requested.

(5)(a) A contractor seeking further review of a determination issued pursuant to subsection (4) of this section shall within twenty-eight calendar days after receiving the department's administrative review conference (ARC) determination letter file a written application for an adjudicative proceeding signed by one of the individuals authorized by subsection (1) of this section with the department's board of appeals.

(b) When the department has sent the ARC determination letter by United States mail, the department shall deem the contractor to have received the department's determination five calendar days after the date of the administrative review determination letter, unless proof of the date of receipt of the letter exists, in which case the actual date of receipt shall be used to determine timeliness of the contractor's application for an adjudicative proceeding. When the department has electronically mailed (email) the ARC determination letter, the date of the department's email containing the ARC determination letter or to which the ARC determination letter is attached will be the date of receipt by the contractor irrespective of when the contractor reads the email.

(c) The contractor shall attach to its application for an adjudicative proceeding the department's administrative review conference determination letter. When the department delivered the ARC determination letter by email either in the body of the email or as an attachment to the email, the contractor must include a copy of the email with the contractor's application for an adjudicative proceeding. A contractor's application for an adjudicative proceeding shall be addressed to the department's board of appeals. The board of appeals date stamp on the application for an administrative proceeding shall be used to determine whether the application is timely. When the application for adjudicative proceeding is filed by fax, the date stamped on the application received by fax will only be used to determine timeliness when the application is postmarked the same date as the faxed application.

(6) A review judge or other presiding officer employed by the department's board of appeals shall conduct the adjudicative proceeding. Except as authorized by subsection (7) of this section, the scope of an adjudicative proceeding shall be limited to the issues specifically raised by the contractor at the administrative review conference and addressed on the merits in the department's administrative review conference determination letter. The contractor shall be deemed to have waived all issues or claims that could have been raised by the contractor relating to the challenged determination or action, but which were not pursued at the conference and not addressed in the department's administrative review conference determination letter. In its request for an adjudicative proceeding or as soon as practicable, the contractor must specify its issues.

(7) If the contractor wishes to have further review of any issue not addressed on its merits, but instead dismissed in the department's administrative review conference determination letter, for failure to supply needed, promised, or requested additional information or documentation, or because the department has concluded the request was untimely or otherwise procedurally defective, the issue shall be considered by the presiding officer for the purpose of upholding the department's dismissal, reinstating the issue and remanding for further agency staff action, or reinstating the issue and rendering a decision on the merits.

(8) An adjudicative proceeding shall be conducted in accordance with this chapter, chapter 388-02 WAC and chapter 34.05 RCW. In the event of a conflict between hearing requirements in chapter 74.46 RCW and chapter 388-96 WAC specific to the nursing facility medicaid payment system and general hearing requirements in chapter 34.05 RCW and chapter 388-02 WAC, the specific requirements of chapter 74.46 RCW and chapter 388-96 WAC shall prevail. The presiding officer assigned by the department's board of appeals to conduct an adjudicative proceeding and who conducts the proceeding shall render the final agency decision.

(9) At the time an adjudicative proceeding is being scheduled for a future time and date certain, or at any appropriate stage of the prehearing process, the presiding officer shall have authority, upon the motion of either party or the presiding officer's own motion, to compel either party to identify specific issues remaining to be litigated.

(10) If the presiding officer determines there is no material issue(s) of fact to be resolved in a case, the presiding officer shall have authority, upon the motion of either party or the presiding officer's own motion, to decide the issue(s) presented without convening or conducting an in-person evidentiary hearing. In such a case, the decision may be reached on documentation admitted to the record, party admissions, written or oral stipulation(s) of facts, and written or oral argument.

(11) The board of appeals shall issue an order dismissing an adjudicative proceeding requested under subsection (5) of this section, unless within two hundred seventy calendar days after the board of appeals receives the application for an adjudicative proceeding:

(a) All issues have been resolved by a written settlement agreement between the contractor and the department signed by both and filed with the board of appeals; or

(b) An adjudicative proceeding has been held for all issues not resolved and the evidentiary record, including all rebuttal evidence and post-hearing or other briefing, is closed.

This time limit may be extended one time thirty additional calendar days for good cause shown upon the motion of either party made prior to the expiration of the initial two hundred seventy day period. It shall be the responsibility of the contractor to request that hearings be scheduled and ensure that settlement agreements are signed and filed with the board of appeals in order to comply with the time limit set forth in this subsection.

(12) Any party dissatisfied with a decision or an order of dismissal of the board of appeals may file a petition for reconsideration within ten calendar days after the decision or order of dismissal is served on such party. The petition shall state the specific grounds upon which relief is sought. The time for seeking reconsideration may be extended by the presiding officer for good cause upon motion of either party. The presiding officer shall rule on a petition for reconsideration and may seek additional argument, briefing, testimony, or other evidence if deemed necessary. Filing a petition for reconsideration shall not be a requisite for seeking judicial review; however, if a petition is filed by either party, the agency decision shall not be deemed final until a ruling is made by the presiding officer.

(13) A contractor dissatisfied with a decision or an order of dismissal of the board of appeals may file a petition for judicial review pursuant to RCW 34.05.570(3) or other applicable authority.

History

Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-904, filed 2/14/11, effective 2/26/11. Statutory Authority: RCW 74.46.431 (11) and (12), 74.46.800, chapter 74.46 RCW, 2004 c 276 § 913, 2001 1st sp.s. c 8. WSR 04-21-027, § 388-96-904, filed 10/13/04, effective 11/13/04. Statutory Authority: RCW 74.46.780 as amended by 1998 c 322 § 41. WSR 98-20-023, § 388-96-904, filed 9/25/98, effective 10/1/98. Statutory Authority: RCW 74.46.800. WSR 96-15-056, § 388-96-904, filed 7/16/96, effective 8/16/96. Statutory Authority: RCW 74.46.800 and 1995 1st sp.s. c 18. WSR 95-19-037 (Order 3896), § 388-96-904, filed 9/12/95, effective 10/13/95. Statutory Authority: RCW 74.46.800. WSR 94-12-043 (Order 3737), § 388-96-904, filed 5/26/94, effective 6/26/94. Statutory Authority: RCW 74.46.800 and 74.09.120. WSR 91-12-026 (Order 3185), § 388-96-904, filed 5/31/91, effective 7/1/91. Statutory Authority: RCW 34.05.220 (1)(a) and 74.09.120. WSR 90-04-071 (Order 3003), § 388-96-904, filed 2/5/90, effective 3/1/90. Statutory Authority: RCW 74.09.180 and 74.46.800. WSR 89-01-095 (Order 2742), § 388-96-904, filed 12/21/88. Statutory Authority: 1987 c 476. WSR 88-01-126 (Order 2573), § 388-96-904, filed 12/23/87. Statutory Authority: RCW 34.04.020. WSR 84-05-040 (Order 2076), § 388-96-904, filed 2/17/84. Statutory Authority: RCW 74.09.120. WSR 82-21-025 (Order 1892), § 388-96-904, filed 10/13/82
Order 1262, § 388-96-904, filed 12/30/77.

Wash. Admin. Code § 388-96-905 Case mix accuracy review of MDS nursing facility resident assessments.

(1) The department shall perform periodic nursing facility on-site accuracy reviews of minimum data set (MDS) assessments of nursing facility residents, for the purpose of verifying the accuracy of facility case mix data used to establish and update medicaid payment rates, and for other purposes the department may deem appropriate.

(2) Contractors, their representatives, and authorized nursing facility personnel may ask questions and raise concerns with the quality assurance nurse (QAN) or other designated department representative at the time a case mix accuracy review is conducted. Contractors, their representatives and authorized nursing facility personnel should attempt to resolve any differences and provide additional documentation, information or clarification prior to the case mix accuracy review exit conference.

(3) Upon completing a case mix accuracy review, the QAN shall hold an exit conference to inform the facility of the QAN's observations and preliminary findings. MDS inaccuracies, if any, will be identified and the findings that substantiate these inaccuracies shall be described.

(4) Within five working days after the case mix accuracy review exit conference is held, the nursing facility district manager (DM) for the facility's district shall send the case mix accuracy review decision letter to the nursing facility administrator at the facility address. The case mix accuracy review decision letter shall be sent certified mail, return receipt requested, shall describe in detail the QAN's findings, and shall identify the:

(a) Resident assessments that were reviewed;

(b) RUG-III or other applicable case mix grouping that was determined for the resident assessments reviewed;

(d) Right of the contractor to appeal any disagreement with the case mix accuracy review decision to the department's case mix accuracy review administrator or his or her delegate:

(i) Where to send an appeal request; and

(ii) The time limit for requesting an appeal.

(5) If the contractor intends to appeal the DM's case mix accuracy review decision letter, the appeal request must be in writing and mailed to the department's case mix accuracy administrator within ten calendar days after receipt of the case mix accuracy review decision letter. The appeal request letter shall:

(a) Be signed by the contractor or by a partner, officer, or authorized employee of the contractor;

(b) State the particular issue(s) raised, including any explanation or basis for disagreeing with the department's findings or actions.

(6) Prior to the informal administrative hearing, the case mix accuracy review administrator shall have no involvement in the case mix accuracy review decision.

(7) Upon receiving a timely appeal request, the administrator shall review any documentation and information submitted with the request, and contact the contractor by telephone to schedule an informal administrative hearing. The purpose of this informal hearing is to give the contractor one opportunity to present information which might warrant modification or deletion of resident-specific accuracy findings resulting from the case mix accuracy review. The scope of the informal administrative hearing shall be limited to clinical issues of resident need and assessment. Nonclinical issues beyond the scope of appeal include, but are not limited to:

(a) Any remedies or negative actions imposed by the department to rectify practices or inaccuracies;

(b) Alleged inconsistencies in the accuracy review process;

(d) Payment rate issues or other adverse actions subject to review under WAC 388-96-904.

(8) On or before the informal hearing date, the contractor must submit all necessary supporting documentation or other information to the case mix accuracy review administrator. The administrator may request additional information or documentation from the contractor at any time before issuing the final, informal hearing decision. The contractor shall provide all information or documentation within the time limits established by this section, or by the administrator. In the event that the contractor fails to submit the required documentation for a claim or issue within the specified time limits, the accuracy review administrator shall dismiss the claim or issue with prejudice.

(9) The informal case mix accuracy review administrative hearing shall be conducted in person, unless both the contractor and the department agree that it can be conducted by telephone.

(10) Within ten days after the informal administrative hearing or within ten days after receipt of any additional information or documentation requested, whichever is later, the case mix accuracy review administrator shall send the appeal decision in writing to the nursing facility administrator at the facility address. The appeal decision letter shall be sent regular mail and shall:

(a) Be the final agency decision of the department;

(b) Be based on the independent judgment of the case mix accuracy review administrator who conducted the informal administrative hearing and reviewed all information and documentation; and

(c) Recite the right of the contractor to seek judicial review under the state's Administrative Procedure Act (chapter 34.05 RCW).

(11) A contractor dissatisfied with the final agency decision issued by the case mix accuracy review administrator may file a petition for judicial review pursuant to RCW 34.05.570(3) or other applicable authority.

History

Statutory Authority: RCW 74.46.780 as amended by 1998 c 322 § 41 and RCW 74.46.800. WSR 98-20-023, § 388-96-905, filed 9/25/98, effective 10/1/98.

Wash. Admin. Code § 388-96-906 Section captions.

Section captions as used in this chapter do not constitute any part of the rule.

History

Statutory Authority: Chapter 74.46 RCW, 2010 1st sp.s. c 34, and 2010 1st sp.s. c 37 § 958. WSR 11-05-068, § 388-96-906, filed 2/14/11, effective 2/26/11.

Wash. Admin. Code § 388-96-910 Safety net assessment.

(1) Chapter 7, Laws of 2011 1st sp. sess. (the act) imposes a safety net assessment (SNA) on nonexempt nursing facilities in Washington. Each year, under section 16 of the act, the department of social and health services (the department) may adjust the amount(s) of the SNA to be paid for the next state fiscal year (SFY), beginning July 1. If necessary, the department may further adjust the amount(s) of the SNA at other times during the SFY. Although subject to change as necessary and as permitted under the act, the expectation is that each year the SNA will be imposed at two different levels: a higher level for most nonexempt facilities, and a significantly lower level for facilities that have either a high medicaid census on the prior year's cost report or a high number of licensed beds. For SFY 2012, those thresholds were thirty-two thousand medicaid resident days, and two hundred and three licensed beds. Those thresholds may change, as necessary and permitted under the act. Beginning July 1, 2012 the department will submit any adjustments to the SNA amount(s), along with the data supporting the adjustments, to the Washington health care association and the aging services of Washington for review and comment at least sixty calendar days prior to implementation of the adjusted assessment amounts. These submissions may be made electronically. If necessary to comply with the sixty-day notice requirement and still make the adjustment effective as of July 1, or another effective date, these notices may be made on a provisional, or potential, basis or bases.

(2) The status of each nursing facility under the act will be determined based on the facility's characteristics as of July 1 of each SFY, but using the information on resident days from the prior calendar year's cost report. For example, a facility's status for the SNA for SFY 2014 (beginning July 1, 2013) would be based on the resident day information from the 2012 cost report. The status of facilities will not be altered thereafter during the SFY. Facilities that become licensed throughout the SFY will be subject to the SNA as of the date of their licensing. The office of rates management (ORM) of the aging and disability services administration (ADSA) of the department will inform each nursing facility of its status under the act. A facility wishing to contest its status under the act as determined by ORM may seek review of the determination under WAC 388-96-904.

(3) An add-on to each nonexempt facility's medicaid daily rate will be paid to reimburse the facility for the SNA it owes in relation to residents whose care is funded by medicaid.

(4) The SNA is assessed and payable on a monthly basis. The SNA must be reported on a form supplied by ORM. The SNA owed for each month, and the reporting form for that month, must be mailed to the department and postmarked no later than the twentieth day of the following month. Payments of the SNA are subject to an interest penalty of one percent per month for any payment which is delinquent for any portion of a month. This interest penalty is in addition to any civil fine or other enforcement action that the department may seek as authorized by section 20 of the act. In addition to the remedies specifically listed in section 20 of the act, the department may also offset such delinquent SNA payments and related penalties and/or fines against the facility's medical assistance reimbursement payments.

(5) The department has applied for, and received a waiver related to the SNA from the federal centers for medicare and medicaid services (CMS). After issuance, such a waiver is subject to ongoing review for continued compliance. In the ongoing review process, it may be necessary for the department to modify the levels of the SNA, the standard(s) for designating facilities that pay the SNA at each level, and/or the categories of fully exempt facilities described in Sec. 17 of the act. In that case, each facility may: be obligated to pay the SNA or pay a different amount of the SNA; be reimbursed for SNA amounts previously paid; or be obligated to repay any SNA add-on it has received, all retroactive to the effective date of the modification contained in the waiver as approved by CMS.

History

Statutory Authority: 2011 1st sp.s. c 7 and chapter 74.48 RCW. WSR 12-04-004, § 388-96-910, filed 1/23/12, effective 2/23/12.

Wash. Admin. Code § 388-96-915 Capital component—Square footage.

(1) Allowable nursing home square footage is the external dimensions of the building utilized and licensed as a nursing home less all unallowable square footage as outlined in subsection (2) of this section. Allowable nursing home square footage includes the following:

(a) All necessary, ordinary, and reasonable space on the campus or adjacent to the campus utilized by the residents and staff of the nursing home including in administrative and support capacities; and

(b) Basements to the extent they are utilized for administrative or support functions including the storage of equipment and records.

(2) Unallowable nursing home square footage includes, but is not limited to:

(a) Courtyards or other areas not surrounded by four walls and a contiguous roof;

(b) Patios and decks; and

(3) Off-site administrative square footage is allowable to the extent it is:

(a) Allocated on the cost report, if appropriate;

(b) Not otherwise unallowable under subsection (2) of this section; and

(4) Off-site administrative square footage is allowable up to ten percent of the combined total allowable square footage. Any square footage over ten percent of the combined total allowable square footage in unallowable.

(5) In order to be allowable, all space must be identified on a site plan, blueprint, or county assessment identifying the gross external square footage.

History

Statutory Authority: RCW 74.46.800, 74.46.561(1). WSR 17-22-037, § 388-96-915, filed 10/24/17, effective 11/24/17.

Wash. Admin. Code § 388-96-916 Capital component—Facility age.

(1) The average age of a facility is the actual facility age reduced for significant renovations.

(2) For the rate beginning July 1, 2016, the department must use renovations data back to 1994 as submitted on facility cost reports to determine an initial age.

(3) Beginning July 1, 2016:

(a) Facilities must all be re-aged to one year older on December 31st of each year.

(b) Facility ages must be reduced during review of the cost report if the value of the renovation completed in any calendar year exceeds two thousand dollars times the number of licensed beds. In order to calculate the new age, the cost of the renovation must be divided by the accumulated depreciation per bed in the year of the renovation to determine the equivalent number of new replacement beds. The new age for the facility is a weighted average with the replacement bed equivalents reflecting an age of zero and the existing licensed beds, minus the new bed equivalents, reflecting their age in the year of the renovation.

(4) At no time may the depreciated age be less than zero or greater than forty-four years.

History

Statutory Authority: RCW 74.46.800, 74.46.561(1). WSR 17-22-037, § 388-96-916, filed 10/24/17, effective 11/24/17.

Wash. Admin. Code § 388-96-917 Direct care—County wage information.

(1) The department must calculate a county wide wage index each rebase year by utilizing the most recent average wage data available from the federal bureau of labor statistics for registered nurses, licensed practical nurses, and certified nursing assistants.

(2) For each county, the department must calculate an average combined wage for all three disciplines based on the percentage of total wages by discipline from the prior year cost report. Each wage must be multiplied by the relative utilization percentage for that discipline. The total of all three disciplines is the average wage in that county.

(3) The department must calculate the statewide average combined wage for all three disciplines based on the average percentage of total wages by discipline from the prior year cost report.

(4) The county index is determined by dividing the county average wage in a given county by the statewide average wage.

History

Statutory Authority: RCW 74.46.800, 74.46.561(1). WSR 17-22-037, § 388-96-917, filed 10/24/17, effective 11/24/17.

Wash. Admin. Code § 388-96-918 Wage equity funding.

(1) The contractor must submit a report of wage equity funding costs in a standardized manner and in accordance with this chapter and chapter 74.46 RCW on the dates specified in this section.

(2) The department will review the contractor's costs of the wage equity funding in accordance with the methodology effective at the time the services were rendered as described in this chapter and session laws of Washington state 2022 c 297 § 204(53).

(3) No later than September 1, 2023, each contractor must submit to the department a wage equity worksheet for the period of July 1, 2022, through June 30, 2023.

(4) Wage equity worksheets for new contractors must be submitted for the period covering their date of contract through June 30, 2023.

(5) A terminating or assigning contractor must submit to the department a wage equity worksheet for the period from July 1, 2022, through the date the contract was terminated or assigned.

(6) To properly complete the wage equity worksheet, the contractor must submit the wage equity worksheet, including the completed certification page to the document electronically.

(7) If the contractor does not properly complete the wage equity worksheet or the department does not receive it by the due date established in this section, the department may recoup any wage equity funding received by the contractor.

(8) The department may impose civil fines or take adverse rate action against contractors and former contractors who do not submit properly completed wage equity worksheets by the applicable due date established in this section.

(9) The department will review the wage equity worksheet to ensure the contractor has used its wage equity funding to increase wages for low-wage workers by up to four dollars per hour.

(10) The department will recover any funding difference between each contractor's wage equity funding and the amount of wage equity funding that the provider utilizes to increase low-wage worker wages.

(11) The department will separate the settlement amount into the funds attributable to direct care employees and funds attributable to indirect care employees. The direct care portion will be divided into two. One half may be used to offset any direct care final settlement monies owed for the 2022 cost report year. One half may be used to offset any direct care preliminary settlement monies owed for the 2023 cost report year. For partial worksheets due to new contractors, or terminating or assigning contractors, the direct care portion may be offset against the applicable cost report's direct care settlement to the appropriate proportionality.

(12) The verification process must use wages paid as of December 31, 2021, as the base wage to compare contractors' wage spending in the designated job categories to the facility-specific amounts of wage equity funding provided, excluding any amounts adjusted by settlement. If a facility did not have a particular category of staff on December 31, 2021, to set a baseline wage, wages from comparable facilities may be used.

(13) The verification and recovery process in this section is a distinct and separate process from the settlement process described in RCW 74.46.022 and elsewhere described in this chapter.

(14) The provisions of 388-96-901 and 388-96-904 apply to this section.

History

Statutory Authority: RCW 74.46.800 and 2022 c 207 § 204(53). WSR 23-20-013, § 388-96-918, filed 9/22/23, effective 10/23/23.

Chapter 388-97 Nursing homes.

Wash. Admin. Code § 388-97-0001 Definitions.

"Abandonment" means action or inaction by an individual or entity with a duty of care for a vulnerable adult that leaves the vulnerable individual without the means or ability to obtain necessary food, clothing, shelter, or health care.

"Abuse" means the willful action or inaction that inflicts injury, unreasonable confinement, intimidation, or punishment of a vulnerable adult. In instances of abuse of a vulnerable adult who is unable to express or demonstrate physical harm, pain, or mental anguish, the abuse is presumed to cause physical harm, pain, or mental anguish. Abuse includes sexual abuse, mental abuse, physical abuse, personal exploitation of a vulnerable adult, and improper use of restraint against a vulnerable adult which have the following meanings:

(1) "Mental abuse" means a willful verbal or nonverbal action that threatens, humiliates, harasses, coerces, intimidates, isolates, unreasonably confines, or punishes a vulnerable adult. Mental abuse may include ridiculing, yelling, or swearing.

(3) "Sexual abuse" means any form of nonconsensual sexual conduct, including, but not limited to, unwanted or inappropriate touching, rape, sodomy, sexual coercion, sexually explicit photographing, and sexual harassment. Sexual conduct may include interactions that do not involve touching, including but not limited to, sending a resident sexually explicit messages, or cuing or encouraging a resident to perform sexual acts. Sexual abuse includes any sexual conduct between a staff person and a resident, whether or not it is consensual.

(5) "Improper use of restraint" means the inappropriate use of chemical, physical, or mechanical restraints for convenience or discipline or in a manner that:

(a) Is inconsistent with federal or state licensing or certification requirements for facilities, hospitals, or programs authorized under chapter 71A.12 RCW;

(b) Is not medically authorized; or

"Administrative hearing" is a formal hearing proceeding before a state administrative law judge that gives:

(1) A licensee an opportunity to be heard in disputes about licensing actions, including the imposition of remedies, taken by the department; or

(2) An individual an opportunity to appeal a finding of abandonment, abuse, neglect, financial exploitation of a resident, or misappropriation of a resident's funds.

"Administrative law judge (ALJ)" means an impartial decision-maker who presides over an administrative hearing. ALJs are employed by the office of administrative hearings (OAH), which is a separate state agency. ALJs are not DSHS employees or DSHS representatives.

"Administrator" means a nursing home administrator, licensed under chapter 18.52 RCW, who must be in active administrative charge of the nursing home, as that term is defined in the board of nursing home administrator's regulations.

"Advanced registered nurse practitioner (ARNP)" means an individual who is licensed to practice as an advanced registered nurse practitioner under chapter 18.79 RCW.

"Applicant" means an individual, partnership, corporation, or other legal entity seeking a license to operate a nursing home.

"ASHRAE" means the American Society of Heating, Refrigerating, and Air Conditioning Engineers, Inc.

"Attending physician" means the doctor responsible for a particular individual's total medical care.

"Berm" means a bank of earth piled against a wall.

"Chemical restraint" means the administration of any drug to manage a vulnerable adult's behavior in a way that reduces the safety risk to the vulnerable adult or others, has the temporary effect of restricting the vulnerable adult's freedom of movement, and is not standard treatment for the vulnerable adult's medical or psychiatric condition.

"Civil adjudication proceeding" means judicial or administrative adjudicative proceeding that results in a finding of, or upholds an agency finding of, domestic violence, abuse, sexual abuse, neglect, abandonment, violation of a professional licensing standard regarding a child or vulnerable adult, or exploitation, or financial exploitation of a child or vulnerable adult under any provision of law, including, but not limited to, chapter 13.34, 26.44, or 74.34 RCW, or rules adopted under chapters 18.51 and 74.42 RCW. "Civil adjudication proceeding" also includes judicial or administrative findings that become final due to the failure of the alleged perpetrator to timely exercise a legal right to administratively challenge such findings.

"Civil fine" means a civil monetary penalty assessed against a nursing home as authorized by chapters 18.51 and 74.42 RCW. There are two types of civil fines, "per day" and "per instance."

(1) "Per day fine" means a fine imposed for each day that a nursing home is out of compliance with a specific requirement. Per day fines are assessed in accordance with WAC 388-97-4580(1); and

(2) "Per instance fine" means a fine imposed for the occurrence of a deficiency.

"Condition on a license" means that the department has imposed certain requirements on a license and the licensee cannot operate the nursing home unless the requirements are observed.

"Commuting distance radius" means the one-way travel time between any two points traveling on the generally fastest route without any impediments such as traffic, road work, or road closure.

"Deficiency" means a nursing home's failed practice, action, or inaction that violates any or all of the following:

(1) Requirements of chapters 18.51 or 74.42 RCW, or the requirements of this chapter; and

(2) In the case of a medicare and medicaid contractor, participation requirements under Title XVIII and XIX of the Social Security Act and federal medicare and medicaid regulations.

"Deficiency citation" or "cited deficiency" means written documentation by the department that describes a nursing home's deficiency(ies); the requirement that the deficiency(ies) violates; and the reasons for the determination of noncompliance.

"Deficient facility practice" or "failed facility practice" means the nursing home action(s), error(s), or lack of action(s) that provide the basis for the deficiency.

"Dementia care" means a therapeutic modality or modalities designed specifically for the care of persons with dementia.

"Denial of payment for new admissions" means an action imposed on a nursing home (facility) by the department that prohibits payment for new medicaid admissions to the nursing home after a specified date. Nursing homes certified to provide medicare and medicaid services may also be subjected to a denial of payment for new admissions by the federal Centers for Medicare and Medicaid Services.

"Department" means the state department of social and health services (DSHS).

"Department on-site monitoring" means an optional remedy of on-site visits to a nursing home by department staff according to department guidelines for the purpose of monitoring resident care or services or both.

"Dietitian" means a qualified dietitian. A qualified dietitian is one who is registered by the American Dietetic Association or certified by the state of Washington.

"Direct care staff" means the staffing domain identified and defined in the Centers for Medicare and Medicaid Service's five-star quality rating system and as reported through the Centers for Medicare and Medicaid Service's payroll-based journal.

"Directly supervising" means that the individual responsible for providing oversight to staff is on the premises and quickly and easily available to provide necessary assessments and other direct care of residents.

"Disclosure statement" means a signed statement by an individual in accordance with the requirements under RCW 43.43.834. The statement should include a disclosure of whether or not the individual has been convicted of certain crimes or has been found by any court, state licensing board, disciplinary board, or protection proceeding to have neglected, sexually abused, financially exploited, or physically abused any minor or adult individual.

"Drug" means a substance:

(1) Recognized as a drug in the official United States Pharmacopoeia, Official Homeopathic Pharmacopoeia of the United States, Official National Formulary, or any supplement to any of them; or

(2) Intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease.

"Drug facility" means a room or area designed and equipped for drug storage and the preparation of drugs for administration.

"Emergency closure" means an order by the department to immediately close a nursing home.

"Emergency transfer" means immediate transfer of residents from a nursing home to safe settings.

"Entity" means any type of firm, partnership, corporation, company, association, or joint stock association.

"Essential community provider" means a nursing home, which is the only nursing home within a commuting distance radius of at least 40 minutes duration, traveling by automobile.

"Essential support person" means an individual who is: at least 18 years of age; designated by the resident, or by the resident's representative, if the resident is determined to be incapacitated or otherwise legally incapacitated; and necessary for the resident's emotional, mental, or physical well-being during situations that include, but are not limited to, circumstances involving compassionate care of end-of-life care, circumstances where visitation from a familiar person will assist with important continuity of care or the reduction of confusion and anxiety for residents with cognitive impairments, or other circumstances where the presence of an essential support person will prevent or reduce significant emotional distress to the resident.

"Financial exploitation" means the illegal or improper use, control over, or withholding of the property, income, resources, or trust funds of the vulnerable adult by any person or entity for any person or entity's profit or advantage other than the vulnerable adult's profit or advantage. Some examples of financial exploitation are given in RCW 74.34.020(7).

"Geriatric behavioral health worker" means a person with a bachelor's or master's degree in social work, who has received specialized training devoted to mental illness and treatment of older adults.

"Habilitative services" means the planned interventions and procedures which constitute a continuing and comprehensive effort to teach an individual previously undeveloped skills.

"Highest practicable physical, mental, and psychosocial well-being" means providing each resident with the necessary individualized care and services to assist the resident to achieve or maintain the highest possible health, functional, and independence level in accordance with the resident's comprehensive assessment and plan of care. Care and services provided by the nursing home must be consistent with all requirements in this chapter, chapters 74.42 and 18.51 RCW, and the resident's informed choices. For medicaid and medicare residents, care and services must also be consistent with Title XVIII and XIX of the Social Security Act and federal medicare and medicaid regulations.

"Informal department review" means a dispute resolution process that provides an opportunity for the licensee or administrator to informally present information to a department representative about disputed, cited deficiencies. Refer to WAC 388-97-4420.

"Inspection" or "survey" means the process by which department staff evaluates the nursing home licensee's compliance with applicable statutes and regulations.

"Intermediate care facility for individuals with intellectual disabilities (ICF/IID)" means an institution certified under chapter 42 C.F.R., Part 483, Subpart I, and licensed under chapter 18.51 RCW.

"Large nonessential community providers" means nonessential community providers that have more than 60 licensed nursing home beds, even if some of those beds are not set up or are not in use.

"License revocation" means an action taken by the department to cancel a nursing home license in accordance with RCW 18.51.060 and WAC 388-97-4220.

"License suspension" means an action taken by the department to temporarily revoke a nursing home license in accordance with RCW 18.51.060 and this chapter.

"Licensee" means an individual, partnership, corporation, or other legal entity licensed to operate a nursing home.

"Licensed practical nurse" means an individual licensed to practice practical nursing under chapter 18.79 RCW.

"Mandated reporter" as used in this chapter means any employee of a nursing home, any health care provider subject to chapter 18.130 RCW, the Uniform Disciplinary Act, and any licensee or operator of a nursing home. Under RCW 74.34.020, mandated reporters also include any employee of the department of social and health services, law enforcement officers, social workers, professional school personnel, individual providers, employees and licensees of assisted living facilities, adult family homes, soldiers' homes, residential habilitation centers, or any other facility licensed by the department, employees of social service, welfare, mental health, adult day health, adult day care, home health, home care, or hospice agencies, county coroners or medical examiners, or Christian Science practitioners.

"Mechanical restraint" means any device attached or adjacent to the vulnerable adult's body that they cannot easily remove that restricts freedom of movement or normal access to their body. "Mechanical restraint" does not include the use of devices, materials, or equipment that are:

(1) Medically authorized, as required; and

(2) Used in a manner that is consistent with federal or state licensing or certification requirements for facilities.

"Misappropriation of resident property" means the deliberate misplacement, exploitation, or wrongful, temporary or permanent use of a resident's belongings or money.

"NFPA" means National Fire Protection Association, Inc.

"Neglect":

(1) In a nursing home licensed under chapter 18.51 RCW, neglect means:

(a) A pattern of conduct or inaction by a person or entity with a duty of care that fails to provide the goods and services that maintain physical or mental health of a vulnerable adult, or that fails to avoid or prevent physical or mental harm or pain to a vulnerable adult; or

(b) An act or omission by a person or entity with a duty of care that demonstrates a serious disregard of consequences of such a magnitude as to constitute a clear and present danger to the vulnerable adult's health, welfare, or safety, including but not limited to conduct prohibited under RCW 9A.42.100.

(2) In a skilled nursing facility or nursing facility, neglect also means a failure to provide a resident with the goods and services necessary to avoid physical harm, mental anguish, or mental illness.

"Noncompliance" means a state of being out of compliance with either state or federal requirements for nursing homes/facilities.

"Nonessential community provider" means a nursing home located within a commuting distance radius of less than 40 minutes duration by automobile from another nursing home.

"Nursing assistant" means a nursing assistant as defined under RCW 18.88A.020 or successor laws.

"Nursing facility (NF)" or "medicaid-certified nursing facility" means a nursing home, or any portion of a hospital, veterans' home, or residential habilitation center, that is certified to provide nursing services to medicaid recipients under section 1919(a) of the federal Social Security Act. All beds in a nursing facility are certified to provide medicaid services, even though one or more of the beds are also certified to provide medicare skilled nursing facility services.

"Nursing home" means any facility licensed to operate under chapter 18.51 RCW.

"Officer" means an individual serving as an officer of a corporation.

"Owner of five percent or more of the assets of a nursing home" means:

(1) The individual, and if applicable, the individual's spouse, who operates, or is applying to operate, the nursing home as a sole proprietorship;

(2) In the case of a corporation, the owner of at least five percent of the shares or capital stock of the corporation; or

(3) In the case of other types of business entities, the owner of a beneficial interest in at least five percent of the capital assets of an entity.

"Partner" means an individual in a partnership owning or operating a nursing home.

"Permanent restraining order" means a restraining order or order of protection issued either following a hearing, or by stipulation of the parties. A "permanent" order may be in force for a specific time period (for example, one year), after which it expires.

"Person" means any individual, firm, partnership, corporation, company, association, or joint stock association.

"Pharmacist" means an individual licensed by the Washington state board of pharmacy under chapter 18.64 RCW.

"Pharmacy" means a place licensed under chapter 18.64 RCW where the practice of pharmacy is conducted.

"Physical restraint" means the application of physical force without the use of any device for the purpose of restraining the free movement of a vulnerable adult's body. "Physical restraint" does not include briefly holding without undue force a vulnerable adult in order to calm or comfort them, or holding a vulnerable adult's hand to safely escort them from one area to another.

"Physician's assistant (PA)" means a physician's assistant as defined under chapter 18.71A RCW or successor laws.

"Plan of correction" means a nursing home's written response to cited deficiencies that explains how it will correct the deficiencies and how it will prevent their reoccurrence.

"Reasonable accommodation" and "reasonably accommodate" has the meaning given in federal and state antidiscrimination laws and regulations. For the purpose of this chapter:

(1) Reasonable accommodation means that the nursing home must:

(a) Not impose admission criteria that excludes individuals unless the criteria is necessary for the provision of nursing home services;

(b) Make reasonable modification to its policies, practices, or procedures if the modifications are necessary to accommodate the needs of the resident;

(2) Reasonable accommodations are not required if:

(a) The resident or individual applying for admission presents a significant risk to the health or safety of others that cannot be eliminated by the reasonable accommodation;

(b) The reasonable accommodations would fundamentally alter the nature of the services provided by the nursing home; or

"Receivership" is established by a court action and results in the removal of a nursing home's current licensee and the appointment of a substitute licensee to temporarily operate the nursing home.

"Recurring deficiency" means a deficiency that was cited by the department, corrected by the nursing home, and then cited again within 15 months of the initial deficiency citation.

"Registered nurse" means an individual licensed to practice as a registered nurse under chapter 18.79 RCW.

"Rehabilitative services" means the planned interventions and procedures which constitute a continuing and comprehensive effort to restore an individual to the individual's former functional and environmental status, or alternatively, to maintain or maximize remaining function.

"Resident" generally means an individual residing in a nursing home. Except as specified elsewhere in this chapter, for decision-making purposes, the term "resident" includes the resident's surrogate decision maker acting under state law. The term resident excludes outpatients and individuals receiving adult day or night care, or respite care.

"Resident care unit" means a functionally separate unit including resident rooms, toilets, bathing facilities, and basic service facilities.

"Resident representative" means:

(1) A court-appointed guardian or conservator of a resident, if any;

(2) An individual otherwise authorized by state or federal law to act on behalf of the resident to support the resident in decision making; access medical, social, or other personal information of the resident; manage financial matters; or receive notifications including, but not limited to:

(a) Agents under power of attorney;

(b) Representative payees; and

(3) If there is no individual who meets the criteria under sections (1) or (2) of this subsection, an individual chosen by the resident to act on behalf of the resident to support the resident in decision making; access medical, social, or other personal information of the resident; manage financial matters; or receive notifications.

(4) The term "resident representative" does not include any individual described in section (1) of this subsection who is affiliated with the nursing home where the resident resides, or its licensee or management company, unless the affiliated individual is a family member of the resident.

"Respiratory isolation" is a technique or techniques instituted to prevent the transmission of pathogenic organisms by means of droplets and droplet nuclei coughed, sneezed, or breathed into the environment.

"Siphon jet clinic service sink" means a plumbing fixture of adequate size and proper design for waste disposal with siphon jet or similar action sufficient to flush solid matter of at least two and one-eighth inches in diameter.

"Skilled nursing facility (SNF)" or "medicare-certified skilled nursing facility" means a nursing home, a portion of a nursing home, or a long-term care wing or unit of a hospital that has been certified to provide nursing services to medicare recipients under section 1819(a) of the federal Social Security Act.

"Small nonessential community providers" means nonessential community providers that have 60 or fewer nursing home licensed beds, even if some of those beds are not set up or are not in use.

"Social/therapeutic leave" means leave which is for the resident's social, emotional, or psychological well-being; it does not include medical leave.

"Staff work station" means a location at which nursing and other staff perform charting and related activities throughout the day.

"Stop placement" or "stop placement order" means an action taken by the department prohibiting nursing home admissions, readmissions, and transfers of patients into the nursing home from the outside.

"Substantial compliance" means the nursing home has no deficiencies higher than severity level 1 as described in WAC 388-97-4500, or for medicaid certified facility, no deficiencies higher than a scope and severity "C."

"Surrogate decision maker" means a resident representative or representatives as outlined in WAC 388-97-0240, and as authorized by RCW 7.70.065.

"Survey" means the same as "inspection" as defined in this section.

"Temporary manager" means an individual or entity appointed by the department to oversee the operation of the nursing home to ensure the health and safety of its residents, pending correction of deficiencies or closure of the facility.

"Temporary restraining order" means restraining order or order of protection that expired without a hearing, was dismissed following an initial hearing, or was dismissed by stipulation of the parties before an initial hearing.

"Termination" means an action taken by:

(1) The department, or the nursing home, to cancel a nursing home's medicaid certification and contract; or

(2) The department of health and human services Centers for Medicare and Medicaid Services, or the nursing home, to cancel a nursing home's provider agreement to provide services to medicaid or medicare recipients, or both.

"Toilet room" means a room containing at least one toilet fixture.

"Uncorrected deficiency" means a deficiency that has been cited by the department and that is not corrected by the licensee by the time the department does a revisit.

"Violation" means the same as "deficiency" as defined in this section.

"Volunteer" means an individual who is a regularly scheduled individual not receiving payment for services and having unsupervised access to a nursing home resident.

"Vulnerable adult" means a person:

(1) Sixty years of age or older who has the functional, mental, or physical inability to care for themselves;

(2) Found incapacitated under RCW 74.34.020;

(3) Who has a developmental disability as defined under RCW 71A.10.020;

(4) Admitted to any facility;

(5) Receiving services from home health, hospice, or home care agencies licensed or required to be licensed under chapter 70.127 RCW;

(6) Receiving services from an individual provider; or

(7) Who self directs their own care and receives services from a personal aide under chapter 74.39 RCW.

"Whistle blower" means a resident, employee of a nursing home, or any person licensed under Title 18 RCW, who in good faith reports alleged abandonment, abuse, financial exploitation, or neglect to the department, the department of health, or to a law enforcement agency.

History

Statutory Authority: RCW 18.20.090, 18.51.070, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 26-05-046, s 388-97-0001, filed 2/12/26, effective 3/15/26. Statutory Authority: RCW 18.20.090, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 25-16-099, s 388-97-0001, filed 8/6/25, effective 9/6/25. Statutory Authority: RCW 18.51.070. WSR 21-23-036, § 388-97-0001, filed 11/8/21, effective 12/9/21. Statutory Authority: Chapters 18.51, 74.42, 74.34, 74.46 RCW, 2015 2nd sp.s. c 2, 2015 c 268, and 2016 c 131. WSR 16-23-094, § 388-97-0001, filed 11/16/16, effective 12/17/16. Statutory Authority: RCW 74.39A.056 and chapters 74.42, 18.51 RCW. WSR 14-14-027, § 388-97-0001, filed 6/24/14, effective 7/25/14. Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 14-12-040, § 388-97-0001, filed 5/29/14, effective 6/29/14
WSR 13-04-093, § 388-97-0001, filed 2/6/13, effective 3/9/13
WSR 11-22-077, § 388-97-0001, filed 11/1/11, effective 12/2/11
WSR 10-02-021, § 388-97-0001, filed 12/29/09, effective 1/29/10. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0001, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-0020 Nursing facility care.

The nursing facility must provide items, care, and services in accordance with this chapter and with federal regulations under 42 C.F.R. § 483.1 through 483.206, or successor laws, and other applicable federal requirements.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0020, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-0040 Discrimination prohibited.

(1) A nursing facility must establish and maintain identical policies and practices regarding transfer, discharge, and the provision of services covered under the state medicaid plan for all individuals regardless of source of payment.

(2) A nursing facility must not require or request:

(a) Residents or potential residents to waive their rights to medicare or medicaid;

(b) Oral or written assurance that residents or potential residents are not eligible for, or will not apply for medicare or medicaid benefits; and

(c) A third party guarantee of payment to the facility as a condition of admission or expedited admission, or continued stay in the facility. However, the facility may require an individual who has legal access to a resident's income or resources available to pay for facility care to sign a contract, without incurring personal financial liability, to provide facility payment from the resident's income or resources.

(3) A nursing facility must inform, in writing, a prospective resident, and where applicable, the resident's representative, before or at the time of admission, that a third party may not be required or requested to personally guarantee payment to the nursing home, as specified in subsection (2)(c) of this section.

(4) A nursing facility must readmit a resident, who has been hospitalized or on therapeutic leave, immediately to the first available bed in a semiprivate room if the resident:

(a) Requires the services provided by the facility; and

(b) Is eligible for medicaid nursing facility services.

(5) A nursing facility must not:

(a) Deny or delay admission or readmission of an individual to the facility because of the individual's status as a medicaid recipient;

(b) Transfer a resident, except from a single room to another room within the facility, because of the resident's status as a medicaid recipient;

(d) Charge medicaid recipients any amounts in excess of the medicaid rate from the date of eligibility, except for any supplementation that may be permitted by department regulation.

(6) A nursing facility must maintain only one list of names of individuals seeking admission to the facility, which is ordered by the date of request for admission, and must:

(a) Offer admission to individuals in the order they appear on the list, except as provided in subsection (7), as long as the facility can meet the needs of the individual with available staff or through the provision of reasonable accommodations required by state or federal laws;

(b) Retain the list of individuals seeking admission for one year from the month admission was requested; and

(c) Offer admission to the portions of the facility certified under medicare and medicaid without discrimination against persons eligible for medicaid, except as provided in subsection (7).

(7) A nursing facility is permitted to give preferential admission to individuals who seek admission from an assisted living facility, licensed under chapter 18.20 RCW, or from independent retirement housing, if:

(a) The nursing facility is owned by the same entity that owns the assisted living facility or independent housing; and

(b) They are located within the same proximate geographic area; and

(c) The purpose of the preferential admission is to allow continued provision of culturally or faith-based services, or services provided by a continuing care retirement community as defined in RCW 74.38.025.

(8) A nursing facility must develop and implement written policies and procedures to ensure nondiscrimination in accordance with this section and RCW 74.42.055.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 13-04-093, § 388-97-0040, filed 2/6/13, effective 3/9/13. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0040, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-0060 Nursing facility admission and payment requirements.

Refer to WAC 388-106-0350 through 388-106-0360.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0060, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-0080 Discharge planning.

(1) A resident has the right to attain or maintain the highest practicable physical, mental, and psychosocial well-being, and to reside in the most independent setting. Therefore, the nursing home must:

(a) Utilize a formal resident discharge planning system with identical policies and practices for all residents regardless of source of payment;

(b) Inform the resident or resident's representative in writing of the nursing home's discharge planning system when the resident is admitted or as soon as practical after the resident's admission, including:

(i) Specific resources available to assist the resident in locating a lesser care setting;

(ii) The name of the nursing home's discharge coordinator(s);

(iii) In the case of a medicaid certified nursing facility, the address and telephone number for the department's local home and community services office; and

(iv) In the case of a resident identified through pre-admission screening and resident review (PASRR) as having a developmental disability or mental illness, the address and telephone number for the division of developmental disabilities or the mental health PASRR contractor.

(2) The nursing home must prepare a detailed, written transfer or discharge plan for each resident determined to have potential for transfer or discharge within the next three months. The nursing home must:

(a) Develop and implement the plan with the active participation of the resident and, where appropriate, the resident's representative;

(b) In the case of a medicaid resident, coordinate the plan with the department's home and community services staff;

(c) In the case of a resident identified through PASRR as having a developmental disability or mental illness, coordinate the plan with the division of developmental disabilities or the mental health PASRR contractor;

(d) Ensure the plan is an integral part of the resident's comprehensive plan of care and, as such, includes measurable objectives and timetables for completion;

(e) Incorporate in the plan relevant factors to include, but not be limited to the:

(i) Resident's preferences;

(ii) Support system;

(iii) Assessments and plan of care; and

(iv) Availability of appropriate resources to match the resident's preferences and needs.

(f) Identify in the plan specific options for more independent placement; and

(g) Provide in the plan for the resident's continuity of care, and to reduce potential transfer trauma, including, but not limited to, pretransfer visit to the new location whenever possible.

(3) For a resident whose transfer or discharge is not anticipated in the next three months, the nursing home must:

(a) Document the specific reasons transfer or discharge is not anticipated in that time frame; and

(b) Review the resident's potential for transfer or discharge at the time of the quarterly comprehensive plan of care review. If the reasons documented under subsection (3)(a) of this section are unchanged, no additional documentation of reasons is necessary at the time of plan of care review.

(4) The nursing home must initiate discharge planning on residents described in subsection (3) of this section:

(a) At the request of the resident or the resident's representative; and

(b) When there is a change in the resident's situation or status which indicates a potential for transfer or discharge within the next three months.

(5) Each resident has the right to request transfer or discharge and to choose a new location. If the resident chooses to leave, the nursing home must assist with and coordinate the resident's transfer or discharge. The medicaid resident, resident's representative, or nursing facility may request assistance from the department's home and community services or, where applicable, the division of developmental disabilities or mental health in the transfer or discharge planning and implementation process.

(6) The nursing home must coordinate all resident transfers and discharges with the resident, the resident's representative and any other involved individual or entity.

(7) When a nursing home anticipates discharge, a resident must have a discharge summary that includes:

(a) A recapitulation of the resident's stay;

(b) A final summary of the resident's status to include items in WAC 388-97-1000(1), at the time of discharge that is available for release to authorized individuals and agencies, with the consent of the resident or and surrogate decision maker; and

(c) A postdischarge plan of care that is developed with the participation of the resident and his or her family, which will assist the resident to adjust to his or her new living environment.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0080, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-0100 Utilization review.

(1) To assure appropriate use of medicaid services, the nursing facility must determine whether each medicaid resident's health has improved sufficiently so the resident no longer needs nursing facility care.

(a) The nursing facility must base its determination on:

(i) An accurate, comprehensive assessment process; and

(ii) Documentation by the resident's physician.

(b) The nursing facility is not responsible to assess under WAC 388-97-1960, PASSR level II screening assessment.

(2) When the nursing facility determines a resident no longer needs nursing facility care under subsection (1) of this section, the nursing facility must initiate transfer or discharge in accordance with WAC 388-97-0120, 388-97-0140, and 42 C.F.R. § 483.12, or successor laws, unless the resident voluntarily chooses to transfer or discharge.

(3) When a nursing facility initiates a transfer or discharge of a medicaid recipient under subsection (2) of this section:

(a) The resident will be ineligible for medicaid nursing facility payment:

(i) Thirty days after the receipt of written notice of transfer or discharge; or

(ii) If the resident appeals the facility determination, thirty days after the final order is entered upholding the nursing home's decision to transfer or discharge a resident.

(b) The department's home and community services may grant extension of a resident's medicaid nursing facility payment after the time specified in subsection (3)(a) of this section, when the department's home and community services staff determine:

(i) The nursing facility is making a good faith effort to relocate the resident; and

(ii) A location appropriate to the resident's medical and other needs is not available.

(4) Department designees may review any assessment or determination made by a nursing facility of a resident's need for nursing facility care.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 10-02-021, § 388-97-0100, filed 12/29/09, effective 1/29/10. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0100, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-0120 Individual transfer and discharge rights and procedures.

The department amended or repealed portions of this section to help facilitate care to align state nursing home rules with federal rules that were amended or suspended during the COVID-19 pandemic from April 13, 2020, through May 23, 2023, in response to the state of emergency. For requirements in place during that time, see WAC 388-97-01201.

(1) The skilled nursing facility and nursing facility must comply with all of the requirements of 42 C.F.R. § 483.10 and § 483.12, and RCW 74.42.450, or successor laws, and the nursing home must comply with all of the requirements of RCW 74.42.450 (1) through (4) and (7), or successor laws, including the following provisions and must not transfer or discharge any resident unless:

(a) At the resident's request;

(b) The transfer or discharge is necessary for the resident's welfare and the resident's needs cannot be met in the facility;

(c) The transfer or discharge is appropriate because the resident's health has improved enough so the resident no longer needs the services provided by the facility;

(d) The safety of individuals in the facility is endangered;

(e) The health of individuals in the facility would otherwise be endangered; or

(f) The resident has failed, after reasonable and appropriate notice, to pay for a stay at the facility.

(2) The following notice requirements apply if a nursing home/facility initiates the transfer or discharge of a resident. The notice must:

(a) Include all information required by 42 C.F.R. § 483.12 when given in a nursing facility;

(b) Be in writing, in language the resident understands;

(c) Be given to the resident, the resident's surrogate decision maker, if any, the resident's family, and to the department;

(d) Be provided 30 days in advance of a transfer or discharge initiated by the nursing facility, except that the notice may be given as soon as practicable when the facility cannot meet the resident's urgent medical needs, or under the conditions described in (1)(c), (d), and (e) of this section; and

(e) Be provided 15 days in advance of a transfer or discharge initiated by the nursing home, unless the transfer is an emergency.

(3) The nursing home must:

(a) Provide sufficient preparation and orientation to the resident to ensure safe and orderly transfer or discharge from the nursing home;

(b) Attempt to avoid the transfer or discharge of a resident from the nursing home through the use of reasonable accommodations unless agreed to by the resident and the requirements of WAC 388-97-0080 are met; and

(c) Develop and implement a bed-hold policy. This policy must be consistent with any bed-hold policy that the department develops.

(4) The nursing home must provide the bed-hold policy, in written format, to the resident, and a family member, before the resident is transferred or goes on therapeutic leave. At a minimum the policy must state:

(a) The number of days, if any, the nursing home will hold a resident's bed pending return from hospitalization or social/therapeutic leave;

(b) That a medicaid eligible resident, whose hospitalization or social/therapeutic leave exceeds the maximum number of bed-hold days will be readmitted to the first available semi-private bed, provided the resident needs nursing facility services. Social/therapeutic leave is defined under WAC 388-97-0001. The number of days of social/therapeutic leave allowed for medicaid residents and the authorization process is found under WAC 388-97-0160; and

(c) That a medicaid eligible resident may be charged if they request that a specific bed be held, but may not be charged a bed-hold fee for the right to return to the first available bed in a semi-private room.

(5) The nursing facility must send a copy of the federally required transfer or discharge notice to:

(a) The department's home and community services when the nursing home has determined under WAC 388-97-0100, that the medicaid resident's health has improved sufficiently so that the resident no longer needs the services provided by the facility; and

(b) The department's designated local office when the transfer or discharge is for any of the following reasons:

(i) The resident's needs cannot be met in the facility;

(ii) The health or safety of individuals in the facility is endangered; or

(iii) The resident has failed to pay for, or to have paid under medicare or medicaid, a stay at the facility.

History

Statutory Authority: RCW 74.42.620. WSR 26-08-015, s 388-97-0120, filed 3/20/26, effective 4/20/26. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0120, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-01201 Individual transfer and discharge rights and procedures—Requirements in effect April 13, 2020, through May 23, 2023, in response to the state of emergency related to the COVID-19 pandemic.

(a) At the resident's request;

(b) The transfer or discharge is necessary for the resident's welfare and the resident's needs cannot be met in the facility;

(c) The transfer or discharge is appropriate because the resident's health has improved enough so the resident no longer needs the services provided by the facility;

(d) The safety of individuals in the facility is endangered;

(e) The health of individuals in the facility would otherwise be endangered; or

(f) The resident has failed, after reasonable and appropriate notice, to pay for a stay at the facility.

(2) The following notice requirements apply if a nursing home/facility initiates the transfer or discharge of a resident. The notice must:

(a) Include all information required by 42 C.F.R. § 483.12 when given in a nursing facility;

(b) Be in writing, in language the resident understands;

(c) Be given to the resident, the resident's surrogate decision maker, if any, the resident's family and to the department;

(d) Beginning December 9, 2021, through May 23, 2023, the following amendment was in effect for subsection (2)(d) of this section, see WSRs 22-01-072, 22-08-062, 22-16-063, 22-23-155, 23-07-108, and 23-11-139: Be provided thirty days in advance of a transfer or discharge initiated by the nursing facility, except that the notice may be given as soon as practicable when the facility cannot meet the resident's urgent medical needs, or under the conditions described in (1)(c), (d), and (e) of this section; or for cohorting purposes related to the COVID-19 pandemic as allowed under any applicable Centers for Medicare and Medicaid Services (CMS) emergency waivers; and

(e) Be provided fifteen days in advance of a transfer or discharge initiated by the nursing home, unless the transfer is an emergency.

(3) The nursing home must:

(a) Provide sufficient preparation and orientation to the resident to ensure safe and orderly transfer or discharge from the nursing home;

(c) Develop and implement a bed-hold policy. This policy must be consistent with any bed-hold policy that the department develops.

(4) Beginning April 13, 2020, through August 3, 2021, the following repeal was in effect for subsection (4) of this section, see WSRs 20-09-074, 20-17-048, 21-01-035, and 21-08-055: The nursing home bed-hold policy must state, at a minimum:

(a) The number of days, if any, the nursing home will hold a resident's bed pending return from hospitalization or social/therapeutic leave;

(c) That a medicaid eligible resident may be charged if he or she requests that a specific bed be held, but may not be charged a bed-hold fee for the right to return to the first available bed in a semi-private room.

(5) The nursing facility must send a copy of the federally required transfer or discharge notice to:

(b) The department's designated local office when the transfer or discharge is for any of the following reasons:

(i) The resident's needs cannot be met in the facility;

(ii) The health or safety of individuals in the facility is endangered; or

(iii) The resident has failed to pay for, or to have paid under medicare or medicaid, a stay at the facility.

History

Statutory Authority: RCW 74.42.620. WSR 26-08-015, s 388-97-01201, filed 3/20/26, effective 4/20/26.

Wash. Admin. Code § 388-97-0140 Transfer and discharge appeals for resident in medicare or medicaid certified facilities.

The department amended or repealed portions of this section from November 30, 2021, through May 23, 2023, by waiving the requirement for nursing homes to suspend certain transfers and discharges pending the outcome of a resident appeal hearing, and improving resident safety by allowing faster grouping of COVID-19 positive residents in one facility, or grouping asymptomatic residents together to help expedite infection control processes, and maximizing the availability of nursing home beds in response to the state of emergency. For requirements in place during that time, see 388-97-01401.

(1) A skilled nursing facility and a nursing facility that initiates transfer or discharge of any resident, regardless of payor status, must:

(a) Provide the required written notice of transfer or discharge to the resident and, if known or appropriate, to a family member or the resident's representative;

(b) Attach a department-designated hearing request form to the transfer or discharge notice;

(i) An appeal request may be made any time up to 90 days from the date the resident receives the notice of transfer or discharge; and

(ii) Transfer or discharge will be suspended when an appeal request is received by the office of administrative hearings on or before the date the resident actually transfers or discharges; and

(iii) The nursing home will assist the resident in requesting a hearing to appeal the transfer or discharge decision.

(3) The resident is entitled to appeal the skilled nursing facility or nursing facility's transfer or discharge decision. The appeals process is set forth in chapter 182-526 WAC and this chapter. In such appeals, the following will apply:

(a) In the event of a conflict between a provision in this chapter and a provision in chapter 182-526 WAC, the provision in this chapter will prevail;

(b) The resident must be the appellant and the skilled nursing facility or the nursing facility will be the respondent;

(c) The department must be notified of the appeal and may choose whether to participate in the proceedings. If the department chooses to participate, its role is to represent the state's interest in assuring that skilled nursing facility and nursing facility transfer and discharge actions comply substantively and procedurally with the law and with federal requirements necessary for federal funds;

(d) If a medicare certified or medicaid certified facility's decision to transfer or discharge a resident is not upheld, and the resident has been relocated, the resident has the right to readmission immediately upon the first available bed in a semi-private room if the resident requires and is eligible for the services provided by a nursing facility or skilled nursing facility;

(e) Any review of the administrative law judge's initial decision shall be conducted under chapter 182-526 WAC.

History

Statutory Authority: RCW 74.42.620. WSR 26-08-015, s 388-97-0140, filed 3/20/26, effective 4/20/26
WSR 20-03-103, § 388-97-0140, filed 1/15/20, effective 2/15/20. Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 11-22-077, § 388-97-0140, filed 11/1/11, effective 12/2/11. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0140, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-01401 Transfer and discharge appeals for resident in medicare or medicaid certified facilities—Requirements in effect November 30, 2021, through May 23, 2023, in response to the state of emergency related to the COVID-19 pandemic.

In response to the state of emergency related to the COVID-19 pandemic, the department adopted emergency rules under RCW 34.05.350 on November 30, 2021, to amend and repeal portions of WAC 388-97-0140. The emergency rules remained in effect until May 23, 2023. The following rule was in effect during that time:

(1) A skilled nursing facility and a nursing facility that initiates transfer or discharge of any resident, regardless of payor status, must:

(a) Provide the required written notice of transfer or discharge to the resident and, if known or appropriate, to a family member or the resident's representative;

(b) Attach a department-designated hearing request form to the transfer or discharge notice;

(i) An appeal request may be made any time up to ninety days from the date the resident receives the notice of transfer or discharge; and

Beginning November 30, 2021, through December 9, 2021, the following repeal was in effect for subsections (1)(c)(ii) through (2)(e) of this section, see WSR 21-24-069:

(ii) The nursing home will assist the resident in requesting a hearing to appeal the transfer or discharge decision.

(2) The resident is entitled to appeal the skilled nursing facility or nursing facility's transfer or discharge decision. The appeals process is set forth in chapter 182-526 WAC and this chapter. In such appeals, the following will apply:

(a) In the event of a conflict between a provision in this chapter and a provision in chapter 182-526 WAC, the provision in this chapter will prevail;

(b) The resident must be the appellant and the skilled nursing facility or the nursing facility will be the respondent;

(e) Any review of the administrative law judge's initial decision shall be conducted under chapter 182-526 WAC.

Beginning December 9, 2021, through May 23, 2023, the following repeal was in effect for subsections (1)(c)(ii) through (2) of this section, see WSRs 22-01-072, 22-08-062, 22-16-063, 22-23-155, 23-07-108, and 23-11-139:

(ii) Transfer or discharge will be suspended when an appeal request is received by the office of administrative hearings on or before the date the resident actually transfers or discharges unless the failure to discharge or transfer would endanger the health or safety of the resident or other individuals in the facility (the facility must document the danger that failure to transfer or discharge would pose); and

(iii) The nursing home will assist the resident in requesting a hearing to appeal the transfer or discharge decision.

(2) A skilled nursing facility or nursing facility must suspend transfer or discharge pending the outcome of the hearing when the resident's appeal is received by the office of administrative hearings on or before the date of the transfer or discharge set forth in the written transfer or discharge notice, or before the resident is actually transferred or discharged unless the failure to discharge or transfer would endanger the health or safety of the resident or other individuals in the facility. The facility must document the danger that failure to transfer or discharge would pose.

(a) In the event of a conflict between a provision in this chapter and a provision in chapter 182-526 WAC, the provision in this chapter will prevail;

(b) The resident must be the appellant and the skilled nursing facility or the nursing facility will be the respondent;

(e) Any review of the administrative law judge's initial decision shall be conducted under chapter 182-526 WAC.

History

Statutory Authority: RCW 74.42.620. WSR 26-08-015, s 388-97-01401, filed 3/20/26, effective 4/20/26.

Wash. Admin. Code § 388-97-0160 Discharge or leave of a nursing facility resident.

(1) A nursing facility must send immediate written notification of the date of discharge or death of a medicaid resident to the department's local home and community service office.

(2) The nursing facility must:

(a) Notify the department of nursing facility discharge and readmission for all medicaid recipients admitted as hospital inpatients; and

(b) Document in the resident's clinical record all social/therapeutic leave exceeding twenty-four hours.

(3) The department will pay the nursing facility for a medicaid resident's social/therapeutic leave not to exceed a total of eighteen days per calendar year per resident.

(4) The department's home and community services may authorize social/therapeutic leave exceeding eighteen days per calendar year per resident when requested by the nursing facility or by the resident. In the absence of prior authorization from the department's home and community services, the department will not make payment to a nursing facility for leave days exceeding eighteen per calendar year per resident.

(5) An individual who is on social/therapeutic leave retains the status of a nursing facility resident.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0160, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-0180 Resident rights.

(1) The nursing home must meet the resident rights requirements of this section and those in the rest of the chapter.

(2) The resident has a right to a dignified existence, self-determination, and timely communication with, and access to individuals and services inside and outside the nursing home, including but not limited to, state and local agencies, and long-term care ombuds.

(3) A nursing home must promote and protect the rights of each resident, including those with limited cognition or other barriers that limit the exercise of rights.

(4) The resident has the right to:

(a) Exercise their rights as a resident of the nursing home and as a citizen or resident of the United States. Refer to WAC 388-97-0240;

(b) Be free of interference, coercion, discrimination, and reprisal from the nursing home in exercising their rights; and

(i) Any resident right set forth in this chapter or in the applicable licensing or certification laws; or

(ii) Any potential liability for personal injury or losses of personal property.

(5) The nursing home must take steps to safeguard residents and their personal property from foreseeable risks of injury or loss.

History

Statutory Authority: RCW 18.20.090, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 25-16-099, s 388-97-0180, filed 8/6/25, effective 9/6/25. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0180, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-0200 Free choice.

The resident has the right to:

(1) Choose a personal attending physician.

(2) Be fully informed in advance about care and treatment and of any changes in that care or treatment that may affect the resident's well-being.

(3) Participate in planning care and treatment or changes in care and treatment.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0200, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-0220 Statute implemented in resident decision making, informed consent, and advance directives.

WAC 388-97-0240, 388-97-0260, and 388-97-0280 implement the federal Patient Self-Determination Act and clarify requirements under chapters 11.94, 7.70, 70.122, 11.88 and 11.92 RCW.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0220, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-0240 Resident decision making.

(1) At the time of admission, or not later than the completion of the initial comprehensive resident assessment, the nursing home must determine if the resident:

(a) Has appointed another individual to make their health care, financial, or other decisions;

(b) Has created any advance directive or other legal documents that will establish a surrogate decision maker in the future; and

(c) Is not making their own decisions, and identify who has the authority for surrogate decision making, and the scope of the surrogate decision maker's authority.

(2) The nursing home must review the requirements of section (1) of this subsection when the resident's condition warrants the review or when there is a significant change in the resident's condition.

(3) In fulfilling its duty to determine who, if anyone, is authorized to make decisions for the resident, the nursing home must:

(a) Obtain copies of the legal documents that establish the surrogate decision maker's authority to act; and

(b) Document in the resident's clinical record:

(i) The name, address, and telephone number of the individual who has legal authority for substitute decision making;

(ii) The type of decision making authority such individual has; and

(iii) Where copies of the legal documents are located at the facility.

(4) In accordance with state law or at the request of the resident, the resident's surrogate decision maker is, in the case of:

(a) A capacitated resident, the individual authorized by the resident to make decisions on the resident's behalf;

(b) A resident adjudicated by a court of law to be incapacitated, the court appointed guardian; and

(i) A legal document, such as a durable power of attorney for health care; or

(ii) Authority for substitute decision making granted by state law, including RCW 7.70.065.

(5) Determination of an individual's incapacity must be a process according to state law not a medical diagnosis only and be based on:

(a) Demonstrated inability in decision making over time that creates a significant risk of personal harm;

(b) A court order; or

(6) The nursing home must promote the resident's right to exercise decision making and self-determination to the fullest extent possible, taking into consideration their ability to understand and respond. Therefore, the nursing home must presume that the resident is the resident's own decision maker unless:

(a) A court has established a full guardianship of the individual;

(b) The capacitated resident has clearly and voluntarily appointed a surrogate decision maker;

(d) The facility determines that the resident is an incapacitated individual according to chapter 11.130 RCW and (5)(a) of this section.

(7) The nursing home must honor the exercise of the resident's rights by the surrogate decision maker as long as the surrogate acts in accordance with this section and with state and federal law which govern their appointment.

(8) If a surrogate decision maker exercises a resident's rights, the nursing home must take into consideration the resident's ability to understand and respond and must:

(a) Inform the resident that a surrogate decision maker has been consulted;

(b) Provide the resident with the information and opportunity to participate in all decision making to the maximum extent possible; and

(i) Protect the resident's rights; and

(ii) Comply with state and federal laws.

(9) The nursing home must:

(a) Regularly review any determination of incapacity based on (4)(b) and (c) of this section;

(b) Except for residents with a guardian, cease to rely upon the surrogate decision maker to exercise the resident's rights, if the resident regains capacity, unless so designated by the resident or by court order; and

(i) The resident regains capacity;

(ii) The guardian is not respecting or promoting the resident's rights;

(iii) The guardianship should be modified; or

(iv) A different guardian needs to be appointed.

History

Statutory Authority: RCW 18.20.090, 18.51.070, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 26-05-046, s 388-97-0240, filed 2/12/26, effective 3/15/26. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0240, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-0260 Informed consent.

(1) The nursing home must ensure that the informed consent process is followed with:

(a) The resident to the maximum extent possible, taking into consideration their ability to understand and respond; and

(b) The surrogate decision maker when the resident is determined to be incapacitated as established through the provision of a legal document such as durable power of attorney for health care, a court proceeding, or as authorized by state law, including RCW 7.70.065. The surrogate decision maker must:

(i) First determine if the resident would consent or refuse the proposed or alternative treatment;

(ii) Discuss determination of consent or refusal with the resident whenever possible; and

(iii) When a determination of the resident's consent or refusal of treatment cannot be made, make the decision in the best interest of the resident.

(2) The informed consent process must include, in words and language that the resident, or if applicable the resident's surrogate decision maker, understands, a description of:

(a) The nature and character of the proposed treatment;

(b) The anticipated results of the proposed treatment;

(d) The recognized serious possible risks, complications, and anticipated benefits involved in the treatment and in the recognized possible alternative forms of treatment including nontreatment; and

(e) The right of the resident to choose not to be informed.

(3) To ensure informed consent or refusal by a resident, or if applicable the resident's surrogate decision maker, regarding plan or care options, the nursing home must:

(a) Provide the informed consent process to the resident in a neutral manner and in a language, words, and manner the resident can understand;

(b) Inform the resident of the right to consent to or refuse care and service options at the time of resident assessment and plan of care development (see WAC 388-97-1000 and 388-97-1020) and with condition changes, as necessary to ensure that the resident's wishes are known;

(c) Inform the resident at the time of initial plan of care decisions and periodically of the right to change their mind about an earlier consent or refusal decision;

(d) Ensure that evidence of informed consent or refusal is consistent with WAC 388-97-1000 and 388-97-1020; and

(e) Where appropriate, include evidence of resident's choice not to be informed as required in subsections (2) and (3) of this section.

History

Statutory Authority: RCW 18.20.090, 18.51.070, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 26-05-046, s 388-97-0260, filed 2/12/26, effective 3/15/26. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0260, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-0280 Advance directives.

(1) "Advance directive" as used in this chapter means any document indicating a resident's choice with regard to a specific service, treatment, medication, or medical procedure option that may be implemented in the future such as power of attorney, health care directive, limited or restricted treatment cardiopulmonary resuscitation (CPR), do not resuscitate (DNR), and organ tissue donation.

(2) The nursing home must carry out the provisions of this section in accordance with the applicable provisions of WAC 388-97-0240 and 388-97-0260, and with state law.

(3) The nursing home must:

(a) Document in the clinical record whether or not the resident has an advance directive;

(b) Not request or require the resident to have any advance directives and not condition the provision of care or otherwise discriminate against a resident on the basis of whether or not the resident has executed an advance directive;

(c) In a language and words the resident understands, inform the resident in writing and orally at the time of admission, and thereafter as necessary to ensure the resident's right to make informed choices, about:

(i) The right to make health care decisions, including the right to change their mind regarding previous decisions;

(ii) Nursing home policies and procedures concerning implementation of advance directives; and

(d) Review and update as needed the resident advance directive information:

(i) At the resident's request;

(ii) When the resident's condition warrants review; and

(iii) When there is a significant change in the resident's condition.

(4) When the nursing home becomes aware that a resident's health care directive is in conflict with facility practices and policies which are consistent with state and federal law, the nursing home must:

(a) Inform the resident of the existence of any nursing home practice or policy which would preclude implementing the health care directive;

(b) Provide the resident with written policies and procedures that explain under what circumstances a resident's health care directive will or will not be implemented by the nursing home;

(d) Determine, in light of the conflicting practice or policy, whether the resident chooses to remain at the nursing home:

(i) If the resident chooses to remain in the nursing home, develop with the resident a plan in accordance with chapter 70.122 RCW to implement the resident's wishes. The nursing home may need to actively participate in ensuring the execution of the plan, including moving the resident at the time of implementation to a care setting that will implement the resident's wishes. Attach the plan to the resident's directive in the resident's clinical record; or

(ii) If, after recognizing the conflict between the resident's wishes and nursing home practice or policy the resident chooses to seek other long-term care services, or another physician who will implement the directive, the nursing home must assist the resident in locating other appropriate services.

(5) If a terminally ill resident, in accordance with state law, wishes to die at home, the nursing home must:

(a) Use the informed consent process as described in WAC 388-97-0260, and explain to the resident the risks associated with discharge; and

(b) Discharge the resident as soon as reasonably possible.

History

Statutory Authority: RCW 18.20.090, 18.51.070, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 26-05-046, s 388-97-0280, filed 2/12/26, effective 3/15/26. Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 10-02-021, § 388-97-0280, filed 12/29/09, effective 1/29/10. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0280, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-0300 Notice of rights and services.

The department amended or suspended portions of this section from May 15, 2020, through May 7, 2022, in response to the state of emergency related to the COVID-19 pandemic. For requirements in place during that time, see WAC 388-97-03001.

(1) The nursing home must provide the resident, before admission, or at the time of admission in the case of an emergency, and as changes occur during the resident's stay, both orally and in writing and in language and words that the resident understands, with the following information:

(a) All rules and regulations governing resident conduct, resident's rights, and responsibilities during the stay in the nursing home;

(b) Advanced directives, and of any nursing home policy or practice that might conflict with the resident's advance directive if made;

(d) Advance notice of deposits and refunds, consistent with RCW 70.129.150; and

(e) Items, services, and activities available in the nursing home and of charges for those services, including any charges for services not covered under medicare or medicaid or by the home's per diem rate.

(2) The resident has the right:

(a) Upon an oral or written request, to access all records pertaining to the resident including clinical records within 24 hours; and

(b) After receipt of their records for inspection, to purchase at a cost not to exceed 25 cents a page, photocopies of the records or any portions of them upon request and two working days advance notice to the nursing home. For the purposes of this chapter, "working days" means Monday through Friday, except for legal holidays.

(3) The resident has the right to:

(a) Be fully informed in words and language that they can understand of their total health status, including, but not limited to, their medical condition;

(b) Accept or refuse treatment; and

(4) The nursing home must inform each resident:

(a) Who is entitled to medicaid benefits, in writing, prior to the time of admission to the nursing facility or, when the resident becomes eligible for medicaid of the items, services, and activities:

(i) That are included in nursing facility services under the medicaid state plan and for which the resident may not be charged; and

(ii) That the nursing home offers and for which the resident may be charged, and the amount of charges for those services.

(b) That deposits, admission fees, and prepayment of charges cannot be solicited or accepted from medicare or medicaid eligible residents; and

(5) The nursing home must, except for emergencies, inform each resident in writing, 30 days in advance before changes are made to the availability or charges for items, services, or activities specified in section (4)(a)(i) and (ii) of this section, or before changes to the nursing home rules.

(6) The private pay resident has the right to the following, regarding fee disclosure-deposits:

(a) Prior to admission, a nursing home that requires payment of an admission fee, deposit, or a minimum stay fee, by or on behalf of an individual seeking admission to the nursing home, must provide the individual:

(i) Full disclosure in writing in a language the potential resident or their representative understands:

(A) Of the nursing home's schedule of charges for items, services, and activities provided by the nursing home; and

(B) Of what portion of the deposits, admissions fees, prepaid charges, or minimum stay fee will be refunded to the resident if the resident leaves the nursing home.

(ii) The amount of any admission fees, deposits, or minimum stay fees.

(iii) If the nursing home does not provide these disclosures, the nursing home must not keep deposits, admission fees, prepaid charges, or minimum stay fees.

(b) If a resident dies, or is hospitalized, or is transferred and does not return to the nursing home, the nursing home:

(i) Must refund any deposit or charges already paid, less the home's per diem rate, for the days the resident actually resided or reserved or retained a bed in the nursing home, regardless of any minimum stay or discharge notice requirements; except that

(ii) The nursing home may retain an additional amount to cover its reasonable, actual expenses incurred as a result of a private pay resident's move, not to exceed five days per diem charges, unless the resident has given advance notice in compliance with the admission agreement.

(c) The nursing home must refund any and all refunds due the resident within 30 days from the resident's date of discharge from the nursing home; and

(d) Where the nursing home requires the execution of an admission contract by or on behalf of an individual seeking admission to the nursing home, the terms of the contract must be consistent with the requirements of this section.

(7) The nursing home must furnish a written description of legal rights which includes:

(a) A description of the manner of protecting personal funds, under WAC 388-97-0340;

(b) In the case of a nursing facility only, a description of the requirements and procedures for establishing eligibility for medicaid, including the right to request an assessment which determines the extent of a couple's nonexempt resources at the time of institutionalization and attributes to the community spouse an equitable share of resources which cannot be considered available for payment toward the cost of the institutionalized spouse's medical care in their process of spending down to medicaid eligibility levels;

(c) A posting of names, addresses, and telephone numbers of all relevant state client advocacy groups such as the state survey and certification agency, the state licensure office, the state ombuds program, the protection and advocacy network, and the medicaid fraud control unit; and

(d) A statement that the resident may file a complaint with the state survey and certification agency concerning resident abandonment, abuse, neglect, financial exploitation, and misappropriation of resident property in the nursing home.

(8) The nursing home must:

(a) Inform each resident of the name, and specialty of the physician responsible for their care; and

(b) Provide a way for each resident to contact their physician.

(9) The skilled nursing facility and nursing facility must prominently display in the facility written information, and provide to residents and individuals applying for admission oral and written information, about how to apply for and use medicare and medicaid benefits, and how to receive refunds for previous payments covered by such benefits.

(10) The written information provided by the nursing home pursuant to this section, and the terms of any admission contract executed between the nursing home and an individual seeking admission to the nursing home, must be consistent with the requirements of chapters 74.42 and 18.51 RCW and, in addition, for facilities certified under medicare or medicaid, with the applicable federal requirements.

History

Statutory Authority: RCW 18.20.090, 18.51.070, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 26-05-046, s 388-97-0300, filed 2/12/26, effective 3/15/26. Statutory Authority: RCW 74.42.620 and chapter 18.51 RCW. WSR 24-07-008, § 388-97-0300, filed 3/7/24, effective 4/7/24. Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 14-12-040, § 388-97-0300, filed 5/29/14, effective 6/29/14. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0300, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-03001 Notice of rights and services—Requirements in effect May 15, 2020, through May 7, 2022, in response to the state of emergency related to the COVID-19 pandemic.

In response to the state of emergency related to the COVID-19 pandemic, the department adopted emergency rules under RCW 34.05.350 on May 15, 2020, to amend and suspend portions of WAC 388-97-0300. The emergency rules remained in effect until May 7, 2022. The following rule was in effect during that time:

(a) All rules and regulations governing resident conduct, resident's rights and responsibilities during the stay in the nursing home;

(b) Advanced directives, and of any nursing home policy or practice that might conflict with the resident's advance directive if made;

(d) Advance notice of deposits and refunds, consistent with RCW 70.129.150; and

(2) The resident has the right to purchase at a cost not to exceed 25 cents a page, photocopies of the records or any portions of them upon request and 10 working days advance notice to the nursing home. For the purposes of this chapter, "working days" means Monday through Friday, except for legal holidays.

(3) The resident has the right to:

(a) Be fully informed in words and language that he or she can understand of his or her total health status, including, but not limited to, his or her medical condition;

(b) Accept or refuse treatment; and

(4) The nursing home must inform each resident:

(i) That are included in nursing facility services under the medicaid state plan and for which the resident may not be charged; and

(ii) That the nursing home offers and for which the resident may be charged, and the amount of charges for those services.

(b) That deposits, admission fees, and prepayment of charges cannot be solicited or accepted from medicare or medicaid eligible residents; and

(6) The private pay resident has the right to the following, regarding fee disclosure-deposits:

(i) Full disclosure in writing in a language the potential resident or his or her representative understands:

(A) Of the nursing home's schedule of charges for items, services, and activities provided by the nursing home; and

(B) Of what portion of the deposits, admissions fees, prepaid charges, or minimum stay fee will be refunded to the resident if the resident leaves the nursing home.

(ii) The amount of any admission fees, deposits, or minimum stay fees.

(iii) If the nursing home does not provide these disclosures, the nursing home must not keep deposits, admission fees, prepaid charges, or minimum stay fees.

(b) If a resident dies or is hospitalized or is transferred and does not return to the nursing home, the nursing home:

(c) The nursing home must refund any and all refunds due the resident within 30 days from the resident's date of discharge from the nursing home; and

(7) The nursing home must furnish a written description of legal rights which includes:

(a) A description of the manner of protecting personal funds, under WAC 388-97-0340;

(b) In the case of a nursing facility only, a description of the requirements and procedures for establishing eligibility for medicaid, including the right to request an assessment which determines the extent of a couple's nonexempt resources at the time of institutionalization and attributes to the community spouse an equitable share of resources which cannot be considered available for payment toward the cost of the institutionalized spouse's medical care in his or her process of spending down to medicaid eligibility levels;

(8) The nursing home must:

(a) Inform each resident of the name, and specialty of the physician responsible for his or her care; and

(b) Provide a way for each resident to contact his or her physician.

History

Statutory Authority: RCW 74.42.620 and chapter 18.51 RCW. WSR 24-07-008, § 388-97-03001, filed 3/7/24, effective 4/7/24.

Wash. Admin. Code § 388-97-0320 Notification of changes.

(1) A nursing home must immediately inform the resident, consult with the resident's physician, and if known, notify the resident's surrogate decision maker, and when appropriate, with resident consent, interested family member(s) when there is:

(a) An accident involving the resident which results in injury and has the potential for requiring physician intervention;

(b) A significant change in the resident's physical, mental, or psychosocial status (i.e., a deterioration in health, mental, or psychological status in either life-threatening conditions or clinical complications); refer to WAC 388-97-0240;

(c) A need to alter treatment significantly (i.e., a need to discontinue an existing form of treatment due to adverse consequences, or to commence a new form of treatment); or

(d) A decision to transfer or discharge the resident from the facility.

(2) The nursing home must also promptly notify the resident and, if known, the resident's surrogate decision maker, and when appropriate, with the resident's consent, interested family member(s) when there is:

(a) A change in room or roommate assignment, refer to the timing requirements in WAC 388-97-0580; or

(b) A change in resident rights under federal or state law or regulations as specified in WAC 388-97-0300.

(3) The nursing home must record and periodically update the address and phone number of the resident's legal surrogate decision maker and interested family member(s).

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0320, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-0340 Protection of resident funds.

(1) The resident has the right to manage their financial affairs and the nursing home may not require residents to deposit their personal funds with the nursing home.

(2) Upon written authorization of a resident, the nursing home must hold, safeguard, manage, and account for the personal funds of the resident deposited with the nursing home.

(3) The nursing home must establish and maintain a system that assures a full, complete, and separate accounting, according to generally accepted accounting principles, of each resident's personal funds entrusted to the nursing home on the resident's behalf and must:

(a) Deposit any resident's personal funds in excess of $50, $100 for medicare residents, in an interest-bearing resident personal fund account or accounts, separate from any nursing home operating accounts, and credit all interest earned to the account;

(b) Keep personal funds under $50, $100 for medicare residents, in a noninterest-bearing account or petty cash fund maintained for residents; and

(c) Make the individual financial record available to the resident or their surrogate decision maker through quarterly statements and on request.

(4) The nursing facility must notify each resident that receives medicaid benefits:

(a) When the amount in the resident's account reaches $200 less than the SSI resource limit for one individual; and

(b) That if the amount in the account, in addition to the value of the resident's other nonexempt resources, reaches the SSI resource limit for one individual, the resident may lose eligibility for medicaid or SSI.

(5) The nursing home must convey the resident's funds, and a final accounting of those funds, to the resident or to the individual or jurisdiction administering the resident's estate, within 30 days of the discharge, transfer, or death of any resident with a personal fund deposited with the nursing home. The funds of a deceased medicaid resident must be sent to the state of Washington, department of social and health services, office of financial recovery.

(6) The nursing facility must purchase a surety bond, or an approved alternative, to assure security of personal funds of residents deposited with the facility.

(7) Medicare certified and medicaid certified facilities may not impose a charge against a resident's personal funds for any item or service for which payment is made under medicaid or medicare as described in 42 C.F.R. § 483.10 (c)(8).

(8) Medicare certified and medicaid certified nursing facilities must:

(a) Not charge a resident, or the resident's representative, for any item or service not requested by the resident;

(b) Not require a resident, or the resident's representative, to request any item or service as a condition of admission or continued stay; and

(c) Inform the resident, or the resident's representative, requesting an item or services for which a charge will be made that there will be a charge for the item or service and what the charge will be.

(9) When a resident's financial eligibility for nursing facility services is established by the department, the facility must refund to the resident:

(a) Any deposit that was required prior to eligibility; and

(b) Any payments for services that will be covered retroactively by medicaid.

History

Statutory Authority: RCW 18.20.090, 18.51.070, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 26-05-046, s 388-97-0340, filed 2/12/26, effective 3/15/26. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0340, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-0360 Privacy and confidentiality.

(1) The resident has the right to personal privacy and confidentiality of their personal and clinical records. Personal privacy includes:

(a) Accommodations;

(b) Medical treatment;

(d) Personal care;

(e) Visits; and

(f) Meetings with family and resident groups.

(2) The resident may approve or refuse the release of personal and clinical records to any individual outside the nursing home, unless the resident has been adjudged incapacitated according to state law.

(3) The resident's right to refuse release of personal and clinical records does not apply when:

(a) The resident is transferred to another health care institution; or

(b) Record release is required by law.

History

Statutory Authority: RCW 18.20.090, 18.51.070, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 26-05-046, s 388-97-0360, filed 2/12/26, effective 3/15/26. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0360, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-0380 Electronic monitoring equipment—Audio monitoring and video monitoring.

(1) Except as provided in this section or in WAC 388-97-0400, the nursing home must not use the following in the facility or on the premises:

(a) Audio monitoring equipment; or

(b) Video monitoring equipment if it includes an audio component.

(2) The nursing home may video monitor and video record activities in the facility or on the premises, without an audio component, only in the following areas:

(a) Entrances and exits as long as the cameras are:

(i) Focused only on the entrance or exit doorways; and

(ii) Not focused on areas where residents gather.

(b) Areas used exclusively by staff persons such as, medication preparation and storage areas or food preparation areas, if residents do not go into these areas;

(d) Designated smoking areas, subject to the following conditions:

(i) Residents have been assessed as needing supervision for smoking;

(ii) A staff person watches the video monitor at any time the area is used by such residents;

(iii) The video camera is clearly visible;

(iv) The video monitor is not viewable by general public; and

(v) The facility notifies all residents in writing of the use of video monitoring equipment.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0380, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-0400 Electronic monitoring equipment—Resident requested use.

(1) The nursing home must not use audio or video monitoring equipment to monitor any resident unless:

(a) The resident has requested the monitoring; and

(b) The monitoring is only used in the sleeping room of the resident who requested the monitoring.

(2) If the resident requests audio or video monitoring, before any electronic monitoring occurs, the nursing home must ensure:

(a) That the electronic monitoring does not violate chapter 9.73 RCW;

(b) The resident has identified a threat to the resident's health, safety or personal property;

(d) The resident and the nursing home have agreed upon a specific duration for the electronic monitoring and the agreement is documented in writing.

(3) The nursing home must:

(a) Reevaluate the need for the electronic monitoring with the resident at least quarterly; and

(b) Have each re-evaluation in writing, signed and dated by the resident.

(4) The nursing home must immediately stop electronic monitoring if the:

(a) Resident no longer wants electronic monitoring;

(b) Roommate objects or withdraws the consent to the electronic monitoring; or

(5) For the purposes of consenting to video electronic monitoring without an audio component, the term "resident" includes the resident's surrogate decision maker.

(6) For purpose of consenting to any audio electronic monitoring, the term "resident" includes:

(a) The individual residing in the nursing home; or

(7) If a resident's decision maker consents to audio electronic monitoring as specified in (6) above, the nursing home must maintain a copy of the court order authorizing such consent in the resident's record.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0400, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-0420 Work.

The resident has the right to:

(1) Refuse to perform services for the nursing home; and

(2) Perform services for the nursing home, if they choose, when:

(a) The facility has documented the need or desire for work in the plan of care;

(b) The plan specifies the nature of the services performed and whether the services are voluntary or paid;

(d) The resident agrees to the work arrangement described in the plan of care.

History

Statutory Authority: RCW 18.20.090, 18.51.070, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 26-05-046, s 388-97-0420, filed 2/12/26, effective 3/15/26. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0420, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-0440 Self-administration of drugs.

A resident may self-administer drugs if the interdisciplinary team has determined that this practice is safe.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0440, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-0460 Grievance rights.

A resident has the right to:

(1) Voice grievances without discrimination or reprisal. Grievances include those with respect to treatment which has been furnished as well as that which has not been furnished.

(2) Prompt efforts by the nursing home to resolve voiced grievances, including those with respect to the behavior of other residents.

(3) File a complaint, contact, or provide information to the department, the long-term care ombuds, the attorney general's office, and law enforcement agencies without interference, discrimination, or reprisal. All forms of retaliatory treatment are prohibited, including those listed in chapter 74.39A RCW.

(4) Receive information from agencies acting as client advocates, and be afforded the opportunity to contact these agencies.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 14-12-040, § 388-97-0460, filed 5/29/14, effective 6/29/14. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0460, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-0480 Examination of survey results.

(1) The resident has the right to examine the results of:

(a) The most recent survey of the nursing home conducted by federal and state surveyors;

(b) Surveys related to any current or subsequent complaint investigation; and

(2) Upon receipt of any deficiency citation report, the nursing home must publicly post a notice:

(a) That the results of the survey or complaint investigation, or both, are available regardless of whether the plan of correction is completed or not; and

(b) Of the location of the deficiency citation reports.

(3) For a report posted prior to the plan of correction being completed, the nursing home may attach an accompanying notice that explains the purpose and status of the plan of correction, informal dispute review, administrative hearing, and other relevant information.

(4) Upon receipt of any citation report, the nursing home must publicly post a copy of the most recent full survey and all subsequent complaint investigation deficiency citation reports, including the completed plans of correction, when one is required.

(5) The notices and any survey reports must be available for viewing or examination in a place or places:

(a) Readily accessible to residents, which does not require staff interventions to access; and

(b) In plain view of the nursing home residents, including individuals visiting those residents, and individuals who inquire about placement in the nursing home.

(6) If the notice is a stop placement order, the nursing home must also follow requirements in WAC 388-97-4540.

History

Statutory Authority: RCW 18.20.090, 18.51.070, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 26-05-046, s 388-97-0480, filed 2/12/26, effective 3/15/26. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0480, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-0500 Resident mail.

The resident has the right and the nursing home must provide immediate access to any resident by the following:

(1) Send and promptly receive mail that is unopened; and

(2) Have access to stationary, postage and writing implements at the resident's own expense.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0500, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-0520 Access and visitation rights.

(1) The resident has the right and the nursing home must provide immediate access to any resident by the following:

(a) For medicare and medicaid residents any representative of the U.S. department of health and human services (DHHS);

(b) Any representative of the state;

(d) Any representative of the state long-term care ombuds program (established under section 307 (a)(12) of the Older American's Act of 1965);

(e) Any representative of the Washington protection and advocacy system, or any other agency (established under part c of the Developmental Disabilities Assistance and Bill of Rights Act);

(f) Any representative of the Washington protection and advocacy system, or any agency (established under the Protection and Advocacy for Mentally Ill Individuals Act);

(g) Subject to the resident's right to deny or withdraw consent at any time, immediate family or other relatives of the resident; and

(h) Subject to reasonable restrictions and the resident's right to deny or withdraw consent at any time, others who are visiting with the consent of the resident.

(2) The nursing home must provide reasonable access to any resident by any entity or individual that provides health, social, legal, or other services to the resident, subject to the resident's right to deny or withdraw consent at any time.

(3) The nursing home must allow representatives of the state ombuds, described in subsection (1)(d) of this section, to examine a resident's clinical records with the permission of the resident or the resident's surrogate decision maker, and consistent with state law. The ombuds may also, under federal and state law, access resident's records when the resident is incapacitated and has no surrogate decision maker, and may access records over the objection of a surrogate decision maker if access is authorized by the state ombuds pursuant to 42 U.S.C. § 3058g(b) and RCW 43.190.065.

(4) Access to their essential support person, as outlined in RCW 70.129.190.

History

Statutory Authority: RCW 18.20.090, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 25-16-099, s 388-97-0520, filed 8/6/25, effective 9/6/25. Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 14-12-040, § 388-97-0520, filed 5/29/14, effective 6/29/14. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0520, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-0540 Telephone.

The resident has the right to have twenty-four hour access to a telephone which:

(1) Provides auditory privacy;

(2) Is accessible to an individual with a disability and accommodates an individual with sensory impairment; and

(3) Does not include the use of telephones in staff offices and at the nurses station(s).

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0540, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-0560 Personal property.

(1) The resident has the right, unless to do so would infringe upon the rights or health and safety of other residents, to:

(a) Retain and use personal possessions, including some furnishings, and appropriate clothing, as space permits;

(b) Provide his or her own bed and other furniture, if desired and space permits; and

(2) The nursing home must:

(a) Not request or require residents to sign waivers of potential liability for losses of personal property; and

(b) Have a system in place to safeguard personal property within the nursing home that protects the personal property and yet allows the resident to use his or her property.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0560, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-0580 Roommates/rooms.

(1) A resident has the right to:

(a) Share a room with their spouse or state registered domestic partners when both residents live in the same facility and both consent to the arrangement and the room complies with the requirements for two occupants; and

(b) Receive three days notice of change in room or roommate except:

(i) For room changes: The move is at the resident's request; and

(ii) For room or roommate changes: A longer or shorter notice is required to protect the health or safety of the resident or another resident; or an admission to the facility is necessary, and the resident is informed in advance. The nursing home must recognize that the change may be traumatic for the resident and take steps to lessen the trauma.

(2) The nursing home must make reasonable efforts to accommodate residents wanting to share the same room.

History

Statutory Authority: RCW 18.20.090, 18.51.070, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 26-05-046, s 388-97-0580, filed 2/12/26, effective 3/15/26. Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 10-02-021, § 388-97-0580, filed 12/29/09, effective 1/29/10. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0580, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-0600 Refusal of certain transfers.

(1) Each resident has the right to refuse a transfer to another room within the facility, if the purpose of the transfer is to make the resident eligible for coverage by the medicare or medicaid program.

(2) Refer to WAC 388-97-0580 for requirements related to a resident's right to notice before room or roommate changes.

(3) At the time of a proposed transfer, the skilled nursing facility or nursing facility must inform the resident of the right to refuse under subsection (1), if the purpose is to make the resident eligible for coverage by the medicare program.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 11-22-077, § 388-97-0600, filed 11/1/11, effective 12/2/11. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0600, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-0620 Chemical and physical restraints.

(1) The resident has the right to be free from any physical or chemical restraint imposed for purposes of:

(a) Discipline or convenience, and not required to treat the resident's medical symptoms; or

(b) Preventing or limiting independent mobility or activity.

(2) The nursing home must develop and implement written policies and procedures governing:

(a) The emergency use of restraints;

(b) The use of chemical and physical restraints, required for the treatment of the resident's medical symptoms, not for discipline or convenience;

(d) Monitoring and controlling the use of restraints.

(3) Physical restraints may be used in an emergency only when:

(a) It has been assessed as necessary to prevent a resident from inflicting injury to self or to others;

(b) The restraint is the least restrictive form of restraint possible;

(i) Within twenty-four hours; and

(ii) The order includes treatments to assist in resolving the emergency situation and eliminating the need for the restraint.

(d) The resident is released from the restraint as soon as the emergency no longer exists.

(4) In certain situations, chemical or physical restraints may be necessary for residents with acute or chronic mental or physical impairments. When chemical or physical restraints are used the nursing home must ensure that:

(a) The use of the restraint is related to a specific medical need or problem identified through a multidisciplinary assessment;

(b) The informed consent process is followed as described under WAC 388-97-0260; and

(5) The nursing home must ensure that any resident physically restrained is released:

(a) At intervals not to exceed two hours; and

(b) For periods long enough to provide for ambulation, exercise, elimination, food and fluid intake, and socialization as independently as possible.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0620, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-0640 Prevention of abuse.

(1) Each resident has the right to be free from verbal, sexual, physical and mental abuse, corporal punishment, and involuntary seclusion.

(2) The nursing home must develop and implement written policies and procedures that:

(a) Prohibit abandonment, abuse, and neglect of residents, financial exploitation, and misappropriation of resident property; and

(b) Require staff to report possible abuse, and other related incidents, as required by chapter 74.34 RCW, and for skilled nursing facilities and nursing facilities as required by 42 C.F.R. § 483.13.

(3) The nursing home must not allow staff to:

(a) Engage in verbal, mental, sexual, or physical abuse;

(b) Use corporal punishment;

(d) Misappropriate resident property.

(4) The nursing home must report any information it has about an action taken by a court of law against an employee to the department's complaint resolution unit and the appropriate department of health licensing authority, if that action would disqualify the individual from employment as described in RCW 43.43.842.

(5) The nursing home must ensure that all allegations involving abandonment, abuse, neglect, financial exploitation, or misappropriation of resident property, including injuries of unknown origin, are reported immediately to the department, other applicable officials, and the administrator of the facility. The nursing home must:

(a) Ensure that the reports are made through established procedures in accordance with state law including chapter 74.34 RCW, and guidelines developed by the department; and

(b) Not have any policy or procedure that interferes with the requirement of chapter 74.34 RCW that employees and other mandatory reporters file reports directly with the department, and also with law enforcement, if they suspect sexual or physical assault has occurred.

(6) The nursing home must:

(a) Have evidence that all alleged violations are thoroughly investigated;

(b) Prevent further potential abandonment, abuse, neglect, financial exploitation, or misappropriation of resident property while the investigation is in progress; and

(c) Report the results of all investigations to the administrator or his designated representative and to other officials in accordance with state law and established procedures (including the state survey and certification agency) within five working days of the incident, and if the alleged violation is verified appropriate action must be taken.

(7) When a mandated reporter has:

(a) Reasonable cause to believe that a vulnerable adult has been abandoned, abused, neglected, financially exploited, or a resident's property has been misappropriated, the individual mandatory reporter must immediately report the incident to the department's aging and disability services administration (ADSA);

(b) Reason to suspect that a vulnerable adult has been sexually or physically assaulted, the individual mandatory reporter must:

(i) Immediately report the incident to the department's aging and disability services administration (ADSA);

(ii) Notify local law enforcement in accordance with the provisions of chapter 74.34 RCW.

(8) Under RCW 74.34.053, it is:

(a) A gross misdemeanor for a mandated reporter knowingly to fail to report as required under this section; and

(b) A misdemeanor for a person to intentionally, maliciously, or in bad faith make a false report of alleged abandonment, abuse, financial exploitation, or neglect of a vulnerable adult.

(9) The nursing home must not employ individuals who are disqualified under the requirements of WAC 388-97-1820.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0640, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-0860 Resident dignity and accommodation of needs.

(1) Dignity. The nursing home must ensure that:

(a) Resident care is provided in a manner to enhance each resident's dignity, and to respect and recognize their individuality; and

(b) Each resident's personal care needs are provided in a private area free from exposure to individuals not involved in providing the care.

(2) Accommodation of needs. Each resident has the right to reasonable accommodation of personal needs and preferences, except when the health or safety of the individual or other residents would be endangered.

History

Statutory Authority: RCW 18.20.090, 18.51.070, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 26-05-046, s 388-97-0860, filed 2/12/26, effective 3/15/26. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0860, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-0880 Environment.

The nursing home must provide and maintain:

(1) A safe, clean, comfortable, and homelike environment, allowing the resident to use their personal belongings to the extent possible;

(2) Housekeeping and maintenance services necessary to maintain a sanitary, orderly, and comfortable interior;

(3) Comfortable and safe temperature levels:

(a) Facilities licensed after October 1, 1990, must maintain a temperature range of 71 to 81 degrees Fahrenheit; and

(b) Regardless of external weather conditions, all nursing homes must develop and implement procedures and processes to maintain a temperature level that is comfortable and safe for residents;

(4) Comfortable sound levels, to include:

(a) Minimizing the use of the public address system to ensure each use is in the best interest of the residents; and

(b) Taking reasonable precautions with noisy services so as not to disturb residents, particularly during their sleeping time; and

(5) Lighting suitable for any task the resident chooses to do, and any task the staff must do.

History

Statutory Authority: RCW 18.20.090, 18.51.070, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 26-05-046, s 388-97-0880, filed 2/12/26, effective 3/15/26. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0880, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-0900 Self determination and participation.

The resident has the right to:

(1) Choose activities, schedules, and health care consistent with their interests, assessments, and plan of care;

(2) Interact with members of the community both inside and outside the nursing home;

(3) Make choices about aspects of their life in the facility that are significant to the resident; and

(4) Participate in social, religious, and community activities that do not interfere with the rights of other residents in the nursing home.

History

Statutory Authority: RCW 18.20.090, 18.51.070, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 26-05-046, s 388-97-0900, filed 2/12/26, effective 3/15/26. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0900, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-0920 Participation in resident and family groups.

The department repealed this section from April 13, 2020, through May 7, 2022, in response to the state of emergency related to the COVID-19 pandemic. The requirements of this section were not in effect during that time.

(1) A resident has the right to organize and participate in resident groups in the nursing home.

(2) The nursing home must provide a resident or family group, if one exists, with private space.

(3) Staff or visitors may attend meetings only at the group's invitation.

(4) The nursing home must provide a designated staff individual responsible for providing assistance and responding to written requests that result from group meetings.

(5) When a resident or family group exists, the nursing home must listen to the views and act upon the grievances and recommendations of residents and families concerning proposed policy and operational decisions affecting resident care and life in the nursing home.

(6) A resident's family has the right to meet in the nursing home with the families of other residents in the facility.

History

Statutory Authority: RCW 74.42.620 and chapter 18.51 RCW. WSR 24-07-008, § 388-97-0920, filed 3/7/24, effective 4/7/24. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0920, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-0940 Activities.

The nursing home must:

(1) Provide for an ongoing program of activities designed to meet, in accordance with the comprehensive assessment, the interests and the physical, mental, and psychosocial well-being of each resident;

(2) Provide activities meaningful to the residents at various times throughout every day and evening based on each resident's need and preference; and

(3) Ensure that the activities program is directed by a qualified professional who:

(a) Is a qualified therapeutic recreation specialist or an activities professional who is eligible for certification as a therapeutic recreation specialist or as an activities professional by a recognized accrediting body on or after October 1, 1990; or

(b) Has two years of experience in a social or recreational program within the last five years, one of which was full-time in a patient activities program in a health care setting; or

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0940, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-0960 Social services.

The nursing home must:

(1) Provide medically related social services to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident; and

(2) Employ a qualified social worker on a full-time basis if the nursing home has more than one hundred twenty beds. A qualified social worker is an individual with:

(a) A bachelor's degree in social work or a bachelor's degree in a human services field including but not limited to sociology, special education, rehabilitation counseling, and psychology; and

(b) One year of supervised social work experience in a health care setting working directly with patients or residents.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0960, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-0980 Pets.

(1) Each resident must have a reasonable opportunity to have regular contact with animals, if desired.

(2) The nursing home must:

(a) Consider the recommendations of nursing home residents, resident councils, and staff;

(b) Determine how to provide residents access to animals;

(c) Determine the type and number of animals available in the facility, which the facility can safely manage. Such animals should include only those customarily considered domestic pets;

(d) Ensure that any resident's rights, preferences, and medical needs are not compromised by the presence of an animal; and

(e) Ensure any animal visiting or living on the premises has a suitable temperament, is healthy, and otherwise poses no significant health or safety risks to residents, staff, or visitors.

(3) Animals living on the nursing home premises must:

(a) Have regular examinations and immunizations, appropriate for the species, by a veterinarian licensed in Washington state; and

(b) Be veterinarian certified to be free of diseases transmittable to humans.

(4) Pets must be restricted from:

(a) Central food preparation areas; and

(b) Residents who object to the presence of pets.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-0980, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1000 Resident assessment.

The department amended or suspended portions of this section from April 13, 2020, through May 10, 2021, in response to the state of emergency related to the COVID-19 pandemic. For requirements in place during that time, see WAC 388-97-10001.

(1) The nursing home must:

(a) Provide resident care based on a systematic, comprehensive, interdisciplinary assessment, and care planning process in which the resident participates, to the fullest extent possible;

(b) Conduct initially and periodically a comprehensive, accurate, standardized, reproducible assessment of each resident's functional capacity;

(i) Have physician's orders for the resident's immediate care; and

(ii) Ensure that the resident's immediate care needs are identified in an admission assessment.

(d) Ensure that the comprehensive assessment of a resident's needs describes the resident's capability to perform daily life functions and significant impairments in functional capacity.

(2) The comprehensive assessment must include at least the following information:

(a) Identification and demographic information;

(b) Customary routine;

(d) Communication;

(e) Vision;

(f) Mood and behavior patterns;

(g) Psychosocial well-being;

(h) Physical functioning and structural problems;

(i) Continence;

(j) Disease diagnosis and health conditions;

(k) Dental and nutritional status;

(l) Skin conditions;

(m) Activity pursuit;

(n) Medications;

(o) Special treatments and procedures;

(p) Discharge potential;

(q) Documentation of summary information regarding the assessment performed; and

(r) Documentation of participation in assessment.

(3) The nursing home must conduct comprehensive assessments:

(a) No later than 14 days after the date of admission;

(b) Promptly after a significant change in the resident's physical or mental condition; and

(4) The nursing home must ensure that:

(a) Each resident is assessed no less than once every three months, and as appropriate, the resident's assessment is revised to assure the continued accuracy of the assessment; and

(b) The results of the assessment are used to develop, review, and revise the resident's comprehensive plan of care under WAC 388-97-1020.

(5) The skilled nursing facility and nursing facility must:

(a) For the required assessment, complete the state approved resident assessment instrument (RAI) for each resident in accordance with federal requirements;

(b) Maintain electronic or paper copies of completed resident assessments in the resident's active medical record for 15 months; this information must be maintained in a centralized location and be easily and readily accessible;

(c) Place the hard copies of the signature pages in the clinical record of each resident if a facility maintains their RAI data electronically and does not use electronic signatures;

(d) Assess each resident not less than every three months, using the state approved assessment instrument; and

(e) Transmit all state and federally required RAI information for each resident to the department:

(i) In a manner approved by the department;

(ii) Within 14 days of completion of any RAI assessment required under this subsection; and

(iii) Within 14 days of discharging or admitting a resident for a tracking record.

History

Statutory Authority: RCW 74.42.620 and chapter 18.51 RCW. WSR 24-07-008, § 388-97-1000, filed 3/7/24, effective 4/7/24. Statutory Authority: Chapter 74.42 RCW and 42 C.F.R. 483.20. WSR 18-11-001, § 388-97-1000, filed 5/2/18, effective 6/2/18. Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 13-04-093, § 388-97-1000, filed 2/6/13, effective 3/9/13. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1000, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-10001 Resident assessment—Requirements in effect April 13, 2020, through May 10, 2021, in response to the state of emergency related to the COVID-19 pandemic.

(1) The nursing home must:

(a) Provide resident care based on a systematic, comprehensive, interdisciplinary assessment, and care planning process in which the resident participates, to the fullest extent possible;

(b) Conduct initially and periodically a comprehensive, accurate, standardized, reproducible assessment of each resident's functional capacity;

(i) Have physician's orders for the resident's immediate care; and

(ii) Ensure that the resident's immediate care needs are identified in an admission assessment.

(d) Ensure that the comprehensive assessment of a resident's needs describes the resident's capability to perform daily life functions and significant impairments in functional capacity.

(2) The comprehensive assessment must include at least the following information:

(a) Identification and demographic information;

(b) Customary routine;

(d) Communication;

(e) Vision;

(f) Mood and behavior patterns;

(g) Psychosocial well-being;

(h) Physical functioning and structural problems;

(i) Continence;

(j) Disease diagnosis and health conditions;

(k) Dental and nutritional status;

(l) Skin conditions;

(m) Activity pursuit;

(n) Medications;

(o) Special treatments and procedures;

(p) Discharge potential;

(q) Documentation of summary information regarding the assessment performed; and

(r) Documentation of participation in assessment.

(3) The nursing home must ensure that:

(a) As appropriate, the resident's assessment is revised to assure the continued accuracy of the assessment; and

(b) The results of the assessment are used to develop, review, and revise the resident's comprehensive plan of care under WAC 388-97-1020.

(4) The skilled nursing facility and nursing facility must:

(a) For the required assessment, complete the state approved resident assessment instrument (RAI) for each resident in accordance with federal requirements;

(c) Place the hard copies of the signature pages in the clinical record of each resident if a facility maintains their RAI data electronically and does not use electronic signatures;

(d) Transmit all state and federally required RAI information for each resident to the department in a manner and time period approved by the department.

History

Statutory Authority: RCW 74.42.620 and chapter 18.51 RCW. WSR 24-07-008, § 388-97-10001, filed 3/7/24, effective 4/7/24.

Wash. Admin. Code § 388-97-1020 Comprehensive plan of care.

(1) The nursing home must develop a comprehensive plan of care for each resident that includes measurable objectives and timetables to meet a resident's medical, nursing and mental, and psychosocial needs that are identified in the comprehensive assessment.

(2) The comprehensive plan of care must:

(a) Describe the services that are to be furnished to attain or maintain the resident's highest practicable physical, mental, and psychosocial well-being as required under WAC 388-97-1060;

(b) Describe any services that would otherwise be required, but are not provided due to the resident's exercise of rights, including the right to refuse treatment (refer to WAC 388-97-0300 and 388-97-0260);

(d) Be prepared by an interdisciplinary team that includes the attending physician, a registered nurse with responsibility for the resident, and other appropriate staff in disciplines as determined by the resident's needs;

(e) Consist of an ongoing process which includes a meeting if desired by the resident or the resident's representative; and

(f) Include the ongoing participation of the resident to the fullest extent possible, the resident's family, or the resident's surrogate decision maker.

(3) The nursing home must implement a plan of care to meet the immediate needs of newly admitted residents, prior to the completion of the comprehensive assessment and plan of care.

(4) The nursing home must:

(a) Follow the informed consent process with the resident as specified in WAC 388-97-0260, regarding the interdisciplinary team's plan of care recommendations;

(b) Respect the resident's right to decide plan of care goals and treatment choices, including acceptance or refusal of plan of care recommendations;

(i) Staff members requested by the resident; and

(ii) Direct care staff who work most closely with the resident.

(d) Respect the resident's wishes regarding which individuals, if any, the resident wants to take part in resident plan of care functions;

(e) Provide reasonable advance notice to and reasonably accommodate the resident family members or other individuals the resident wishes to have attend, when scheduling plan of care meeting times; and

(f) Where for practical reasons any individuals significant to the plan of care process, including the resident, are unable to attend plan of care meetings, provide a method for such individuals to give timely input and recommendations.

(5) The nursing home must ensure that each comprehensive plan of care:

(a) Designates the discipline of the individuals responsible for carrying out the program; and

(b) Is reviewed at least quarterly by qualified staff, as part of the ongoing process of monitoring the resident's needs and preferences.

History

Statutory Authority: RCW 74.42.620 and chapter 18.51 RCW. WSR 24-07-008, § 388-97-1020, filed 3/7/24, effective 4/7/24. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1020, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-10201 Comprehensive plan of care—Requirements in effect April 13, 2020, through May 10, 2021, in response to the state of emergency related to the COVID-19 pandemic.

(2) The comprehensive plan of care must:

(a) Describe the services that are to be furnished to attain or maintain the resident's highest practicable physical, mental, and psychosocial well-being as required under WAC 388-97-1060;

(c) Be prepared by an interdisciplinary team that includes the attending physician, a registered nurse with responsibility for the resident, and other appropriate staff in disciplines as determined by the resident's needs;

(d) Consist of an ongoing process which includes a meeting if desired by the resident or the resident's representative; and

(e) Include the ongoing participation of the resident to the fullest extent possible, the resident's family, or the resident's surrogate decision maker.

(3) The nursing home must implement a plan of care to meet the immediate needs of newly admitted residents, prior to the completion of the comprehensive assessment and plan of care.

(4) The nursing home must:

(a) Follow the informed consent process with the resident as specified in WAC 388-97-0260, regarding the interdisciplinary team's plan of care recommendations;

(b) Respect the resident's right to decide plan of care goals and treatment choices, including acceptance or refusal of plan of care recommendations;

(i) Staff members requested by the resident; and

(ii) Direct care staff who work most closely with the resident.

(d) Respect the resident's wishes regarding which individuals, if any, the resident wants to take part in the resident's plan of care functions;

(5) The nursing home must ensure that each comprehensive plan of care:

(a) Designates the discipline of the individuals responsible for carrying out the program; and

(b) Is reviewed at least quarterly by qualified staff, as part of the ongoing process of monitoring the resident's needs and preferences.

History

Statutory Authority: RCW 74.42.620 and chapter 18.51 RCW. WSR 24-07-008, § 388-97-10201, filed 3/7/24, effective 4/7/24.

Wash. Admin. Code § 388-97-1040 Dementia care.

(1) A nursing home must ensure that it provides residents with dementia with an environment designed to attain or maintain the highest level of functioning and well-being possible, taking into consideration the resident's medical condition and functional status. Therefore, the nursing home must:

(a) Have a program designed to meet the identified needs of the residents;

(b) Develop and implement program policies and procedures; and

(c) Train all staff, who have resident contact, in the special needs and care approaches applicable to residents with dementia. This training must be ongoing and consistent with requirements under WAC 388-97-1680 (2)(b).

(2) A nursing home that has a locked or secured dementia unit must:

(a) Always have staff present in the unit, available to meet the needs of the residents and to protect them in the event of an emergency;

(b) Have staff available to assist residents, as needed, in accessing outdoor areas;

(i) The process of informed consent is followed before admission to or transfer/discharge from the unit;

(ii) The resident is provided with unit specific admission or transfer/discharge criteria, prior to admission to the unit;

(iii) The resident's need for admission to the unit from another part of the nursing home, or transfer/discharge from the unit, is based on the comprehensive assessment and plan of care;

(iv) Through an evaluation prior to admission, a resident admitted directly from outside the nursing home meets the cognitive and functional criteria of the unit; and

(v) In the case of an individual admitted directly to the unit from outside the nursing home, as specified in subsection (2)(b)(iv) above, the nursing home may complete the comprehensive assessment after the individual's admission to the unit, provided that the nursing home complies with required time frames for completion of the resident assessment under WAC 388-97-1000.

(d) Provide private pay residents, or their surrogate decision maker written notification:

(i) If admitted from outside the nursing home, of additional charges, if any, for services, items, and activities in the unit, prior to admission; and

(ii) If admitted from another part of the nursing home, thirty days in advance of changes to those charges.

(e) Comply with physical plant requirements in WAC 388-97-2800 through 388-97-2920, for existing facilities and for new construction.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1040, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1060 Quality of care.

(1) Consistent with resident rights, the nursing home must provide each resident with the necessary care and services to attain or maintain the highest practicable physical, mental and psychosocial well-being, self-care and independence in accordance with his or her comprehensive assessment and plan of care.

(2) Based on the comprehensive assessment of a resident, the nursing home must ensure that:

(a) A resident's abilities in activities of daily living do not decline unless circumstances of the resident's clinical condition demonstrate that the decline was unavoidable. This includes the resident's ability to:

(i) Bathe, dress, and groom;

(ii) Transfer and ambulate;

(iii) Toilet;

(iv) Eat; and

(v) Use speech, language, or other functional communication systems.

(b) A resident is given the appropriate treatment and services to maintain or improve the resident's abilities in activities of daily living specified in subsection (2)(a) of this section; and

(c) A resident who is unable to carry out activities of daily living receives the necessary services to maintain good nutrition, grooming, and personal and oral hygiene.

(3) The nursing home must ensure that the appropriate care and services are provided to the resident in the following areas, as applicable in accordance with the resident's individualized assessments and plan of care:

(a) Vision and hearing;

(b) Skin;

(d) Range of motion;

(e) Mental and psychosocial functioning and adjustment;

(f) Nasogastric and gastrostomy tubes;

(g) Accident prevention;

(h) Nutrition;

(i) Hydration;

(j) Special needs, including:

(i) Injections;

(ii) Parenteral and enteral fluids;

(iii) Colostomy, ureterostomy, or ileostomy care;

(iv) Tracheostomy care;

(v) Tracheal suction;

(vi) Respiratory care;

(vii) Dental care;

(viii) Foot care; and

(ix) Prostheses.

(k) Medications, including freedom from:

(i) Unnecessary drugs;

(ii) Nursing home error rate of five percent or greater; and

(iii) Significant medication errors.

(l) Self-administration of medication; and

(m) Independent living skills.

(4) The nursing home must ensure that each resident is monitored for desired responses and undesirable side effects of prescribed drugs.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1060, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1080 Nursing services.

(1) The nursing home must ensure that a sufficient number of qualified nursing personnel are available on a twenty-four hour basis seven days per week to provide nursing and related services to attain or maintain the highest practicable physical, mental and psychosocial well-being of each resident as determined by resident assessments and individual plans of care.

(2) The nursing home must:

(a) Designate a registered nurse or licensed practical nurse to serve as charge nurse who is accountable for nursing services on each shift; and

(b) Have a full time director of nursing service who is a registered nurse.

(3) Large nonessential community providers must have a registered nurse on duty directly supervising resident care twenty-four hours per day, seven days per week.

(4) The department may permit limited exceptions to subsection (3) of this section if the nursing home can a demonstrate good faith effort to hire a registered nurse for the last eight hours of required coverage per day. The department may not grant exceptions for coverage that are less than sixteen hours per day. When considering an exception, the department may consider the following:

(a) Wages and benefits offered by the nursing home; and

(b) The availability of registered nurses in the nursing home's geographical area.

(5) The department may grant a one-year exception that may be renewable for up to three consecutive years.

(6) If a registered nurse is not on-site and readily available to complete full assessments during a shift, the department may limit the admission of new residents based on the resident's medical conditions or complexity during this period only for the particular shift that a registered nurse is not on-site or readily available.

(7) If the department grants an exception for a nursing home, the department must include this information in its nursing home locator.

(8) Essential community providers and small nonessential community providers must have a registered nurse on duty who directly supervises resident care a minimum of sixteen hours per day, seven days per week, and a registered nurse or a licensed practical nurse on duty who directly supervises resident care the remaining eight hours per day, seven days per week.

(9) The nursing home must ensure that staff respond to resident requests for assistance in a manner that promptly meets the resident's quality of life and quality of care needs.

(10) The director of nursing services is responsible for:

(a) Coordinating the plan of care for each resident;

(b) Ensuring that registered nurses and licensed practical nurses comply with chapter 18.79 RCW; and

(c) Ensuring that the nursing care provided is based on the nursing process in accordance with nationally recognized and accepted standards of professional nursing practice.

History

Statutory Authority: Chapters 18.51, 74.42, 74.34, 74.46 RCW, 2015 2nd sp.s. c 2, 2015 c 268, and 2016 c 131. WSR 16-23-094, § 388-97-1080, filed 11/16/16, effective 12/17/16. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1080, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1090 Direct care hours.

(1) Each nursing home must provide a minimum of 3.4 hours of direct care per resident day (HRD). Direct care means the staffing domain identified and defined in the Centers for Medicare and Medicaid Services' five star quality rating system and as reported through the Centers for Medicare and Medicaid Services' payroll-based journal. Compliance with the minimum staffing standard must be measured using the Centers for Medicare and Medicaid Services' payroll based journal and nursing home census and payroll data.

(a) For purposes of calculating hours per resident day minimum staffing standards for facilities with 61 or more licensed beds, the director of nursing services classification (job title code five), as identified in the Centers for Medicaid and Medicaid Service's payroll-based journal, shall not be used.

(b) For facilities with 60 or fewer beds, the director of nursing services classification (job title code five) shall be included in calculating hours per resident day minimum staffing standards.

(2) On a quarterly basis the department will use the Centers for Medicare and Medicaid Services' payroll based journal to determine compliance with the minimum staffing standard.

(3) Payroll based journal data must be submitted after the end of each calendar quarter and filed electronically.

(4) The department will presume that all hours worked by direct care employees at the nursing home have been spent providing direct care.

(5) The department may use census and payroll data from facilities to perform enforcement audits.

(6) The department must periodically review the nursing home's census information, reported staff hours, and payroll data to determine whether HRD figures are relatively constant throughout a quarter or are being increased at the end of the quarter through unusual spending on direct care.

(7) A nursing home may use the hours of geriatric behavioral health workers as defined under RCW 74.42.010 to meet this section's direct care minimum staffing requirements.

(8) A nursing home that fails to meet the minimum staffing requirement of 3.4 hours and of direct care per resident day for any quarter is subject to a fine. The department will determine the amount of the fine as follows:

(a) The fine must be based on the total cost the nursing home would have incurred had it complied with the 3.4 HRD requirement;

(b) The department will use a formula that calculates a fine based on the cost of certified nurse aid wages and benefits for the missing staff hours;

(c) If the nursing home believes that the department's application of the standard in subsection (8)(b) of this section is inequitable, it may explain its position to the department and request consideration of an alternative method of calculating the fine; and

(d) The fine will be one and a half times the additional amount it would have cost the nursing home to provide direct care at the 3.4 HRD standard for a nursing home's first violation and two times the additional amount for each subsequent violation by the nursing home. After a nursing home has not violated the 3.4 HRD requirement for three years the department will reset the nursing home's status and treat any subsequent violation as an initial violation.

(9) The amount of money the nursing home would have been required to spend to reach 3.4 HRD must be treated as a direct care cost for the year in which the staffing was deficient for settlement purposes. The portion of the fine representing the additional one-half or one times that amount is a penalty, and will not be added to the actual costs of the nursing home in the settlement process.

(10) The nursing home must pay penalties under WAC 388-97-1090(8) by check. The department will deposit penalty checks into the nursing home quality enhancement account in the custody of the state treasurer. The department's secretary, or the secretary's designee, may authorize expenditures from the nursing home quality enhancement account. Such expenditures may only be for: Technical assistance to nursing homes, specialized training for nursing homes, or an increase to the quality enhancement component of the daily medicaid rate provided by RCW 74.46.581.

(11) In the event the Centers for Medicare and Medicaid Services' payroll-based journal is not available, the department may use any data source that is reasonably consistent with data metrics used by the payroll-based journal to measure direct care being provided by a nursing home. To gather data similar to the data gathered by the payroll-based journal, the department may provide a written survey to nursing homes. The metrics will be used to determine whether the nursing home has complied with the 3.4 HRD requirement.

History

Statutory Authority: RCW 34.05.353, 74.42.360, and 74.42.620. WSR 26-07-022, s 388-97-1090, filed 3/9/26, effective 4/9/26. Statutory Authority: RCW 18.51.070. WSR 21-23-036, § 388-97-1090, filed 11/8/21, effective 12/9/21. Statutory Authority: Chapters 18.51, 74.42, 74.34, 74.46 RCW, 2015 2nd sp.s. c 2, 2015 c 268, and 2016 c 131. WSR 16-23-094, § 388-97-1090, filed 11/16/16, effective 12/17/16.

Wash. Admin. Code § 388-97-1100 Dietary services.

The nursing home must:

(1) Provide each resident with a nourishing, palatable, well-balanced diet that meets their daily nutritional and special dietary needs.

(2) Serve food in an attractive manner and at temperatures safe and acceptable to each resident.

(3) Ensure that food service is in compliance with chapter 246-215 WAC.

(4) Retain dated menus, dated records of foods received, a record of the number of meals served, and standardized recipes for at least three months for department review as necessary.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1100, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1120 Meal provision.

The nursing home must:

(1) Provide a minimum of three meals in each twenty-four period, at regular times similar to normal meal times in the community;

(2) Make fresh fruits and vegetables, in season, available to residents on a daily basis;

(3) Make reasonable efforts to:

(a) Accommodate individual mealtime preferences and portion sizes, as well as preferences for between meal and evening snacks when not medically contraindicated;

(b) Offer a late breakfast or an alternative to the regular breakfast for late risers; and

(4) Use input from residents and the resident council, if the nursing home has one, in meal planning, scheduling, and the meal selection process.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1120, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1140 Individual dietary needs.

The nursing home must:

(1) Encourage residents to continue eating independently;

(2) Provide effective adaptive utensils as needed to promote independence;

(3) Allow sufficient time for eating in a relaxed manner;

(4) Provide individualized assistance as needed;

(5) Provide table service, for all residents capable of eating at a table, in a dining area/room, located outside of the resident's room; and

(6) Offer a substitute of similar nutritive value when a resident refuses food served.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1140, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1160 Dietary personnel.

The nursing home must have sufficient support personnel capable of carrying out the functions of dietary services and must:

(1) Employ a qualified dietitian either full-time, part-time or on a consultant basis who must:

(a) Approve regular and therapeutic menus which meet the dietary allowances of the Food and Nutrition Board of the National Research Council, National Academy of Sciences;

(b) Prepare dated menus for general and modified diets at least three weeks in advance;

(i) Nutrition assessment;

(ii) Liaison with medical and nursing staff, and administrator;

(iii) Inservice training; and

(iv) Guidance to the director of food service, and food service staff.

(2) If a qualified dietitian is not employed full-time as the food service manager the nursing home must employ a food service manager to serve as the director of food service.

(3) The food service manager means:

(a) An individual who is a qualified dietitian; or

(b) An individual:

(i) Who has completed a dietetic technician or dietetic assistant training program, correspondence or classroom, approved by the American Dietetic Association/Dietary Manager Association; and

(ii) Receives regularly scheduled consultation from a qualified dietitian.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1160, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1180 Dietary menus.

The nursing home must:

(1) Ensure that menus are followed;

(2) Post the current dated general menu, including substitutes, in the food service area and in a place accessible and conspicuous to residents and visitors, in print the residents can read; and

(3) Note any changes to the regular menu on the posted menu.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1180, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1200 Dietary orders.

The nursing home must:

(1) Ensure that residents' diets are provided as prescribed by the physician. Diet modifications, for texture only, may be used as an interim measure when ordered by a registered nurse; and

(2) Provide supplementary fluid and nourishment in accordance with each resident's needs as determined by the assessment process.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1200, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1220 Modified diets.

The nursing home must review a resident's modified diet to ensure that the food form and texture are consistent with the resident's current needs and functional level:

(1) At the request of the resident.

(2) When the resident's condition warrants.

(3) At the time of the plan of care review.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1220, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1240 Tube feedings.

If the nursing home prepares tube feeding formula, or mixes additives to the prepared formula it must ensure that:

(1) Each resident's tube feedings are of uniform consistency and quality; and

(2) Tube feeding formulas are prepared, stored, distributed, and served in such a manner so as to maintain uniformity and to prevent contamination.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1240, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1260 Physician services.

The department amended or suspended portions of this section from April 28, 2020, through May 7, 2022, in response to the state of emergency related to the COVID-19 pandemic. For requirements in place during that time, see WAC 388-97-12601.

(1) The nursing home must ensure that the resident is seen by the physician whenever necessary.

(2) Except as specified in RCW 74.42.200, a physician must personally approve in writing a recommendation that an individual be admitted to a nursing home.

(3) The nursing home must ensure that:

(a) Except as specified in RCW 74.42.200, the medical care of each resident is supervised by a physician;

(b) Another physician supervises the medical care of residents when their attending physician is unavailable; and

(4) The physician must:

(a) Write, sign, and date progress notes at each visit;

(b) Sign and date all orders; and

(c) In medicare and medicare/medicaid certified facilities, review the resident's total program of care, including medications and treatments, at each federally required visit.

(5) Except as specified in subsections (6), (7), and (9) of this section, a physician may delegate tasks to a physician's assistant or advanced registered nurse practitioner who is:

(a) Licensed by the state;

(b) Acting within the scope of practice as defined by state law; and

(6) The physician may not delegate a task when the delegation is prohibited under state law or by the facility's own policies.

(7) If the resident's primary payor source is medicare, the physician may:

(a) Alternate federally required physician visits between personal visits by:

(i) The physician; and

(ii) An advanced registered nurse practitioner or physician's assistant; and

(b) Not delegate responsibility for the initial required physician visit. This initial visit must occur within the first 30 days of admission to the facility.

(8) If the resident's payor source is medicaid, the physician may delegate any federally required physician task, including tasks which the regulations specify must be performed personally by the physician, to a physician's assistant or advanced registered nurse practitioner who is not an employee of the facility but who is working in collaboration with a physician.

(9) If the resident's payor source is not medicare or medicaid:

(a) In the medicare only certified facility or in the medicare certified area of a medicare/medicaid facility, the physician may alternate federally required physician visits between personal visits by the physician and an advanced registered nurse practitioner or physician's assistant. The physician may not delegate responsibility for the initial required physician visit.

(b) In the medicaid only certified facility or in the medicaid certified area of a medicare/medicaid facility, the physician may delegate any federally required physician task, including tasks which the regulations specify must be performed personally by the physician, to a physician's assistant or advanced registered nurse practitioner who is not an employee of the facility but who is working in collaboration with a physician.

(10) The following table describes the physician visit requirements related to medicare or medicaid certified area and payor type.

| | Beds in medicare only certified area | Beds in medicare/medicaid certified area | Beds in medicaid only certified area | | --- | --- | --- | --- | | Payor source: | Initial by physician | Initial by physician | N/A | | medicare | Physician may delegate alternate visits | Physician may delegate alternate visits | | | Payor source: | N/A | Delegate all tasks | Delegate all tasks | | medicaid | | Nonemployee | Nonemployee | | Payor source: | Initial by physician | Initial by physician | Delegate all tasks | | Others: such as insurance, private pay, Veteran Affairs | Physician may delegate alternate visits | Physician may delegate alternate visits | Nonemployee |

(11) The attending physician, or the physician-designated advanced registered nurse practitioner or physician's assistant must:

(a) Participate in the interdisciplinary plan of care process as described in WAC 388-97-1020;

(b) Provide to the resident, or where applicable the resident's surrogate decision maker, information so that the resident can make an informed consent to care or refusal of care (see WAC 388-97-0260); and

(12) The nursing home must obtain from the physician the following medical information before or at the time of the resident's admission:

(a) A summary or summaries of the resident's current health status, including history and physical findings reflecting a review of systems;

(b) Orders, as necessary for medications, treatments, diagnostic studies, specialized rehabilitative services, diet, and any restrictions related to physical mobility; and

History

Statutory Authority: RCW 74.42.620 and chapter 18.51 RCW. WSR 24-07-008, § 388-97-1260, filed 3/7/24, effective 4/7/24. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1260, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-12601 Physician services—Requirements in effect April 28, 2020, through May 7, 2022, in response to the state of emergency related to the COVID-19 pandemic.

In response to the state of emergency related to the COVID-19 pandemic, the department adopted emergency rules under RCW 34.05.350 on April 28, 2020, to amend and suspend portions of WAC 388-97-1260. The emergency rules remained in effect until May 7, 2022. The following rule was in effect during that time:

(1) The nursing home must ensure that the resident is seen by the physician whenever necessary.

(2) Except as specified in RCW 74.42.200, a physician must personally approve in writing a recommendation that an individual be admitted to a nursing home.

(3) The nursing home must ensure that:

(a) Except as specified in RCW 74.42.200, the medical care of each resident is supervised by a physician;

(b) Another physician supervises the medical care of residents when their attending physician is unavailable; and

(4) The physician must:

(a) Write, sign, and date progress notes at each visit;

(b) Sign and date all orders; and

(c) In medicare and medicare/medicaid certified facilities, review the resident's total program of care, including medications and treatments, at each federally required visit.

(5) Except as specified in subsection (6) of this section, a physician may delegate tasks, including tasks that, under state law, must be performed personally by the physician, to a physician's assistant or advanced registered nurse practitioner who is:

(a) Licensed by the state;

(b) Acting within the scope of practice as defined by state law;

(d) Not an employee of the facility, if caring for a resident whose payor source is medicaid.

(6) The physician may not delegate a task when the delegation is prohibited under state law or by the facility's own policies.

(7) The attending physician, or the physician-designated advanced registered nurse practitioner or physician's assistant must:

(a) Participate in the interdisciplinary plan of care process as described in WAC 388-97-1020;

(8) The nursing home must obtain from the physician the following medical information before or at the time of the resident's admission:

(a) A summary or summaries of the resident's current health status, including history and physical findings reflecting a review of systems;

(b) Orders, as necessary for medications, treatments, diagnostic studies, specialized rehabilitative services, diet, and any restrictions related to physical mobility; and

History

Statutory Authority: RCW 74.42.620 and chapter 18.51 RCW. WSR 24-07-008, § 388-97-12601, filed 3/7/24, effective 4/7/24.

Wash. Admin. Code § 388-97-1280 Specialized habilitative and rehabilitative services.

(1) If specialized habilitative and rehabilitative services such as, but not limited to, physical therapy, speech-language pathology, occupational therapy, and mental health rehabilitative services for mental illness and mental retardation, are required in the resident's comprehensive plan of care, the facility must:

(a) Provide the required services; or

(b) Obtain the required services from an outside provider of specialized rehabilitative services.

(2) As determined by the resident's individualized comprehensive plan of care, qualified therapists, as defined in RCW 74.46.020(40), will provide specialized habilitative or rehabilitative services under the written order of the physician. According to state law and at the qualified therapist's discretion, certain services may be delegated to and provided by support personnel under appropriate supervision.

(3) The nursing facility must:

(a) Ensure that residents who display mental or psychosocial adjustment difficulties receive appropriate treatment and services to correct the assessed problem; and

(b) Provide or arrange for the mental health or mental retardation services needed by residents that are of a lesser intensity than the specialized services defined at WAC 388-97-1960.

(4) The nursing home may provide specialized rehabilitative and habilitative services to outpatients on the facility premises, only if the nursing home continues to also meet the needs of current residents.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1280, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1300 Pharmacy services.

(1) The nursing home must:

(a) Obtain routine and emergency drugs and biologicals for its residents under an agreement with a licensed pharmacy;

(b) Ensure that pharmaceutical services:

(i) Meet the needs of each resident;

(ii) Establish and monitor systems for the accurate acquiring, receiving, dispensing, and administering of all drugs and biologicals; and

(i) Provide consultation on all aspects of the provision of pharmacy services in the nursing home;

(ii) Determine that nursing home drug records are in order;

(iii) Perform regular reviews at least once each month of each resident's drug therapy; and

(iv) Document and report drug irregularities to the attending physician and the director of nursing.

(2) Drugs and biologicals used in the nursing home must be labeled and stored in accordance with applicable state and federal laws.

(3) The nursing home must provide pharmaceutical services that:

(a) Meet recognized and accepted standards of pharmacy practice; and

(b) Comply with chapter 246-865 WAC, except nursing home staff administering drugs to residents may document administration at the time of pouring the drug or immediately after administration.

(4) The nursing home must ensure:

(a) Education and training for nursing home staff by the licensed pharmacist on drug-related subjects including, but not limited to:

(i) Recognized and accepted standards of pharmacy practice and applicable pharmacy laws and rules;

(ii) Appropriate monitoring of residents to determine desired effect and undesirable side effects of drug regimens; and

(iii) Use of psychotropic drugs.

(b) Reference materials regarding medication administration, adverse reactions, toxicology, and poison center information are readily available;

(d) Accurate detection, documentation, reporting and resolution of drug errors and adverse drug reactions; and

(e) Only individuals authorized by state law to do so will receive drug orders and administer drugs;

(5) The resident has the right to a choice of pharmacies when purchasing prescription and nonprescription drugs as long as the following conditions are met to ensure the resident is protected from medication errors:

(a) The medications are delivered in a unit of use compatible with the established system of the facility for dispensing drugs; and

(b) The medications are delivered in a timely manner to prevent interruption of dose schedule.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1300, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1320 Infection control.

(1) The nursing home must:

(a) Establish and maintain an effective infection control program designed to provide a safe, sanitary, and comfortable environment and to help prevent the development and transmission of disease and infection;

(b) Prohibit any employee with a communicable disease or infected skin lesion from direct contact with residents or their food, if direct contact could transmit the disease; and

(c) Require staff to wash their hands after each direct resident contact for which handwashing is indicated by accepted professional practice.

(2) Under the infection control program, the nursing home must:

(a) Investigate, control and prevent infections in the facility;

(b) Decide what procedures should be applied in individual circumstances; and

(3) Nursing home personnel must handle, store, process, and transport linens so as to prevent the spread of infection.

(4) The nursing home must develop and implement effective methods for the safe storage, transport and disposal of garbage, refuse and infectious waste, consistent with all applicable local, state, and federal requirements for such disposal.

(5) The nursing home must provide areas, equipment, and supplies to implement an effective infection control program and ensure:

(a) Ready availability of hand cleaning supplies and appropriate drying equipment or material at each sink;

(b) Safe use of disposable and single service supplies and equipment;

(d) Chemicals and equipment used for cleaning, disinfecting, and sterilizing, including chemicals used to launder personal clothing, are used in accordance with manufacturer's directions and recommendations; and

(e) Safe and effective procedures for disinfecting:

(i) All bathing and therapy tubs between each resident use; and

(ii) Swimming pools, spas and hot tubs.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1320, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1340 Influenza and pneumococcal immunizations.

(1) The nursing home shall provide residents access on-site or make available elsewhere, the ability to obtain the influenza virus immunization on an annual basis.

(2) Upon admission, the nursing home shall inform residents or the resident's representative, verbally and in writing, of the benefits of receiving the influenza virus immunization and the pneumococcal disease immunization.

(3) Nursing homes who rely exclusively upon treatment by nonmedical religious healing methods, including prayer, are exempt from the above rules.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1340, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1360 Surveillance, management and early identification of individuals with active tuberculosis.

(1) The nursing home must develop and implement policies and procedures that comply with nationally recognized tuberculosis standards set by the Centers for Disease Control (CDC), and applicable state law. Such policies and procedures include, but are not limited to, the following:

(a) Evaluation of any resident or employee with symptoms suggestive of tuberculosis whether tuberculin skin test results were positive or negative;

(b) Identifying and following up residents and personnel with suspected or actual tuberculosis, in a timely manner; and

(2) The nursing home must comply with chapter 49.17 RCW, Washington Industrial Safety and Health Act (WISHA) requirements to protect the health and safety of employees.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1360, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1380 Tuberculosis—Testing required.

The department amended or suspended portions of this section from January 25, 2021, through September 23, 2021, in response to the state of emergency related to the COVID-19 pandemic. For requirements in place during that time, see WAC 388-97-13801.

(1) The nursing home must develop and implement a system to ensure that facility personnel and residents have tuberculosis testing within three days of employment or admission.

(2) The nursing home must also ensure that facility personnel are tested annually.

(3) For the purposes of WAC 388-97-1360 through 388-97-1580 "person" means facility personnel and residents.

History

Statutory Authority: RCW 74.42.620 and chapter 18.51 RCW. WSR 24-07-008, § 388-97-1380, filed 3/7/24, effective 4/7/24. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1380, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-13801 Tuberculosis—Testing required—Requirements in effect January 25, 2021, through September 23, 2021, in response to the state of emergency related to the COVID-19 pandemic.

In response to the state of emergency related to the COVID-19 pandemic, the department adopted emergency rules under RCW 34.05.350 on January 25, 2021, to amend and suspend portions of WAC 388-97-1380. The emergency rules remained in effect until September 23, 2021. The following rule was in effect during that time:

(1) Unless the nursing home decides to defer tuberculosis testing in accordance with subsection (2) of this section, or the resident or staff person is excluded from testing from WAC 388-97-1440, the nursing home must:

(a) Ensure that facility personnel and residents have tuberculosis testing within three days of employment or admission; and

(b) Ensure that facility personnel are tested annually.

(2) The nursing home may defer tuberculosis testing of facility personnel and residents to complete the COVID-19 vaccination process if the nursing home has considered the risks and benefits of such delay and if the delay is consistent with the current centers for disease control and prevention COVID-19 vaccination guidance.

(3) If testing is deferred for a resident or facility staff person, in accordance with subsection (2) of this section, the nursing home must:

(a) Assess the person for symptoms of tuberculosis within three days of employment or admission, and if the person has tuberculosis symptoms, follow WAC 388-97-1560; and

(b) Complete tuberculosis testing in accordance with WAC 388-97-1400 through 388-97-1580 as soon as indicated by the centers for disease control and prevention COVID-19 vaccination guidelines.

(4) For the purposes of WAC 388-97-1360 through 388-97-1580, "person" means facility personnel and residents.

History

Statutory Authority: RCW 74.42.620 and chapter 18.51 RCW. WSR 24-07-008, § 388-97-13801, filed 3/7/24, effective 4/7/24.

Wash. Admin. Code § 388-97-1400 Tuberculosis—Testing method—Required.

The nursing home must ensure that all tuberculosis testing is done through either:

(1) Intradermal (Mantoux) administration with test results read:

(a) Within forty-eight to seventy-two hours of the test; and

(b) By a trained professional; or

(2) A blood test for tuberculosis called interferon-gamma release assay (IGRA).

History

Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 10-02-021, § 388-97-1400, filed 12/29/09, effective 1/29/10. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1400, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1440 Tuberculosis—No testing.

The nursing home is not required to have a person tested for tuberculosis if the person has:

(1) A documented history of a previous positive skin test results;

(2) A documented history of a previous positive blood test; or

(3) Documented evidence of:

(a) Adequate therapy for active disease; or

(b) Completion of treatment for latent tuberculosis infection preventive therapy.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 10-02-021, § 388-97-1440, filed 12/29/09, effective 1/29/10. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1440, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1460 Tuberculosis—One test.

The nursing home is only required to have a person take one test if the person has any of the following:

(1) A documented history of a negative result from a previous two step test done no more than one to three weeks apart; or

(2) A documented negative result from one skin or blood test in the previous twelve months.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 10-02-021, § 388-97-1460, filed 12/29/09, effective 1/29/10. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1460, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1480 Tuberculosis—Two-step skin testing.

Unless the person meets the requirement for having no skin testing or only one test, the nursing home, choosing to do skin testing, must ensure that each person has the following two-step skin testing:

(1) An initial skin test within three days of employment; and

(2) A second test done one to three weeks after the first test.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 10-02-021, § 388-97-1480, filed 12/29/09, effective 1/29/10. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1480, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1500 Tuberculosis—Positive test result.

When there is a positive result to tuberculosis skin or blood testing the nursing home must:

(1) Ensure that the person has a chest X-ray within seven days;

(2) Evaluate each resident or person with a positive test result for signs and symptoms of tuberculosis; and

(3) Follow the recommendation of the person's health care provider.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 10-02-021, § 388-97-1500, filed 12/29/09, effective 1/29/10. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1500, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1520 Tuberculosis—Negative test result.

The nursing home may be required by the public health provider or licensing authority to ensure that persons with negative test results have follow-up testing in certain circumstances, such as:

(1) After exposure to active tuberculosis;

(2) When tuberculosis symptoms are present; or

(3) For periodic testing as determined by the health provider.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 10-02-021, § 388-97-1520, filed 12/29/09, effective 1/29/10. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1520, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1540 Tuberculosis—Declining a skin test.

The nursing home must ensure that a person take the blood test for tuberculosis if they decline the skin test.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 10-02-021, § 388-97-1540, filed 12/29/09, effective 1/29/10. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1540, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1560 Tuberculosis—Reporting—Required.

The nursing home must:

(1) Report any person with tuberculosis symptoms or a positive chest X-ray to the appropriate health care provider or public health provider;

(2) Follow the infection control and safety measures ordered by the person's health care provider, including a public health provider;

(3) Institute appropriate measures for the control of the transmission of droplet nuclei;

(4) Apply living or work restrictions where residents or personnel are, or may be, infectious and pose a risk to other residents and personnel; and

(5) Ensure that personnel caring for a resident with suspected tuberculosis comply with the WISHA standard for respiratory protection found in chapter 296-842 WAC.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 10-02-021, § 388-97-1560, filed 12/29/09, effective 1/29/10. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1560, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1580 Tuberculosis—Test records.

(1) The department amended or suspended portions of this section from January 25, 2021, through September 23, 2021, in response to the state of emergency related to the COVID-19 pandemic. For requirements in place during that time, see WAC 388-97-15801.

(2) The nursing home must:

(a) Keep the records of tuberculin test results, reports of X-ray findings, and any physician or public health provider orders in the nursing home;

(b) Make the records readily available to the appropriate health authority and licensing agency;

(d) Provide the person a copy of their test results.

History

Statutory Authority: RCW 74.42.620 and chapter 18.51 RCW. WSR 24-07-008, § 388-97-1580, filed 3/7/24, effective 4/7/24. Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 10-02-021, § 388-97-1580, filed 12/29/09, effective 1/29/10. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1580, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-15801 Tuberculosis—Test records—Requirements in effect January 25, 2021, through September 23, 2021, in response to the state of emergency related to the COVID-19 pandemic.

(1) In response to the state of emergency related to the COVID-19 pandemic, the department adopted emergency rules under RCW 34.05.350 on January 25, 2021, to amend and suspend portions of WAC 388-97-1580. The emergency rules remained in effect until September 23, 2021. The following rule was in effect during that time:

(2) The nursing home must:

(a) Keep the records of tuberculin test results, reports of X-ray findings, and any physician or public health provider orders in the nursing home;

(b) Keep the records of the tuberculosis symptom assessment and the documented rationale for deferring the tuberculosis testing in the nursing home, if tuberculosis testing is deferred in accordance with WAC 388-97-1380(2);

(d) Retain the records for 18 months beyond the date of employment termination; and

(e) Provide the person a copy of their test results.

History

Statutory Authority: RCW 74.42.620 and chapter 18.51 RCW. WSR 24-07-008, § 388-97-15801, filed 3/7/24, effective 4/7/24.

Wash. Admin. Code § 388-97-1600 Care of residents with active tuberculosis.

(1) When the nursing home accepts the care of a resident with suspected or confirmed tuberculosis, the nursing home must:

(a) Coordinate the resident's admission, nursing home care, discharge planning, and discharge with the health care provider;

(b) Provide necessary education about tuberculosis for staff, visitors, and residents; and

(c) Ensure that personnel caring for a resident with active tuberculosis comply with the WISHA standards for respiratory protection, chapter 296-842 WAC.

(2) For a resident who requires respiratory isolation for tuberculosis, the nursing home must:

(a) Provide a private or semiprivate isolation room:

(i) In accordance with WAC 388-97-2480;

(ii) In which, construction review of the department of health determines that room air is maintained under negative pressure; and appropriately exhausted, either directly to the outside away from intake vents or through properly designed, installed, and maintained high efficiency particulate air (HEPA) filters, or other measures deemed appropriate to protect others in the facility;

(iii) However, when a semiprivate isolation room is used, only residents requiring respiratory isolation for confirmed or suspected tuberculosis are placed together.

(b) Provide supplemental environment approaches, such as ultraviolet lights, where deemed to be necessary;

(d) Have measures in place for the decontamination of equipment and other items used by the resident.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 10-02-021, § 388-97-1600, filed 12/29/09, effective 1/29/10. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1600, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1620 General administration.

(1) The nursing home must be administered in a manner that enables it to use its resources effectively and efficiently to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident.

(2) The nursing home must:

(a) Be licensed under chapter 18.51 RCW;

(b) Operate and provide services in compliance with:

(i) All applicable federal, state and local laws, regulations, and codes;

(ii) Accepted professional standards and principles that apply to professionals providing services in nursing homes; and

(c) Have a governing body or designated individuals functioning as a governing body, that is legally responsible for establishing and implementing policies regarding the management and operation of the nursing home.

(3) The governing body of the nursing home must appoint the administrator who:

(a) Is licensed by the state;

(b) Is responsible for management of the nursing home;

(d) Complies with all requirements of chapter 18.52 RCW, and all regulations adopted under that chapter;

(e) Is an on-site, full-time individual in active administrative charge at the premises of only one nursing home, a minimum of four days and an average of forty hours per week except as provided in WAC 246-843-010.

(4) Nursing homes temporarily without an administrator may operate up to four continuous weeks under a responsible individual authorized to act as nursing home administrator designee.

(a) The designee must be qualified by experience to assume designated duties; and

(b) The nursing home must have a written agreement with a nursing home administrator, licensed in the state of Washington, who must be readily available to consult with the designee.

(c) The nursing home may make a written request to the department's designated aging and disability services administration field office for an extension of the four weeks by stating why an extension is needed, how a resident's safety or well-being is maintained during an extension and giving the estimated date by which a full-time, qualified nursing home administrator will be on-site.

(5) The nursing home must employ on a full-time, part time or consultant basis those professionals necessary to carry out the requirements of this chapter.

(6) If the nursing home does not employ a qualified professional individual to furnish a specific service to be provided by the nursing home, the nursing home must:

(a) Have that service furnished to residents by an individual or agency outside the nursing home under a written arrangement or agreement; and

(b) Ensure the arrangement or agreement referred to in (a) of this subsection specifies in writing that the nursing home assumes responsibility for:

(i) Obtaining services that meet professional standards and principles that apply to professionals providing services in nursing homes; and

(ii) The timeliness of services.

(7) The nursing home must:

(a) Report to the local law enforcement agency and the department any individual threatening bodily harm or causing a disturbance which threatens any individual's welfare and safety;

(b) Identify, investigate, and report incidents involving residents, according to department established nursing home guidelines; and

(8) The department will:

(a) Investigate complaints, made to the department according to established protocols including protocols described in RCW 74.39A.060;

(b) Take action against a nursing home that is found to have used retaliatory treatment toward a resident or employee who has voiced grievances to nursing home staff or administration, or lodged a good faith complaint with the department; and

(i) Any mandated reporter that knowingly fails to report in accordance with WAC 388-97-0640; and

(ii) Any person that intentionally, maliciously or in bad faith makes a false report of alleged abandonment, abuse, financial exploitation, or neglect of a vulnerable adult.

(9) Refer also to WAC 388-97-1840, Retaliation.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 13-04-093, § 388-97-1620, filed 2/6/13, effective 3/9/13. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1620, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1640 Required notification and reporting.

(1) The nursing home must immediately notify the department's home and community living administration of:

(a) Any allegations of resident abandonment, abuse, or neglect, including substantial injuries of an unknown source, financial exploitation and misappropriation of a resident's property;

(b) Any unusual event, having an actual or potential negative impact on residents, requiring the actual or potential implementation of the nursing home's disaster plan. These unusual events include but are not limited to those listed under WAC 388-97-1740 (1)(a) through (o), and could include the evacuation of all or part of the residents to another area of the nursing home or to another address; and

(2) Mandated reporters must notify the department and law enforcement as directed in WAC 388-97-0640, and according to department established nursing home guidelines.

(3) The nursing home must notify the department's home and community living administration of:

(a) Physical plant changes, including but not limited to:

(i) New construction;

(ii) Proposed resident area or room use change;

(iii) Resident room number changes; and

(iv) Proposed bed banking.

(b) Mechanical failure of equipment important to the everyday functioning of the nursing home, which cannot be repaired within a reasonable time frame, such as an elevator; and

(4) The nursing home must notify, in writing, the department's home and community living administration and each resident, of a loss of, or change in, the nursing home's administrator or director of nursing services at the time the loss or change occurs.

(5) The nursing home licensee must notify the department's home and community living administration in writing of any change in the name of the licensee, or of the nursing home, at the time the change occurs.

(6) If a licensee operates in a building it does not own, the licensee must immediately notify the department of the occurrence of any event of default under the terms of the lease, or if it receives verbal or written notice that the lease agreement will be terminated, or that the lease agreement will not be renewed.

(7) The nursing home must report any case or suspected case of a reportable disease to the appropriate department of health officer and must also notify the appropriate department(s) of other health and safety issues, according to state and local laws.

(8) In the event of a nursing home's voluntary closure, the nursing home must:

(a) Notify all residents and resident representatives, the department's designated home and community living administration office, the state long-term ombuds, and, if the facility is medicare-certified, the Centers for Medicare and Medicaid Services;

(b) Send the written notification at least 60 days before closure;

(c) Ensure that the relocation of residents and any required notice to the Centers for Medicare and Medicaid Services and the public is done in accordance with WAC 388-97-4320.

(9) The nursing home licensee must provide written notice of its intention to voluntarily terminate its medicare or medicaid contract, to:

(a) The department's designated home and community living administration office;

(b) The Washington health care authority;

(d) All residents and, when appropriate, resident representatives; and

(e) The public.

(10) The written notice required in subsection (9) of this section must be provided, at least 60 days before contract termination, except notice to Centers for Medicare and Medicaid Services and the public must be provided in accordance with the requirements of 42 C.F.R. 489.52.

(11) If a nursing home voluntarily withdraws from participation in the medicaid program, but continues to provide nursing facility services, the nursing home will be subject to 42 U.S.C. 1396r (c)(2)(F), which prohibits the discharge of medicaid residents who are residing in the facility before the effective date of the withdrawal.

History

Statutory Authority: RCW 18.20.090, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 25-16-099, s 388-97-1640, filed 8/6/25, effective 9/6/25. Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 14-12-040, § 388-97-1640, filed 5/29/14, effective 6/29/14
WSR 13-04-093, § 388-97-1640, filed 2/6/13, effective 3/9/13
WSR 11-22-077, § 388-97-1640, filed 11/1/11, effective 12/2/11. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1640, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1645 Resident roster and complete contact information.

(1) Resident roster;

The nursing home must:

(a) Create and regularly maintain a current resident roster containing the name and room number of each resident; and

(b) Provide a written copy of the resident roster upon an in-person request from any long-term care ombuds at the time of the visit and not later than the conclusion of the visit.

(2) Complete contact information;

The nursing home must:

(a) Create and regularly maintain current, accurate, and complete contact information for all residents including the following resident information:

(i) Name;

(ii) Room number;

(iii) Phone number, if available;

(iv) Email address, if available; and

(v) If a resident has a representative, the representative's:

(A) Name;

(B) Relationship to the resident;

(D) Email address, if available; and

(E) Mailing address, if available.

(b) Record and update the aggregated contact information required by this section upon receipt of new or updated contact information from the resident or resident representative; and

(c) Upon the written request, either physical or electronic, of any long-term care ombuds that includes reference to RCW 18.51.095 and the relevant legal functions and duties of long-term care ombuds, provide a copy of the aggregated contact information required by this section at the time of the visit and not later than the conclusion of the visit, by electronic copy to the secure email address or facsimile number provided in the written request.

History

Statutory Authority: RCW 18.20.090, 18.51.070, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 26-05-046, s 388-97-1645, filed 2/12/26, effective 3/15/26.

Wash. Admin. Code § 388-97-1660 Staff and equipment.

(1) The nursing home must ensure that:

(a) Sufficient numbers of appropriately qualified and trained staff are available to provide necessary care and services safely under routine conditions, as well as fire, emergency, and disaster situations;

(b) Adequate equipment, supplies and space are available to carry out all functions and responsibilities of the nursing home;

(i) Empowering each resident to attain or maintain the highest practicable physical, mental, and psychosocial well-being, self-care and independence;

(ii) Respecting resident rights; and

(iii) Enhancing each resident's quality of life.

(2) The nursing home must ensure that any employee giving direct resident care, excluding professionally licensed nursing staff:

(a) Has successfully completed or is a student in a DSHS-approved nursing assistant training program; and

(b) Meets other requirements applicable to individuals performing nursing related duties in a nursing home, including those which apply to minors.

(3) The nursing home must ensure:

(a) Students in an DSHS-approved nursing assistant training program:

(i) Complete training and competency evaluation within four months of beginning work as a nursing assistant;

(ii) Complete at least sixteen hours of training in communication and interpersonal skills, infection control, safety/emergency procedures including the Heimlich maneuver, promoting residents' independence, and respecting residents' rights before any direct contact with a resident; and

(iii) Wear name tags which clearly identify student or trainee status at all times in all interactions with residents and visitors in all nursing homes, including the nursing homes in which the student completes clinical training requirements and in which the student is employed.

(b) Residents and visitors have sufficient information to distinguish between the varying qualifications of nursing assistants; and

(c) Each employee hired as a nursing assistant applies for registration with the department of health within three days of employment in accordance with chapter 18.88A RCW.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1660, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1680 Staff development.

(1) The nursing home must have a staff development program that is under the direction of a designated registered nurse or licensed practical nurse.

(2) The nursing home must:

(a) Ensure each employee receives initial orientation to the facility and its policies and is initially assigned only to duties for which the employee has demonstrated competence;

(b) Ensure all employees receive appropriate inservice education to maintain a level of knowledge appropriate to, and demonstrated competence in, the performance of ongoing job duties consistent with the principle of assisting the resident to attain or maintain the highest practicable physical, mental, and psychosocial well-being. To this end, the nursing home must:

(i) Assess the specific training needs of each employee and address those needs; and

(ii) Determine the special needs of the nursing home's resident population which may require training emphasis.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1680, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1700 Medical director.

(1) The nursing home must designate a physician to serve as medical director.

(2) The medical director is responsible for:

(a) Implementation of resident care policies; and

(b) The coordination of medical care in the facility.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1700, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1720 Clinical records.

(1) The nursing home must:

(a) Maintain clinical records on each resident in accordance with accepted professional standards and practices that are:

(i) Complete;

(ii) Accurately documented;

(iii) Readily accessible; and

(iv) Systematically organized.

(b) Safeguard clinical record information against alteration, loss, destruction, and unauthorized use; and

(c) Keep confidential all information contained in the resident's records, regardless of the form or storage method of the records, except when release is required by:

(i) Transfer to another health care institution;

(ii) Law;

(iii) Third party payment contract; or

(iv) The resident.

(2) The nursing home must ensure the clinical record of each resident includes at least the following:

(a) Resident identification and sociological data, including:

(i) Name;

(ii) Room number;

(iii) Resident telephone number, if available; and

(iv) Resident email address, if available.

(b) If a resident has a representative, the following representative information:

(i) Name;

(ii) Relationship to the resident;

(iii) Phone number;

(iv) Email address, if available; and

(v) Mailing address, if available.

(d) Medical information required under WAC 388-97-1260;

(e) Physician's orders;

(f) Assessments;

(g) Plans of care;

(h) Services provided;

(i) In the case of the medicaid-certified nursing facility, records related to preadmission screening and resident review;

(j) Progress notes;

(k) Medications administered;

(l) Consents, authorizations, releases;

(m) Allergic responses;

(n) Laboratory, X-ray, and other findings; and

(o) Other records as appropriate.

(3) The nursing home must:

(a) Designate an individual responsible for the record system who:

(i) Has appropriate training and experience in clinical record management; or

(ii) Receives consultation from a qualified clinical record practitioner, such as a registered health information administrator or registered health information technician.

(b) Make all records available to authorized representatives of the department for review and duplication as necessary; and

(i) A master resident index having a reference for each resident including the health record number, if applicable; full name; date of birth; admission dates; and discharge dates; and

(ii) A chronological census register, including all admissions, discharge, deaths, and transfers, and noting the receiving facility. The nursing home must ensure the register includes discharges for social leave and transfers to other treatment facilities in excess of 24 hours.

(4) The nursing home must ensure the clinical record of each resident:

(a) Is documented and authenticated accurately, promptly, and legibly by individuals giving the order, making the observation, performing the examination, assessment, treatment, or providing the care and services. "Authenticated" means the authorization of a written entry in a record by signature, including the first initial and last name and title, or a unique identifier allowing identification of the responsible individual; and:

(i) Documents from other health care facilities that are clearly identified as being authenticated at that facility will be considered authenticated at the receiving facility; and

(ii) The original or a durable, legible, direct copy of each document will be accepted.

(b) Contains appropriate information for a deceased resident including:

(i) The time and date of death;

(ii) Apparent cause of death;

(iii) Notification of the physician and appropriate resident representative; and

(iv) The disposition of the body and personal effects.

(5) In cases where the nursing home maintains records by computer rather than hard copy, the nursing home must:

(a) Have in place safeguards to prevent unauthorized access; and

(b) Provide for reconstruction of information.

(6) The nursing home licensee must:

(a) Retain health records for the time period required in RCW 18.51.300:

(i) For a period of no less than eight years following the most recent discharge of the resident; except

(ii) That the records of minors must be retained for no less than three years following the attainment of age 18 years, or 10 years following their most recent discharge, whichever is longer.

(b) In the event of a change of ownership, provide for the orderly transfer of clinical records to the new licensee;

(c) In the event a nursing home ceases operation, make arrangements prior to cessation, as approved by the department, for preservation of the clinical records. The nursing home licensee must provide a plan for preservation of clinical records to the department's designated local home and community living administration office no later than seven days after the date of notice of nursing home closure as required by WAC 388-97-1640 (8) and (9) unless an alternate date has been approved by the department; and

(d) Provide a resident access to all records pertaining to the resident as required under WAC 388-97-0300(2).

History

Statutory Authority: RCW 18.20.090, 18.51.070, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 26-05-046, s 388-97-1720, filed 2/12/26, effective 3/15/26. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1720, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1740 Disaster and emergency preparedness.

The department amended or suspended portions of this section from June 23, 2020, through June 7, 2022, in response to the state of emergency related to the COVID-19 pandemic. For requirements in place during that time, see WAC 388-97-17401.

(1) The nursing home must develop and implement detailed written plans and procedures to meet potential emergencies and disasters. At a minimum the nursing home must ensure these plans provide for:

(a) Fire or smoke;

(b) Flood;

(d) Loss of power or water;

(e) Earthquake;

(f) Explosion;

(g) Missing resident, elopement;

(h) Loss of normal water supply;

(i) Bomb threats;

(j) Armed individuals;

(k) Gas leak, or loss of service;

(l) Loss of heat supply;

(m) Infectious disease outbreak; and

(n) Any other events that may require sheltering in place, evacuations, or other emergency measures to protect the health and safety of residents.

(2) The nursing home emergency preparedness plan must:

(a) Be developed and maintained with the assistance of qualified fire, safety, and other appropriate experts as necessary;

(b) Include procedures for:

(i) Staff roles and responsibilities;

(ii) Accounting for residents;

(iii) Summoning emergency assistance and coordinating with first responders;

(iv) Plans for evacuation of the facility;

(v) Communicating emergency information to staff and residents as well as external partners, including emergency contacts for residents, state and local agencies, developmental disability ombuds, and long-term care ombuds;

(vi) How resident care and treatment needs will be maintained; and

(vii) Provision of essential resident needs and supplies, including water, food, medications, and personal care items.

(3) The nursing home must incorporate infection prevention and control capabilities into its emergency preparedness plan. At a minimum, the plan must:

(b) Describe how the facility will ensure adequate staffing and implement isolation or cohorting procedures during an infectious disease emergency.

(4) In addition to the plan requirements, the nursing home must:

(b) Train all employees in emergency procedures when they begin work in the nursing home, review emergency procedures with existing staff at least annually, and carry out unannounced staff drills using those procedures;

(d) Communicate the location of the emergency preparedness plan to residents and staff to ensure access as needed during emergencies;

(e) Prominently post evacuation route(s) throughout the facility, and at minimum on every floor, if applicable; and

(f) Comply with WAC 388-97-4360.

History

Statutory Authority: RCW 18.20.090, 18.51.070, 70.97.230, chapters 70.129, 74.42, and 74.39 RCW. WSR 26-02-045, s 388-97-1740, filed 1/2/26, effective 2/2/26. Statutory Authority: RCW 74.42.620 and chapter 18.51 RCW. WSR 24-07-008, § 388-97-1740, filed 3/7/24, effective 4/7/24. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1740, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-17401 Disaster and emergency preparedness—Requirements in effect June 23, 2020, through June 7, 2022, in response to the state of emergency related to the COVID-19 pandemic.

In response to the state of emergency related to the COVID-19 pandemic, the department adopted emergency rules under RCW 34.05.350 on June 23, 2020, to amend and suspend portions of WAC 388-97-1740. The emergency rules remained in effect until June 7, 2022. The following rule was in effect during that time:

(1) The nursing home must develop and implement detailed written plans and procedures to meet potential emergencies and disasters. At a minimum the nursing home must ensure these plans provide for:

(a) Fire or smoke;

(b) Severe weather;

(d) Earthquake;

(e) Explosion;

(f) Missing resident, elopement;

(g) Loss of normal water supply;

(h) Bomb threats;

(i) Armed individuals;

(j) Gas leak, or loss of service; and

(k) Loss of heat supply.

(2) The nursing home must train all employees in emergency procedures when they begin work in the nursing home, and periodically review emergency procedures with existing staff.

(3) The nursing home must ensure emergency plans:

(a) Are developed and maintained with the assistance of qualified fire, safety, and other appropriate experts as necessary;

(b) Are reviewed annually; and

History

Statutory Authority: RCW 74.42.620 and chapter 18.51 RCW. WSR 24-07-008, § 388-97-17401, filed 3/7/24, effective 4/7/24.

Wash. Admin. Code § 388-97-1760 Quality assessment and assurance.

The department amended or suspended portions of this section from June 23, 2020, through May 7, 2022, in response to the state of emergency related to the COVID-19 pandemic. For requirements in place during that time, see WAC 388-97-17601.

(1) The nursing home must maintain a process for quality assessment and assurance. The department may not require disclosure of the records of the quality assessment and assurance committee except in so far as such disclosure is related to ensuring compliance with the requirements of this section.

(2) The nursing home must ensure the quality assessment and assurance process:

(a) Seeks out and incorporates input from the resident and family councils, if any, or individual residents and support groups; and

(b) Reviews expressed concerns and grievances.

History

Statutory Authority: RCW 74.42.620 and chapter 18.51 RCW. WSR 24-07-008, § 388-97-1760, filed 3/7/24, effective 4/7/24. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1760, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-17601 Quality assessment and assurance—Requirements in effect June 23, 2020, through May 7, 2022, in response to the state of emergency related to the COVID-19 pandemic.

In response to the state of emergency related to the COVID-19 pandemic, the department adopted emergency rules under RCW 34.05.350 on June 23, 2020, to amend and suspend portions of WAC 388-97-1760. The emergency rules remained in effect until May 7, 2022. The following rule was in effect during that time:

(2) The nursing home must ensure the quality assessment and assurance process:

(a) Seeks out and incorporates input from the residents and resident representatives; and

(b) At a minimum, reviews adverse events and infection control.

History

Statutory Authority: RCW 74.42.620 and chapter 18.51 RCW. WSR 24-07-008, § 388-97-17601, filed 3/7/24, effective 4/7/24.

Wash. Admin. Code § 388-97-1780 Policies and procedures.

(1) The nursing home must develop and implement written policies and procedures, including those specified in RCW 74.42.430, for all services provided in the facility.

(2) The nursing home must ensure the written policies and procedures:

(a) Promote and protect each resident's:

(i) Rights, including health care decision making;

(ii) Personal interests; and

(iii) Financial and property interests.

(b) Are readily available to staff, residents, members of residents' families, the public, and representatives of the department;

(d) Are consistent with other state and federal laws applicable to nursing home operations.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1780, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1790 Background checks—General.

(1) If any background check results show that an employee or prospective employee has a conviction or pending charge for a crime that is not automatically disqualifying under chapter 388-113 WAC, then the nursing home must:

(a) Determine whether the person has the character, competence and suitability to work with vulnerable adults in long-term care; and

(b) Document in writing the basis for making the decision, and make it available to the department upon request.

(2) Nothing in this section should be interpreted as requiring the employment of any person against the better judgment of the nursing home. In addition to chapter 71A.12 RCW, these rules are authorized by RCW 43.20A.710, 43.43.830 through 43.43.842 and 74.39A.051.

History

Statutory Authority: RCW 74.39A.056 and chapters 74.42, 18.51 RCW. WSR 14-14-027, § 388-97-1790, filed 6/24/14, effective 7/25/14.

Wash. Admin. Code § 388-97-1800 Criminal history disclosure and background inquiries.

(1) As used in this section, the term "nursing home" includes a nursing facility and a skilled nursing facility.

(2) The nursing home must:

(a) Have a valid criminal history background check for any individual employed, directly or by contract, or any individual accepted as a volunteer or student who may have unsupervised access to any resident; and

(b) Repeat the check every two years.

(3) A nursing home licensed under chapter 18.51 RCW, or nursing facility or skilled nursing facility must make a background inquiry request to one of the following:

(a) The department;

(b) The most recent employer licensed under chapters 18.51, 18.20, and 70.128 RCW provided termination of that employment was within twelve months of the current employment application and provided the inquiry was completed by the department or the Washington state patrol within the two years of the current date of application; or

(c) A nurse pool agency licensed under chapter 18.52C RCW, or hereafter renamed, provided the background inquiry was completed by the Washington state patrol within two years before the current date of employment in the nursing home.

(4) A nursing home may not rely on a criminal background inquiry from a former employer, including a nursing pool, if the nursing home knows or has reason to know that the individual applying for the job is, or may be disqualified under the requirements of WAC 388-97-1820.

(5) Nursing homes must:

(a) Request a background inquiry of any individual employed, directly or by agreement or contract, or accepted as a volunteer or student; and

(b) Notify the appropriate licensing or certification agency of any individual who resigns or is terminated because he or she is disqualified from employment under WAC 388-97-1820.

(6) Before a nursing home employs any individual, directly or by contract, or accepts any individual as a volunteer or student, a nursing home must:

(a) Inform the individual that the nursing home must make a background inquiry and require the individual to sign a disclosure statement, under penalty of perjury and in accordance with RCW 43.43.834;

(b) Inform the individual that he or she may request a copy of the results of the completed background inquiry described in this section; and

(c) Require the individual to sign a statement authorizing the nursing home, the department, and the Washington state patrol to make a background inquiry; and

(d) Verbally inform the individual of the background inquiry results within seventy-two hours of receipt.

(7) The nursing home must establish procedures ensuring that:

(a) The individual is verbally informed of the background inquiry results within seventy-two hours of receipt;

(b) All disclosure statements and background inquiry responses and all copies are maintained in a confidential and secure manner;

(d) Disclosure statements and background inquiry responses are not disclosed to any individual except:

(i) The individual about whom the nursing home made the disclosure or background inquiry;

(ii) Authorized state employees including the department's licensure and certification staff, resident protection program staff and background inquiry unit staff;

(iii) Authorized federal employees including those from the Department of Health and Human Services, Centers for Medicare and Medicaid Services;

(iv) The Washington state patrol auditor; and

(v) Potential employers licensed under chapters 18.51, 18.20, and 70.128 RCW who are making a request as provided for under subsection (1) of this section.

(e) A record of findings be retained by the nursing home for twelve months beyond the date of employment termination.

History

Statutory Authority: RCW 74.39A.056 and chapters 74.42, 18.51 RCW. WSR 14-14-027, § 388-97-1800, filed 6/24/14, effective 7/25/14. Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 10-02-021, § 388-97-1800, filed 12/29/09, effective 1/29/10. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1800, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1820 Disqualification from nursing home employment.

(1) The nursing home must not employ directly or by contract, or accept as a volunteer or student, any individual:

(a) Who has a criminal conviction or pending charge for a crime, which is automatically disqualifying under chapter 388-113 WAC;

(b) Who has one or more of the following disqualifying negative actions:

(i) Is on a registry based upon a final finding of abuse, neglect, or financial exploitation of a vulnerable adult, unless the finding was made by adult protective services prior to October 2003;

(ii) Has a founded finding of abuse or neglect of a child that was made against the person, unless the finding was made by child protective services prior to October 1, 1998;

(iii) Had a contract or license denied, terminated, revoked, or suspended due to abuse, neglect, financial exploitation, or mistreatment of a child or vulnerable adult;

(iv) Has relinquished a license or terminated a contract because an agency was taking an action against the individual related to alleged abuse, neglect, financial exploitation or mistreatment of a child or vulnerable adult;

(v) Was found in any dependency action to have sexually assaulted or exploited any child or to have physically abused any child;

(vi) Was found by a court in a domestic relations proceeding under Title 26 RCW, or under any comparable state or federal law, to have sexually abused or exploited any child or to have physically abused any child;

(vii) A court has issued a permanent restraining order or order of protection, either active or expired, against the individual that was based upon abuse, neglect, financial exploitation, or mistreatment of a child or vulnerable adult; or

(viii) Is a registered sex offender.

(2) In addition to chapters 18.51 and 74.42 RCW, these rules are authorized by RCW 43.20A.710, 43.43.830 through 43.43.842 and 74.39A.050(8).

History

Statutory Authority: RCW 74.39A.056 and chapters 74.42, 18.51 RCW. WSR 14-14-027, § 388-97-1820, filed 6/24/14, effective 7/25/14. Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 10-02-021, § 388-97-1820, filed 12/29/09, effective 1/29/10. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1820, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1840 Retaliation or discrimination prohibited.

(1) The licensee or the nursing home must not discriminate or retaliate in any manner against a resident or employee in its nursing home who has initiated or participated in any action or proceeding authorized under nursing home licensing law. Examples of such participation include, but are not limited to the following:

(a) The resident, or someone acting on behalf of the resident, or the employee:

(i) Made a complaint, including a whistle blower complaint, to the department, the department of health, the long-term care ombuds, attorney general's office, the courts or law enforcement;

(ii) Provided information to the department, the department of health, the long-term care ombuds, attorney general's office, the courts or law enforcement; or

(iii) Testified in a proceeding related to the nursing home or its staff.

(2) For purposes of this chapter, "retaliation" or "discrimination" against a resident means an act including, but not limited to:

(a) Verbal or physical harassment or abuse;

(b) Any attempt to expel the resident from the facility;

(d) Lessening of the level of care when not medically appropriate;

(e) Nonvoluntary relocation within a nursing home without appropriate medical, psychosocial, or nursing justification;

(f) Neglect or negligent treatment;

(g) Withholding privileges;

(h) Monitoring resident's phone, mail or visits without resident's permission;

(i) Withholding or threatening to withhold food or treatment unless authorized by terminally ill resident or the resident's representative;

(j) Persistently delaying responses to resident's request for services of assistance; or

(k) Infringement on a resident's rights described in chapter 74.42 RCW, RCW 74.39A.060(7), WAC 388-97-0180, and also, for medicaid and medicare certified nursing facilities, in federal laws and regulations.

(3) For purposes of this chapter, "retaliation" or "discrimination" against an employee means an act including, but not limited to:

(a) Harassment;

(b) Unwarranted firing;

(d) Unjustified disciplinary action;

(e) Denial of adequate staff to perform duties;

(f) Frequent staff changes;

(g) Frequent and undesirable office changes;

(h) Refusal to assign meaningful work;

(i) Unwarranted and unsubstantiated report of misconduct under Title 18 RCW;

(j) Unsubstantiated letters of reprimand;

(k) Unsubstantiated unsatisfactory performance evaluations;

(l) Denial of employment;

(m) A supervisor or superior encouraging coworkers to behave in a hostile manner toward the whistle blower; or

(n) Workplace reprisal or retaliatory action as defined in RCW 74.34.180 (3)(b).

(4) For purposes of this chapter, a "whistle blower" is defined in WAC 388-97-0001.

(5) If, within one year of the complaint by or on behalf of a resident, the resident is involuntarily discharged from the nursing home, or is subjected to any type of discriminatory treatment, there will be a presumption that the action was in retaliation for the filing of the complaint. Under these circumstances, the nursing home will have the burden of establishing that the action was not retaliatory, in accordance with RCW 18.51.220 and 74.34.180(2).

History

Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 14-12-040, § 388-97-1840, filed 5/29/14, effective 6/29/14. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1840, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1860 Laundry services.

(1) The nursing home must meet the requirements of WAC 388-97-2780, and:

(a) Launder nursing home linens on the premises; or

(b) Contract with a laundry service capable of meeting quality standards, infection control, and turn-around time requirements; and

(2) For residents' personal clothing, the nursing home:

(a) Must have a system in place to ensure that personal clothing is not damaged or lost during handling and laundering; and

(b) May use a chemical disinfectant in lieu of hot water disinfection provided that the nursing home:

(i) Uses the product according to the manufacturer's instructions; and

(ii) Has readily available, current documentation from the manufacturer that supports the claim that the product is effective as a laundry disinfectant and such documentation is based on scientific studies or other rational data. "Disinfectant" means a germicide that inactivates virtually all recognized pathogenic microorganisms (but not necessarily all microbial forms, such as bacterial spores) on inanimate objects.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1860, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1880 Short-term care, including respite services and adult day or night care.

(1) The nursing home may provide short-term care to individuals which include:

(a) Respite services to provide relief care for families or other caregivers of individuals with disabilities which must:

(i) Provide short-term care and supervision in substitution for the caregiver;

(ii) Be for short-term stays up to a maximum of thirty-one days; and

(iii) Not be used as a short-term placement pending the individual's admission to the nursing home.

(b) Adult day or night care to provide short-term nursing home care:

(i) Not to exceed sixteen hours each day; and

(ii) May be on a regular or intermittent basis.

(2) The nursing home providing respite services, and adult day or night care must:

(a) Develop and implement policies and procedures consistent with this section;

(b) Ensure that individuals receiving short-term services under respite or adult day or night care are treated and cared for in accordance with the rights and choices of long-term residents, except for transfer and discharge rights which are provided under the program for short-term services which covers the individual in the nursing home;

(c) Have appropriate and adequate staff, space, and equipment to meet the individual's needs without jeopardy to the care of regular residents;

(d) Before or at the time of admission, obtain sufficient information to meet the individual's anticipated needs. At a minimum, such information must include:

(i) The name, address, and telephone number of the individual's attending physician, and alternate physician if any;

(ii) Medical and social history, which may be obtained from a respite care assessment and service plan performed by a case manager designated by an area agency on aging under contract with the department, and mental and physical assessment data; and

(iii) Physician's orders for diet, medication and routine care consistent with the individual's status on admission.

(e) Ensure the individuals have assessments performed, where needed, and where the assessment of the individual reveals symptoms of tuberculosis, follow tuberculosis testing requirements under WAC 388-97-1360 through 388-97-1580;

(f) With the participation of the individual and, where appropriate, their representative, develop a plan of care to maintain or improve their health and functional status during their stay or care in the nursing home;

(g) Provide for the individual to:

(i) Bring medications from home in accordance with nursing home policy; and

(ii) Self-medicate where determined safe.

(h) Promptly report injury, illness, or other adverse change in health condition to the attending physician; and

(i) Inquire as to the need for and comply with any request of the individual, or where appropriate, the individual's representative, to secure cash and other valuables brought to the nursing home during the stay/care.

(3) The nursing home may, in lieu of opening a new record, reopen the individual's clinical record with each period of stay or care up to one year from the previous stay or care, provided the nursing home reviews and updates the recorded information.

(4) Medicaid certified nursing facilities must complete the state-approved resident assessment instrument, within fourteen days, for any individual whose respite stay exceeds fourteen days.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1880, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1900 Dialysis services.

(1) The nursing home must ensure that appropriate care, treatment, and services are provided to each nursing home resident who receives dialysis in the nursing home.

(2) For the purposes of this section the following definitions apply:

(a) "Dialysis" means the process of separating crystalloids and colloids in solution by means of the crystalloids and colloids unequal diffusion through a natural or artificial semipermeable membrane. This includes both peritoneal and hemodialysis.

(b) A "kidney center" means a facility as defined and certified by the federal government to provide end stage renal (ESRD) services.

(3) The nursing home must not administer dialysis for a resident with acute renal failure in the nursing home.

(4) A nursing home may only administer maintenance dialysis in the nursing home after:

(a) Other options have been analyzed and rejected, based on the resident's best interest; and

(b) A decision is made jointly by a team of individuals representing the kidney center and the nursing home, the resident, and the resident's nephrologist.

(5) The nursing home must ensure that a current written agreement is in effect with each kidney center responsible for the management and care of each nursing home resident undergoing dialysis. The agreement must include all aspects of how the resident's care is to be managed including:

(a) Medical and nonmedical emergencies;

(b) Development and implementation of the resident's care plan related to dialysis issues;

(d) The responsibility for waste handling, sterilization, and disinfection of equipment for dialysis done in the nursing home.

(6) The nursing home must ensure implementation of policies and procedures developed with the kidney center that:

(a) Meet current standards of practice;

(b) Addresses both dialysis provided by or in the nursing home as well as dialysis provided by the kidney center; and

History

Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 10-02-021, § 388-97-1900, filed 12/29/09, effective 1/29/10. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-1900, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-1910 Definitions related with PASRR.

"AAA" means area agency on aging.

"Advance categorical determination" means a determination by a mental health or DDA PASRR evaluator that an individual may be admitted to a nursing facility on a temporary basis. The PASRR evaluator will do an abbreviated evaluation that is sufficient to determine that the individual has an intellectual disability or related condition and that the individual meets nursing facility level of care, but does not need specialized services at that time. The potential reasons are:

(1) Protective services stay of not more than seven days;

(2) Respite in a nursing facility for not more than thirty days; and

(3) Delirium (full level II evaluation required when condition improves).

"DDA" means the developmental disabilities administration within the department.

"Exempted hospital discharge" means the process by which an individual who meets the criteria may be admitted to a nursing facility without a PASRR level II evaluation, even though he or she may have a serious mental illness or an intellectual disability or related condition.

"HCS" means home and community services within the department.

"Intellectual disability or related condition" means a condition as defined in 42 C.F.R. §483.102(b)(3) and 42 C.F.R. §435.1010 or successor laws.

"Preadmission screening and resident review process" or "PASRR process" means the process required by federal law to determine if placement in a nursing facility is appropriate for an individual who has a serious mental illness, an intellectual disability or related condition, or both, and if so, to determine whether specialized services are necessary. The PASRR process includes the following steps:

(1) A "PASRR level I" screening is conducted by a referring provider, such as a hospital or physician, or by designated HCS, AAA or DDA staff, to identify whether an individual may have a mental illness, an intellectual disability or related condition, or both. Under the limited circumstances described in this chapter, a nursing facility may conduct the screening. The standardized form and guidelines developed by the department's PASRR program must be used to conduct the Level 1 screening.

(2) A "PASRR level II" evaluation is conducted by the DDA or mental health PASRR evaluator, or both, as appropriate. This evaluation is performed with individuals who, based upon the PASRR level I screening, are suspected of having a mental illness, an intellectual disability or related condition, or both. The level II evaluator determines:

(a) Whether the individual has a serious mental illness and/or an intellectual disability or related condition;

(b) If so, whether nursing facility placement is appropriate; and

"Resident review" means a PASRR level II evaluation of a resident with serious mental illness and/or intellectual disability or related condition after that resident has experienced a significant change in physical or mental condition, as defined in this section.

"Serious mental illness" means a condition as defined in 42 C.F.R. §483.102 (b)(1) or successor laws.

"Significant change in physical or mental condition" for PASRR purpose means a deterioration or improvement in the physical or mental condition of a resident with serious mental illness or intellectual disability or related condition such that:

(1) The resident may reasonably require new, different, or fewer specialized services than the resident had been receiving; or

(2) Community placement is a reasonable consideration for the resident.

"Specialized services" are services provided or arranged for by the department as described in 42 C.F.R. §483.120 or successor laws, which are additional to services the nursing facility is required to provide. The PASRR level II evaluation identifies the specialized services needed by the resident.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. § 483.100-138. WSR 15-18-026, § 388-97-1910, filed 8/25/15, effective 9/25/15.

Wash. Admin. Code § 388-97-1915 PASRR requirements prior to admission of new residents.

The department amended or repealed portions of this section to help facilitate care to align state nursing home rules with federal rules that were amended or suspended to facilitate care during the COVID-19 pandemic from April 13, 2020, through May 10, 2023, in response to the state of emergency. For requirements in place during that time, see WAC 388-97-19151. Prior to every admission of a new resident, the nursing facility must:

(1) Verify that a PASRR level I screening has been completed, and deny admission until that screening has been completed.

(2) Verify that a PASRR level II evaluation has been completed when the individual's PASRR level I screening indicates that the individual may have serious mental illness, intellectual disability, related condition, or any of these and deny admission until that evaluation has been completed, unless all three of the following criteria apply and are documented in the PASRR level I screening:

(a) The individual is admitted directly from a hospital after receiving acute inpatient care;

(b) The individual requires nursing facility services for the condition for which they received care in the hospital; and

(c) The individual's attending physician has certified that the individual is likely to require fewer than 30 days of nursing facility services.

(3) Decline to admit any individual whose PASRR level II evaluation determines that they do not require nursing facility services or that a nursing facility placement is otherwise inappropriate.

(4) Coordinate with PASRR evaluators to the maximum extent practicable in order to avoid duplicative assessments and effort, and to ensure continuity of care for nursing facility residents with a serious mental illness, an intellectual disability, related condition, or any of these.

History

Statutory Authority: RCW 74.42.620. WSR 26-08-015, s 388-97-1915, filed 3/20/26, effective 4/20/26. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. § 483.100-138. WSR 15-18-026, § 388-97-1915, filed 8/25/15, effective 9/25/15.

Wash. Admin. Code § 388-97-19151 PASRR requirements for new residents—Requirements in effect April 13, 2020, through May 10, 2023, in response to the state of emergency related to the COVID-19 pandemic.

In response to the state of emergency related to the COVID-19 pandemic, the department adopted emergency rules under RCW 34.05.350 on April 13, 2020, to amend and repeal portions of WAC 388-97-1915. The emergency rules remained in effect until May 10, 2023. The following rule was in effect during that time, see WSRs 20-09-074, 20-17-048, 21-01-035, 21-08-055, 21-11-018, 21-18-065, 22-01-166, 22-09-014, 22-11-078, 22-19-023, and 23-03-048:

Within 30 days of admission, the nursing facility must:

(1) Complete a PASRR level I screening, or verify that a PASRR level I screening has been completed.

(2) Require a PASRR level II evaluation, or verify that a PASRR level II evaluation has been requested when the individual's PASRR level I screening indicates that the individual may have serious mental illness and/or intellectual disability or related condition.

(3) Coordinate with PASRR evaluators to the maximum extent practicable in order to avoid duplicative assessments and effort, and to ensure continuity of care for nursing facility residents with a serious mental illness and/or an intellectual disability or related condition.

History

Statutory Authority: RCW 74.42.620. WSR 26-08-015, s 388-97-19151, filed 3/20/26, effective 4/20/26.

Wash. Admin. Code § 388-97-1975 PASRR requirements after admission of a resident.

Following a resident's admission, the nursing facility must:

(1) Review all level I screening forms for accuracy. If at any time the facility finds that the previous level I screening was incomplete, erroneous, or is no longer accurate, the facility must immediately complete a new screening using the department's standardized level I form, following the directions provided by the department's PASRR program. If the corrected level I screening identifies a possible serious mental illness or intellectual disability or related condition, the facility must notify DDA or the mental health PASRR evaluator or both so a level II evaluation can be conducted.

(2) Record the evidence of the level I screening and level II determinations (and any subsequent changes) in the resident assessment in accordance with the schedule required under WAC 388-97-1000.

(3) Maintain the level I form and the level II evaluation report in the resident's active clinical record.

(4) Immediately complete a level I screening using the department's standardized form if the facility discovers that a resident does not have a level I screening in their clinical record, following directions provided by the department's PASRR program. If the level I screening identifies a possible serious mental illness or intellectual disability or related condition, notify the DDA, or mental health PASRR evaluator, or both so a level II evaluation can be conducted.

(5) Notify the DDA, or mental health PASRR evaluator, or both when a resident who was admitted on an exempted hospital discharge appears likely to need nursing facility services for more than 30 days, so a level II evaluation can be performed. This notification must occur as soon as the nursing facility anticipates that the resident may require more than 30 days of nursing facility services, and no later than the 25th day after admission unless good cause is documented for later notification.

(6) Notify the DDA, or mental health PASRR evaluator, or both when a resident who was admitted with an advance categorical determination appears likely to need nursing facility services for longer than the period specified by DDA, or the mental health PASRR evaluator, or both, so that a full assessment of the individual's need for specialized services can be performed. This notification must occur as soon as the nursing facility anticipates that the resident will require more than the number of days of nursing facility services authorized for the specific advance categorical determination and no later than five days before expiration of the period (three days for protective services) unless good cause is documented for later notification.

(7) Immediately notify the DDA, or mental health PASRR evaluator, or both for a possible resident review when there has been a significant change in the physical or mental condition, as defined in WAC 388-97-1910, of any resident who has been determined to have a serious mental illness or intellectual disability or related condition. Complete a new level I screening for the significant change.

(8) Provide or arrange for the provision of any services recommended by a PASRR level II evaluator that are within the scope of nursing facility services. If the facility believes that the recommended service either cannot or should not be provided, the facility must document the reason(s) for not providing the service and communicate the reason(s) to the level II evaluator.

(9) Immediately complete a new level I screening using the department's standardized form if the facility finds that a resident, not previously determined to have a serious mental illness, develops symptoms of a serious mental illness, and refer the resident to the mental health PASRR evaluator for further evaluation.

(10) Provide services and interventions that complement, reinforce, and are consistent with any specialized services recommended by the level II evaluator. The resident's plan of care must specify how the facility will integrate relevant activities to achieve this consistency and the enhancement of the PASRR goals.

(11) Discharge, in accordance with WAC 388-97-0120, any resident with a serious mental illness or intellectual disability or related condition who does not meet nursing facility level of care, unless the resident has continuously resided in the facility for at least 30 months and requires specialized services. The nursing facility must cooperate with the DDA, or mental health PASRR evaluator, or both as it prepares the resident for a safe and orderly discharge.

History

Statutory Authority: RCW 74.42.620. WSR 26-08-015, s 388-97-1975, filed 3/20/26, effective 4/20/26. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. § 483.100-138. WSR 15-18-026, § 388-97-1975, filed 8/25/15, effective 9/25/15.

Wash. Admin. Code § 388-97-19751 PASRR requirements after admission of a resident—Requirements in effect April 13, 2020, through May 10, 2023, in response to the state of emergency related to the COVID-19 pandemic.

In response to the state of emergency related to the COVID-19 pandemic, the department adopted emergency rules under RCW 34.05.350 on April 13, 2020, to amend and suspend portions of WAC 388-97-1975. The emergency rules remained in effect until May 10, 2023. The following rule was in effect during that time, see WSRs 20-09-074, 20-17-048, 21-01-035, 21-08-055, 21-11-018, 21-18-065, 22-01-166, 22-09-014, 22-11-078, 22-19-023, and 23-03-048:

After the 30th day of a resident's admission, the nursing facility must:

(1) Review all level I screening forms for accuracy. If at any time the facility finds that the previous level I screening was incomplete, erroneous, or is no longer accurate, the facility must immediately complete a new screening using the department's standardized level I form, following the directions provided by the department's PASRR program. If the corrected level I screening identifies a possible serious mental illness or intellectual disability or related condition, the facility must notify DDA and/or the mental health PASRR evaluator so a level II evaluation can be conducted.

(2) Record the evidence of the level I screening and level II determinations (and any subsequent changes) in the resident assessment in accordance with the schedule required under WAC 388-97-1000.

(3) Maintain the level I form and the level II evaluation report in the resident's active clinical record.

(4) Immediately complete a level I screening using the department's standardized form if the facility discovers that a resident does not have a level I screening in his or her clinical record, following directions provided by the department's PASRR program. If the level I screening identifies a possible serious mental illness or intellectual disability or related condition, notify the DDA and/or mental health PASRR evaluator so a level II evaluation can be conducted.

(5) Notify the DDA and/or mental health PASRR evaluator when a resident who was admitted with an advance categorical determination appears likely to need nursing facility services for longer than the period specified by DDA and/or the mental health PASRR evaluator, so that a full assessment of the individual's need for specialized services can be performed. This notification must occur as soon as the nursing facility anticipates that the resident will require more than the number of days of nursing facility services authorized for the specific advance categorical determination and no later than five days before expiration of the period (three days for protective services) unless good cause is documented for later notification.

(6) Immediately notify the DDA and/or mental health PASRR evaluator for a possible resident review when there has been a significant change in the physical or mental condition, as defined in WAC 388-97-1910, of any resident who has been determined to have a serious mental illness or intellectual disability or related condition. Complete a new level I screening for the significant change.

(7) Provide or arrange for the provision of any services recommended by a PASRR level II evaluator that are within the scope of nursing facility services. If the facility believes that the recommended service either cannot or should not be provided, the facility must document the reason(s) for not providing the service and communicate the reason(s) to the level II evaluator.

(8) Immediately complete a new level I screening using the department's standardized form if the facility finds that a resident, not previously determined to have a serious mental illness, develops symptoms of a serious mental illness, and refer the resident to the mental health PASRR evaluator for further evaluation.

(9) Provide services and interventions that complement, reinforce, and are consistent with any specialized services recommended by the level II evaluator. The resident's plan of care must specify how the facility will integrate relevant activities to achieve this consistency and the enhancement of the PASRR goals.

(10) Discharge, in accordance with WAC 388-97-0120, any resident with a serious mental illness or intellectual disability or related condition who does not meet nursing facility level of care, unless the resident has continuously resided in the facility for at least 30 months and requires specialized services. The nursing facility must cooperate with DDA and/or mental health PASRR evaluator as it prepares the resident for a safe and orderly discharge.

History

Statutory Authority: RCW 74.42.620. WSR 26-08-015, s 388-97-19751, filed 3/20/26, effective 4/20/26.

Wash. Admin. Code § 388-97-2000 Preadmission screening and resident review (PASRR) determination and appeal rights.

(1) The resident has the right to choose to remain in the nursing facility and receive specialized services if:

(a) He or she has continuously resided in a nursing facility since October 1, 1987; and

(b) The department determined, in 1990, that the resident required specialized services for a serious mental illness or developmental disability but did not require nursing facility services.

(2) A nursing facility resident who has been adversely impacted by a PASRR determination may appeal the department's determination that the individual is:

(a) Not in need of nursing facility care as defined under WAC 388-106-0350 through 388-106-0360;

(b) Not in need of specialized services as defined under WAC 388-97-1910; or

(3) The nursing facility must assist a resident, as needed, in requesting a hearing to appeal the department's PASRR determination.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. § 483.100-138. WSR 15-18-026, § 388-97-2000, filed 8/25/15, effective 9/25/15. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2000, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2020 Intermediate care facilities for individuals with intellectual disabilities.

(1) ICF/IID nursing facilities must meet the requirements of 42 C.F.R. § 483 Subpart I and the requirements of this subchapter except that in an ICF/IID nursing facility:

(a) There must be at least one registered nurse or licensed practical nurse on duty eight hours per day, and additional licensed staff on any shift if indicated. WAC 388-97-1080 (2)(a) and (3)(a) and (b) do not apply to ICF/MR nursing facilities; and

(b) A medical director is not required.

(2) Staff from the division of developmental disabilities will approve of social/therapeutic leave for individuals who reside in ICF/IID nursing facilities.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 13-04-093, § 388-97-2020, filed 2/6/13, effective 3/9/13. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2020, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2040 Design.

The design of a nursing home must facilitate resident-centered care and services in a safe, clean, comfortable and homelike environment that allows the resident to use his or her personal belongings to the greatest extent possible.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2040, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2060 New construction compliance.

The nursing home must ensure that:

(1) New construction, as defined in WAC 388-97-2160, complies with all the requirements of subchapter II of this chapter;

(2) New construction must maintain compliance with the regulations in effect at the time of initial submission to the department of health, certificate of need and construction review services; except if the previous construction jeopardizes resident health and safety, the department may require compliance with current construction rules;

(3) The department of health, certificate of need and construction review programs, are contacted for review and that the programs issue applicable determinations and approvals for all new construction; and

(4) Construction is completed in compliance with the final construction review services approved documents. Compliance with these standards and regulations does not relieve the nursing home of the need to comply with applicable state and local building and zoning codes.

(5) The department has done a pre-occupancy survey and has notified the nursing home that it may begin admitting residents.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 10-02-021, § 388-97-2060, filed 12/29/09, effective 1/29/10. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2060, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2080 Fire standards and approval, and other standards.

The nursing home must:

(1) Conform to at least the minimum standards for the prevention of fire, and for the protection of life and property against fire, according to the International Fire Code, RCW 19.27.031, the federal Life Safety Code, 42 C.F.R. 483.70(a), and additional state requirements in chapter 212-12 WAC; and

(2) Comply with all other applicable requirements of state and federal law.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2080, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2100 Maintenance and repair.

All nursing homes must:

(1) Maintain electrical, mechanical, and patient care equipment in safe and operating condition; and

(2) Ensure floors, walls, ceilings, and equipment surfaces are maintained in clean condition and in good repair.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2100, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2120 Noise.

(1) All nursing homes must maintain comfortable sound levels, to include minimizing the use of the public address system and taking reasonable precautions with noisy services so residents are not disturbed, particularly during their sleeping time; and

(2) In new construction, the nursing home must:

(a) Have walls, floor/ceiling and roof/ceiling assemblies constructed with materials that provide comfortable sound levels in all resident areas, rated at an STC 50 or greater; and

(b) Utilize an alternative to the public address system for nonemergency communication that best serves the residents' needs.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2120, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2140 Accessibility in new construction.

The nursing home must be readily accessible to a person with disability and comply with WAC 388-97-3520.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2140, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2160 Types of new construction.

New construction includes, but is not limited to:

(1) New structures.

(a) A new building to be licensed as a nursing home; or

(b) An addition to a building currently licensed as a nursing home.

(2) Existing buildings.

(a) Conversion of another building to a nursing home;

(b) Change in the use of space for access by residents within an existing nursing home; and

(c) Alterations including physical, mechanical, or electrical changes made to an existing nursing home, except for normal routine maintenance and repair.

(3) See WAC 388-97-3400(3) for less extensive alterations.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2160, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2180 ICF/IID exceptions to physical plan requirements.

The following regulations do not apply to nursing homes certified exclusively under 42 C.F.R. § 483, Subpart I, or successor laws:

(1) WAC 388-97-2440, regarding the required number of square feet per bed; and

(2) WAC 388-97-2660, regarding cubicle curtains.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 13-04-093, § 388-97-2180, filed 2/6/13, effective 3/9/13. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2180, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2200 Emergency power.

(1) The nursing home must have an alternate source of power and automatic transfer equipment to connect the alternate source within ten seconds of the failure of the normal source.

(2) The nursing home must ensure the alternate source is a generator:

(a) With on-site fuel supply;

(b) Permanently fixed in place;

(d) An on premises emergency generator, as defined in NFPA 99, Health care facilities, when life support systems are used.

(3) The nursing home must ensure the emergency power supply provides a minimum of four hours of effective power for lighting for night lights, exit signs, exit corridors, stairways, dining and recreation areas, work stations, medication preparation areas, boiler rooms, electrical service room and emergency generator locations.

(4) A nursing home first licensed on or after October 1, 1981, must have emergency power supplied to:

(a) Communication systems, all alarm systems, an elevator that reaches every resident floor including the ground floor, equipment to provide heating for resident rooms or a room to which all residents can be moved; and

(b) Electrical outlets located in medication preparation areas, pharmacy dispensing areas, staff work stations, dining areas, resident corridors, and resident bed locations designated for use with life support systems.

(5) In new construction the emergency power equipment must meet the:

(a) Earthquake standards for the facility's geographic locale; and

(b) Requirements in NFPA 110, Generators.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2200, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2220 Location of the resident care unit.

The nursing home must ensure that:

(1) Each resident care unit is located to minimize through traffic to any general service, diagnostic, treatment, or administrative area; and

(2) In new construction, the resident care unit, and the services to support resident care and nursing needs, are designed to serve a maximum of sixty beds on the same floor.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2220, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2240 Required service areas on resident care units.

(1) The nursing home must ensure each resident care unit has at least the following required service areas:

(a) A staff work station;

(b) A medicine storage and preparation area;

(d) Storage space for linen, other supplies, and equipment; and

(e) Housekeeping services and janitor's closet.

(2) In new construction resident care units may share required services if the units are in close proximity to each other and the combined units serve a total of not more than sixty residents; except the nursing home must have a separate staff work station on a secured dementia care unit.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2240, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2260 Staff work stations on resident care units.

(1) On each unit, the nursing home must have a staff work station appropriate to the needs of staff using the space. At a minimum, the nursing home must equip the area with:

(a) A charting surface;

(b) A rack or other storage for current health records;

(d) A telephone;

(e) A resident call system; and

(f) A clock.

(2) In new construction the work station space must be open to the corridor.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2260, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2280 Call systems on resident care units.

The nursing home must provide a system that meets the following standards:

(1) A wired or wireless communication system which registers a call by distinctive light at the room door and by distinctive light and audible tone at the staff work station. The system must be equipped to receive resident calls from:

(a) The bedside of each resident;

(b) Every common area, dining and activity areas, common use toilet rooms, and other areas used by residents; and

(2) An emergency signal device that meets the needs of the resident and adapted for easy reach by the resident. A signal device must be adapted to meet resident needs and, in the dementia unit, may be adapted for staff and family use, see WAC 388-97-2900.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 10-02-021, § 388-97-2280, filed 12/29/09, effective 1/29/10. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2280, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2300 Telephones on resident care units.

The nursing home must provide 24-hour access to a telephone for resident use per RCW 18.51.575 which:

(1) Provides auditory privacy;

(2) Allows for communications with family, medical providers, and others;

(3) Allows for emergency contact to and from facility staff;

(4) Is accessible to a person with a disability and accommodates a person with sensory impairment; and

(5) Does not require payment for local calls.

History

Statutory Authority: RCW 18.20.090, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 25-16-099, s 388-97-2300, filed 8/6/25, effective 9/6/25. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2300, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2320 Utility service rooms on resident care units.

(1) All nursing homes must:

(a) Provide utility rooms designed, equipped, and maintained to ensure separation of clean and sterile supplies and equipment from those that are contaminated;

(b) Ensure that each clean utility room has:

(i) A work counter;

(ii) A sink equipped with single use hand drying towels and soap for handwashing; and

(iii) Closed storage units for supplies and small equipment; and

(i) A work counter and a sink large enough to totally submerge the items being cleaned and disinfected;

(ii) Storage for cleaning supplies and other items, including equipment, to meet nursing home needs;

(iii) Locked storage for cleaning agents, disinfectants and other caustic or toxic agents;

(iv) Adequate space for waste containers, linen hampers, and other large equipment; and

(v) Adequate ventilation to remove odors and moisture.

(2) In new construction:

(a) A resident room must not be more than ninety feet from a clean utility room and a soiled utility room;

(b) The clean utility room and the soiled utility room must be separate rooms;

(i) A double-compartment sink with inside dimensions of each compartment deep enough to totally submerge items being cleaned and disinfected;

(ii) Sufficient, available work surface on each side of the sink to adequately process and dry equipment with a minimum of three feet of work surface on the clean side;

(iii) Drying/draining racks for wet equipment;

(iv) Work counters, sinks, and other fixed equipment arranged to prevent intermingling of clean and contaminated items during the cleaning process; and

(v) A siphon jet type clinic service sink or equivalent installed on the soiled side of the utility room away from the door.

(d) The nursing home's space for waste containers, linen hampers, and other large equipment must not block work areas; and

(e) The utility rooms must meet the ventilation requirements of Table 6 in WAC 388-97-4040.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2320, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2340 Drug facilities on resident care units.

The nursing home must provide an area designed and equipped for drug preparation and locked storage convenient to each work station. The nursing home must ensure:

(1) The drug facilities are well illuminated, ventilated, and equipped with a work counter, sink with hot and cold running water, and drug storage units;

(2) The drug storage units are one or more of the following:

(a) Locked cabinetry constructed in accordance with board of pharmacy regulations for drug storage which has:

(i) Separately keyed storage for Schedule II and III controlled substances; and

(ii) Segregated storage of different residents' drugs; or

(b) An automated medication distribution device or storage.

(3) There is a refrigerator for storage of thermolabile drugs in the drug facility;

(4) Locks and keys for drug facilities are different from other locks and keys within the nursing home; and

(5) In new construction, the drug facility must be a separate room.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2340, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2360 Linen storage on resident care units.

The nursing home must provide:

(1) A clean area for storage of clean linen and other bedding. This may be an area within the clean utility room;

(2) A soiled linen area for the collection and temporary storage of soiled linen. This may be within the soiled utility room; and

(3) In new construction, storage for linen barrels and clean linen carts.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2360, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2380 Janitors closets on resident care units.

(1) The nursing home must have a janitor's closet with a service sink and adequate storage space for housekeeping equipment and supplies convenient to each resident unit.

(2) In new construction a janitor's closet must meet the ventilation requirements of Table 6, in WAC 388-97-4040.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2380, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2400 Resident rooms.

(1) The nursing home must ensure that each resident bedroom:

(a) Has direct access to a hall or corridor;

(b) Is located on an exterior wall with a transparent glass window; and

(2) In a new building or addition, each resident bedroom must:

(a) Have an exterior transparent glass window:

(i) With an area equal to at least 1/10th of the bedroom usable floor area;

(ii) Located 24 feet or more from another building or the opposite wall of a court, or 10 feet or more away from a property line, except on street sides;

(iii) Located eight feet or more from any exterior walkway, paved surface, or driveway; and

(iv) With a sill three feet or less above the floor.

(b) Be located on a floor level at or above grade level except for earth berms. "Grade" means the level of ground adjacent to the building floor level measured at the required exterior window. The ground must be level or slope downward for a distance of at least 10 feet from the wall of the building. From there the ground may slope upward to the maximum sill height of the required window at a rate of one foot vertical for two feet horizontal.

History

Statutory Authority: RCW 74.42.620 and chapter 18.51 RCW. WSR 24-07-008, § 388-97-2400, filed 3/7/24, effective 4/7/24. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2400, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-24001 Resident rooms—Requirements in effect June 23, 2020, through June 7, 2022, in response to the state of emergency related to the COVID-19 pandemic.

In response to the state of emergency related to the COVID-19 pandemic, the department adopted emergency rules under RCW 34.05.350 on June 23, 2020, to amend and suspend portions of WAC 388-97-2400. The emergency rules remained in effect until June 7, 2022. The following rule was in effect during that time:

(1) The nursing home must ensure that each resident bedroom:

(a) Has direct access to a hall or corridor; and

(b) Is located to prevent through traffic.

(2) In a new building or addition, unless otherwise necessary for infection control, each resident bedroom must:

(a) Have an exterior transparent glass window:

(i) With an area equal to at least 1/10th of the bedroom usable floor area;

(ii) Located 24 feet or more from another building or the opposite wall of a court, or 10 feet or more away from a property line, except on street sides;

(iii) Located eight feet or more from any exterior walkway, paved surface, or driveway; and

(iv) With a sill three feet or less above the floor.

History

Statutory Authority: RCW 74.42.620 and chapter 18.51 RCW. WSR 24-07-008, § 388-97-24001, filed 3/7/24, effective 4/7/24.

Wash. Admin. Code § 388-97-2420 Capacity of resident rooms.

(1) The nursing home must ensure that any resident bedroom has:

(a) No more than two beds between any resident bed and exterior window wall; and

(b) A maximum capacity of four beds.

(2) In a new building, addition, or change of use to a resident bedroom the maximum capacity is two beds per room, for plans submitted after September 1, 1995.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2420, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2440 Size of resident rooms.

The nursing home must ensure that minimum usable room space exclusive of toilet rooms, closets, lockers, wardrobes, must:

(1) In existing facilities, be at least eighty square feet per bed in each multibed room and at least one hundred square feet for each single bed room;

(2) In a new building or addition, be one-hundred and ten square feet per bed in multibed rooms, and one-hundred square feet in single bed rooms;

(3) In new construction, ensure that the minimum usable room space is also exclusive of vestibules; and

(4) For exceptions to room size requirements refer to WAC 388-97-2180.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2440, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2460 Privacy in resident rooms.

The nursing home must ensure that each resident bedroom is designed or equipped to ensure full visual privacy for each resident.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2460, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2480 Resident isolation rooms.

If a nursing home provides an isolation room, the nursing home must ensure the room is uncarpeted and contains:

(1) A handwashing sink with water supplied through a mixing valve;

(2) Its own adjoining toilet room containing a bathing facility; and

(3) In new construction, the handwashing sink must be located between the entry door and the nearest bed.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2480, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2500 Resident room size variance.

The director of residential care services, aging and disability services administration, or their designee, may permit exceptions to WAC 388-97-2420 (1)(a) and 388-97-2440(1) when the nursing home demonstrates in writing that the exception:

(1) Is in accordance with the special needs of the resident; and

(2) Will not adversely affect any resident's health or safety.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2500, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2520 Resident room equipment.

The nursing home must determine a resident's furniture and equipment needs at the time of admission and routinely thereafter to ensure resident comfort. Except as specified in WAC 388-97-0560, the nursing home must provide each resident with the following items required in WAC 388-97-2540 through 388-97-2680.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2520, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2540 Resident bed and bedside equipment.

The nursing home must provide:

(1) A comfortable bed of size and height to maximize a resident's independent functioning. Beds may be arranged to satisfy the needs and desires of the individual resident provided the arrangement does not negatively impact the health or safety of other residents;

(2) Appropriate bedding; and

(3) A bedside cabinet that allows for storage of small personal articles and a separate drawer or enclosed compartment for storage of resident care utensils/equipment.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2540, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2560 Lockable storage space in a resident room.

The nursing home must provide:

(1) A lockable storage space accessible to each resident for storage of small personal items, upon request; and

(2) In a new building or addition, a lockable cabinet space or drawer for storage of personal belongings for each resident bed, in addition to the bedside cabinet.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2560, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2580 Wardrobes in a resident room.

The nursing home must provide:

(1) A separated, enclosed wardrobe or closet for each resident's clothing and belongings accessible to the resident; and

(2) In a new building or addition, each bed in each room must have a separate, enclosed wardrobe or closet accessible to the resident with:

(a) Minimum inside dimensions of twenty-two inches deep by a minimum of twenty-six inches wide by sixty inches high; and

(b) Inside space including a rod, at least fifteen inches long, and allowing for fifty-four inches of clear hanging length adjustable to meet the needs of the resident.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2580, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2600 Seating in a resident room.

The nursing home must provide comfortable seating for residents and visitors, not including resident care equipment, that provides proper body alignment and support.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2600, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2620 Lighting in resident rooms.

The nursing home must provide a permanently mounted or equivalent light suitable for any task the resident chooses to do or any task the staff must do.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2620, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2640 Call signal device in resident rooms.

The nursing home must provide a resident call signal device that complies with WAC 388-97-2280.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2640, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2660 Cubicle curtains in resident rooms.

The nursing home must provide:

(1) Flame-retardant cubicle curtains in multibed rooms that ensures full visual privacy for each resident;

(2) In a new building or addition, the cubicle curtain or enclosed space ensures full visual privacy for each bed in a multibed room with enclosed space containing at least sixty-four square feet of floor area with a minimum dimension of seven feet. "Full visual privacy" in a multibed room prevents staff, visitors and other residents from seeing a resident in bed, while allowing staff, visitors, and other residents access to the toilet room, handwashing sink, exterior window, and the entrance door;

(3) For exceptions to cubicle curtain requirements refer to WAC 388-97-2180.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2660, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2680 Miscellaneous equipment in resident rooms in a new building or addition.

The nursing home must provide:

(1) A phone jack for each bed in each room;

(2) A handwashing sink in each multibed room and a handwashing sink in each single room that does not have an adjoining toilet room containing a handwashing sink. A handwashing sink located in a resident bedroom must be located between the corridor entry door and the nearest resident bed; and

(3) Storage that meets the requirements of WAC 388-97-3000, 388-97-3020, and 388-97-3040.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2680, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2700 Resident toilet facilities or rooms.

The nursing home must ensure that:

(1) Each resident room is equipped with or located convenient to toilet facilities.

(2) For new construction, a toilet room must:

(a) Be directly accessible from each resident room and from each bathing facility without going through or entering a general corridor while maintaining resident dignity;

(b) Serve two bedrooms or less;

(d) Contain at least one handwashing sink; and

(e) Provide a properly located and securely mounted grab bar at each side and the back of each toilet fixture in each toilet room and stall. Grab bars on the open side must be located twelve to eighteen inches from the center line of the toilet. Grab bars on the open side must be able to swing up.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2700, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2720 Resident bathing facilities or rooms.

The nursing home must ensure:

(1) Each resident room is equipped with or located near bathing facilities;

(2) At least one bathing unit for no more than thirty residents that is not located in a room served by an adjoining bathroom;

(3) At least one bathing device for immersion per floor;

(4) At least one roll in shower or equivalent on each resident care unit:

(a) Designed and equipped for unobstructed ease of shower chair entry and use; and

(b) With a spray attachment equipped with a backflow prevention device.

(5) Resident bathing equipment is smooth, cleanable, and able to be disinfected after each use.

(6) For new construction, in each bathing unit containing more than one bathing facility:

(a) Each bathtub, shower, or equivalent, is located in a separate room or compartment with three solid walls;

(b) The entry wall may be a "shower" type curtain or equivalent;

(c) The area for each bathtub and shower is sufficient to accommodate a shower chair, an attendant, and provide visual privacy for bathing, drying, and dressing;

(d) Shower and tub surfaces are slip-resistant;

(e) Bathing areas are constructed of materials that are impervious to water and cleanable; and

(f) Grab bars are installed on all three sides of a shower with the shower head grab bar being "L" shaped.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2720, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2740 Locks in toilet and bathing facilities.

The nursing home must ensure:

(1) All lockable toilet facilities and bathrooms have a readily available means of unlocking from the outside; and

(2) Locks are operable from the inside with a single motion.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2740, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2760 Dining, dayrooms, and resident activity areas.

(1) The nursing home must provide one or more rooms designated for resident dining and activities that are:

(a) Well lighted;

(b) Well ventilated;

(d) Large enough to accommodate all activities.

(2) In a new building or addition, the nursing home must design space for dining rooms, dayrooms, and activity areas for resident convenience and comfort and to provide a homelike environment. These areas must be located on the same floor as the residents who will use the areas. The nursing home must:

(a) Ensure these rooms or areas are exterior rooms with windows that have a maximum sill height of thirty-six inches;

(b) Provide space for dining, day use, and activities with a minimum combined total of thirty square feet for each licensed bed;

(d) Locate a day room on each resident care unit;

(e) Provide storage spaces for all activity and recreational equipment and supplies, adjoining or adjacent to the facilities provided; and

(f) Locate a common use toilet facility, with handwashing sink and accessories, providing direct access from the hallway and within a maximum of forty feet from these spaces.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2760, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2780 Laundry services and storage.

The nursing home must comply with WAC 388-97-1860 and ensure:

(1) Sufficient laundry washing and drying facilities to meet the residents' care and comfort needs without delay.

(2) That the nursing home linen is disinfected in accordance with:

(a) The temperature and time of the cycle as specified by the manufacturer; or

(b) The hot water cycle using the following table:

| Water Temperature | Cycle Length | | --- | --- | | 160 degrees F | At least 5 minutes | | 140 degrees F | At least 15 minutes |

(3) In new construction, soiled linens and soiled clothing are stored and sorted in a room ventilated according to Table 6 in WAC 388-97-4040. The room must:

(a) Have self-closing doors;

(b) Be separated from the washing and drying facilities;

(d) Have a floor drain; and

(e) Contain a clinic service sink.

(4) In new construction, clean linen is stored in a room ventilated according to Table 6 in WAC 388-97-4040. The room must:

(a) Be separated from the washing and drying facilities; and

(b) Have self closing doors.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2780, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2800 Dementia care unit.

A nursing home that began operating a dementia care unit at any time after November 13, 1989, must meet all requirements of this section, WAC 388-97-2820 through 388-97-2920, and the resident care unit requirements of WAC 388-97-2220 through 388-97-2380. Refer to WAC 388-97-1040, for program requirements.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2800, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2820 Dining areas on a dementia care unit.

(1) The nursing home must provide dining areas in the dementia care unit which may also serve as day areas for the unit.

(2) In a new building or addition, the dining, dayroom, and activity area or areas on the unit must provide a minimum of thirty square feet per resident.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2820, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2840 Outdoor areas on a dementia care unit.

The nursing home must provide the dementia care unit with:

(1) Secured outdoor space and walkways;

(2) An ambulation area with accessible walking surfaces that:

(a) Are firm, stable, and free from cracks and abrupt changes with a maximum of one inch between sidewalk and adjoining landscape areas;

(b) Have slip-resistant surfaces if subject to wet conditions; and

(c) Sufficient space and outdoor furniture with flexibility in arrangement of the furniture to accommodate residents who use wheelchairs and mobility aids.

(3) Nontoxic outdoor plants in areas accessible to residents.

(4) In new construction the outdoor areas must also meet the requirements of WAC 388-97-3740.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2840, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2860 Indoor areas on a dementia care unit.

The nursing home must provide the dementia care unit with:

(1) Indoor ambulation areas that meet the needs of the residents and are maintained free of equipment; and

(2) Nontoxic indoor plants in areas accessible to residents.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2860, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2880 Ambulation route on a dementia care unit in a new building or addition.

The nursing home must ensure that the dementia care unit has a continuous ambulation route which may include outdoor ambulation areas and allows the resident to return to the resident's starting point without reversing direction.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2880, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2900 Physical plant on a dementia care unit.

The nursing home must:

(1) Provide a staff toilet room with a handwashing sink;

(2) Ensure that floors, walls, and ceiling surfaces display contrasting color for identification:

(a) Surfaces may have a disguise design to obscure or conceal areas that residents should not enter, except for exit doors and doorways; and

(b) Exit doors must be marked so that they are readily distinguishable from adjacent construction and the way of exit travel is obvious and direct.

(3) Ensure that door thresholds are one-half inch high or less;

(4) Provide a signal device adapted:

(a) To meet residents' needs; and

(b) For staff and family use, if necessary.

(5) Ensure that the public address system is used only for emergency use; and

(6) Refer to WAC 388-97-470(2) for dementia care unit exceptions to individual temperature controls.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2900, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2920 Special egress control devices on a dementia care unit.

In dementia care units the nursing home must:

(1) Have proof that required approvals for any special egress control devices were obtained from the state fire marshal, department of social and health services, and the local official who enforces the International Building Code and International Fire Code; and

(2) In a new building or addition, or when adding special egress control devices to be used on doors and gates which are a part of the exit system, the building must:

(a) Have obtained approval from department of health construction review and the local official who enforces the International Building Code and International Fire Code;

(b) Have an approved automatic fire alarm system;

(c) Have an approved supervised automatic fire sprinkler system which is electrically interconnected with the fire alarm system; and

(d) Have a system which must:

(i) Automatically release if power to the system is lost;

(ii) Automatically release with activation of the building's fire alarm system;

(iii) Release with an override switch installed at each staff work station or at a constantly staff attended location within the building; and

(iv) Have directions for releasing the device at each egress controlled door and gate; and

(e) Prohibit the use of keyed locks at all doors and gates in all egress pathways.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2920, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2940 Specialized rehabilitation.

(1) If nursing homes initially licensed after October 1, 1981 provide inpatient specialized rehabilitation, they must ensure that those services provide:

(a) Easy access in general service areas;

(b) Exercise, treatment, and supportive equipment as required by the narrative program in the construction documents;

(d) Privacy cubicle curtains on tracks or the equivalent around treatment areas;

(e) A sink in the treatment area and a toilet and handwashing sink in a toilet room nearby;

(f) Space and a desk or equivalent for administrative, clerical, interviewing, and consultative functions;

(g) Adequate enclosed storage cabinets for clean linen and supplies and locked storage for cleaning chemicals in the rehabilitation room or nearby janitor's closet;

(h) Adequate storage space for large equipment;

(i) A janitor's closet close to the area;

(j) Soiled linen storage; and

(k) A separate room or area for hydrotherapy tanks, or the equivalent, if provided.

(2) For any new construction under WAC 388-97-2160, nursing homes licensed before October 1, 1981, must comply with the requirements in subsection (1) of this section.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2940, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2960 Outpatient rehabilitation.

The nursing home must ensure that facilities with outpatient programs provide:

(1) A designated reception and waiting room or area and space for interviewing or counseling individual outpatients and their families;

(2) Adequate space for the program so that disruption to designated resident care units is minimized;

(3) Accessible toilet and shower facilities nearby;

(4) Lockers or a safe place to store outpatient personal belongings;

(5) A separate room or area for hydrotherapy tanks, or the equivalent, if provided; and

(6) In new construction, required access must come from the exterior without passing through the interior of the facility.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2960, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-2980 Food service areas.

The nursing home must ensure food service areas are in compliance with chapter 246-215 WAC, state board of health rules governing food service sanitation. The nursing home must:

(1) Ensure food service areas are provided for the purpose of preparing, serving, and storing food and drink unless food service is provided from another licensed food service facility;

(2) Ensure food service areas are located to facilitate receiving of food supplies, disposal of kitchen waste, and transportation of food to dining and resident care areas;

(3) Locate and arrange the kitchen to avoid contamination of food, to prevent heat and noise entering resident care areas, and to prevent through traffic;

(4) Locate the receiving area for ready access to storage and refrigeration areas;

(5) Conveniently locate a handwashing sink near the food preparation and dishwashing area, and include a waste receptacle and dispensers stocked with soap and paper towels;

(6) Adequately ventilate, light, and equip the dishwashing room or area for sanitary processing of dishes;

(7) Locate the garbage storage area in a well-ventilated room or an outside area;

(8) Provide hot and cold water and a floor drain connected to the sanitary sewage system in a can wash area, unless located in outside covered area;

(9) Provide space for an office or a desk and files for food service management located central to deliveries and kitchen operations; and

(10) Include housekeeping facilities or a janitor's closet for the exclusive use of food service with a service sink and storage of housekeeping equipment and supplies.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-2980, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3000 Storage of equipment.

The nursing home must:

(1) Provide adequate storage space for wheelchairs and other ambulation equipment;

(2) Ensure stored equipment does not impinge upon the required corridor space; and

(3) In new construction, provide adequate storage of four square feet or more of storage space per bed which does not impinge upon required corridor space.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3000, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3020 Storage of resident room equipment in a new building or addition.

The nursing home must provide separate storage for extra pillows and blankets for each bed. This may be in a location convenient to the resident room or combined with the wardrobe or closet if it does not impinge upon the required space for clothing.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3020, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3040 General storage in new construction.

A nursing home must have general storage space of not less than five square feet per bed in addition to the closets and storage required in WAC 388-97-2560.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3040, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3060 Lighting.

The nursing home must ensure that lighting and lighting levels:

(1) Are adequate and comfortable for the functions being conducted in each area of the nursing home;

(2) Are suitable for any task the resident chooses or any task the staff must do;

(3) Support the independent functioning of the resident;

(4) Provide a homelike environment; and

(5) Minimize glare.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3060, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3080 Natural or artificial light.

(1) The nursing home must ensure that adequate natural or artificial light for inside illumination is provided in every useable room area, including but not limited to storerooms, attic and basement rooms, hallways, stairways, inclines, and ramps.

(2) In new buildings and additions, the nursing home must utilize:

(a) Windows and skylights to minimize the need for artificial light and to allow a resident to experience the natural daylight cycle; and

(b) Windows and skylights near entrances/exits in order to avoid difficulty in adjusting to light levels when entering or leaving the facility.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3080, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3100 Outside lighting.

The nursing home must ensure:

(1) Lighting levels in parking lots and approaches to buildings are appropriate for resident and visitor convenience and safety; and

(2) All outside areas where nursing home equipment and machinery are stored have proper lighting.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3100, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3120 Light shields.

The nursing home must ensure that light shields are provided in food preparation and serving areas, utility rooms, medication rooms, exam rooms, pool enclosures, laundry areas, and on ceiling mounted fluorescent lights in resident rooms.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3120, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3140 Illumination levels in new buildings and additions.

The nursing home must ensure:

(1) Lighting fixtures and circuitry provide at least the illumination levels appropriate to the task;

(2) Design takes into consideration that lighting systems normally decrease in output with age and dirt accumulation; and

(3) Light fixture locations and switching arrangements are appropriate for the needs of the occupants of the spaces and follow Illuminating Engineering Society (IES) recommendations for health care facilities.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3140, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3160 Night lights in new construction.

The nursing home must install in each resident room a night light that is:

(1) Flush mounted on the wall;

(2) Designed to prevent viewing the light source from thirty inches or more above the floor;

(3) Located to provide safe pathway lighting for the staff and residents; and

(4) Controlled by a switch at each resident room entrance door or by a master switch.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3160, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3180 Switches in new construction.

The nursing home must install quiet operating switches for general illumination adjacent to doors in all areas and accessible to residents in resident rooms.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3180, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3200 Electrical outlets.

(1) The nursing home must provide enough electrical outlets to meet the care and personal appliance needs of each resident. An approved power tap may be used only for portable appliances with specific overcurrent protection needs, such as a computer. A "power tap" is a device for indoor use consisting of an attachment plug on the end of a flexible cord and two or more receptacles on the opposite end, with overcurrent protection. A power tap must be:

(a) Polarized or grounded;

(b) UL listed; and

(2) In new construction, the nursing home must ensure:

(a) There are a minimum of seven outlets:

(i) Four hospital grade electrical outlets located convenient to each residents' bed and centered at forty to forty-four inches above the floor, with a minimum of:

(A) Two additional electrical outlets at separate, convenient locations in each resident room; and

(B) One duplex electrical outlet located adjacent to each handwashing sink intended for resident use.

(b) All electrical outlets located within five feet of any sink, toilet, bath, or shower must be protected by a ground fault circuit interrupter.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3200, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3220 Safety.

The nursing home must provide:

(1) A safe, functional, sanitary, and comfortable environment for the residents, staff, and the public; and

(2) Signs to designate areas of hazard.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3220, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3240 Safety—Poisons and nonmedical chemicals.

The nursing home must ensure that poisons and nonmedicinal chemicals are stored in containers identified with warning labels. The containers must be stored:

(1) In a separate locked storage when not in use by staff; and

(2) Separate from drugs used for medicinal purposes.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3240, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3260 Safety—Storage of equipment and supplies.

The nursing home must ensure that the manner in which equipment and supplies are stored does not jeopardize the safety of residents, staff, or the public.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3260, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3280 Safety—Handrails.

The nursing home must:

(1) Provide handrails on each side of all corridors and stairwells accessible to residents; and

(2) In new construction ensure that:

(a) Ends of handrails are returned to the walls;

(b) Handrails are mounted thirty to thirty-four inches above the floor and project not more than three and three-quarters inches from the wall; and

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3280, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3300 Water supply.

The nursing home must comply with the requirements of the group A, Public Water Systems, chapter 246-290 WAC or group B, Public Water Systems, chapter 246-291 WAC.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3300, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3320 Hot water.

The nursing home must ensure:

(1) The hot water system maintains water temperatures at one hundred ten degrees Fahrenheit, plus or minus ten degrees Fahrenheit, at fixtures used by residents and staff.

(2) For laundry temperatures, refer to WAC 388-97-2780.

(3) For dishwashing temperatures, refer to chapter 246-215 WAC.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3320, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3340 Cross connections.

The nursing home must:

(1) Prohibit all cross connections between potable and nonpotable water;

(2) Use backflow prevention devices on plumbing fixtures, equipment, facilities, buildings, premises or areas which are actual or potential cross-connections to prevent the backflow of water or other liquids, gases, mixtures or substances into a water distribution system or other fixtures, equipment, facilities, buildings or areas; and

(3) Follow guidelines, practices, procedures, interpretations and enforcement as outlined in the manual titled "Accepted Procedure and Practice in Cross-Connection Control; Pacific NW Edition; American Waterworks Association," or any successor manual, referenced in chapter 246-290 WAC for public water supply.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3340, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3360 Pest control.

The nursing home must:

(1) Maintain an effective pest control program so that the facility is free of pests such as rodents and insects;

(2) Construct and maintain buildings to prevent the entrance of pests such as rodents and insects; and

(3) Provide mesh screens or equivalent with a minimum mesh of one-sixteenth inch on all windows and other openings that can be left open.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3360, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3380 Sewage and liquid waste disposal.

The nursing home must ensure:

(1) All sewage and liquid wastes are discharged into an approved public sewage system where such system is available; or

(2) Sewage and liquid wastes are collected, treated, and disposed of in an on-site sewage system in accordance with chapter 246-272A WAC and meets with the approval of the local health department and/or the state department of health.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3380, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3400 General new construction documents.

(1) The project sponsor must submit plans for all new construction to the department of health, construction review, for review and approval. Documents must be approved before the work begins. The project sponsor must also submit documents to department of health, certificate of need for review and applicable determination.

(2) The nursing home may request exemptions to new construction requirements as described in WAC 388-97-3500.

(3) If the proposed project is not extensive enough to require professional architectural or engineering services, the project sponsor must submit a written description to the department of health, construction review, to determine if WAC 388-97-3440 applies.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3400, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3420 Preliminary new construction documents.

If preliminary documents and specifications are submitted, they must:

(1) Include a narrative program with drawings. Copies of these documents must be sent to the department of health, certificate of need and construction review, and to aging and disability services administration. The narrative program must identify:

(a) How the design promotes a homelike environment and facilitates resident-centered care and services;

(b) Functional space requirements;

(d) Each function to be performed;

(e) Types of equipment required; and

(f) Services that will not be provided directly, but will instead be provided through contract.

(2) Refer to WAC 388-97-3400(3), if the proposed project is not extensive enough to require professional architectural or engineering services.

(3) Be drawn to scale and include:

(a) A site plan showing streets, entrance ways, driveways, parking, design statements for adequate water supply, sewage and disposal systems, space for the storage of recycled materials, and the arrangement of buildings on the site noting handicapped accessible parking and entrances;

(b) Floor plans showing existing and proposed arrangements within the building, including the fixed and major movable equipment; and

(4) Include a general description of construction and materials, including interior finishes.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3420, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3440 Final new construction documents.

(1) Construction must not start until at least two sets of final construction documents drawn to scale with complete specifications have been submitted to and approved by the department of health, construction review, in coordination with aging and disability services administration and the department of health, certificate of need.

(2) An architect or engineer licensed by the state of Washington must prepare, stamp, sign, and date the final construction documents.

(3) Construction documents that are changed after approval by the department of health, construction review, require resubmission before any construction on the proposed change is started.

(4) The construction of the facility must follow the final approved construction documents.

(5) These drawings and specifications must show complete details to be furnished to contractors for construction of the buildings, including:

(a) Site plan;

(b) Drawings of each floor of the building, including fixed equipment;

(d) Schedule of floor, wall, and ceiling finishes, door and window sizes and types, and door finish hardware;

(e) Mechanical and electrical systems;

(f) Provision for noise, dust, smoke, and draft control, fire protection, safety and comfort of the residents if construction work takes place in or near occupied areas; and

(g) Landscape plans and vegetation planting schedules for dementia care units.

(6) A reduced set of the final construction floor plans on eight and one half by eleven inch or eleven by seventeen inch sheets showing each room function and number must be submitted.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3440, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3460 Preinstallation submissions for new construction.

The department of health, construction review, must receive and approve preinstallation submissions prior to installation. Preinstallation submissions may include any or all of the following:

(1) Stamped shop drawings, hydraulic calculations, and equipment information sheets for fire sprinkler system(s);

(2) Shop drawings, battery calculations, and equipment information sheets for fire detection and alarm systems;

(3) Shop drawings and equipment information sheets for a kitchen hood and duct automatic fire extinguishing system;

(4) Drawings and equipment information sheets for special egress control devices; and

(5) Drawings and/or a finish schedule denoting areas to be carpeted with:

(a) A coding system identifying type of carpet in each area;

(b) A copy the manufacturer's specifications for each type of carpet; and

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3460, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3480 New construction timelines.

(1) Construction documents must be resubmitted for review as a new project according to current requirements if construction:

(a) Has not started within one year from the date of approval; or

(b) Is not completed within two years from the date of approval.

(2) To obtain an extension beyond two years, a written request must be submitted and approved thirty days prior to the end of the two-year period.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3480, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3500 Exemptions to new construction requirements.

(1) The director of residential care services, aging and disability services administration, may grant exemptions to new construction requirements for:

(a) Alterations when the applicant demonstrates the proposed alterations will serve to correct deficiencies or will upgrade the nursing home in order to better serve residents; and

(b) Substitution of procedures, materials, or equipment for requirements specified in this chapter when such procedures, materials, or equipment have been demonstrated to the director's satisfaction to better serve residents.

(2) The nursing home must ensure requests for exemptions are in writing and include any necessary approvals from the local code enforcement authority and the state fire marshal.

(3) The nursing home must ensure all exemptions granted under the foregoing provisions are kept on file at the nursing home.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3500, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3520 State building code in new construction.

The nursing home must through its design, construction and necessary permits demonstrate compliance with the following codes and local jurisdiction standards. The nursing home that submitted plans for construction review after July 1, 2007 must also comply with the following International Building Codes and Standards:

(1) The International Building Code, and International Building Code Standards, as published by the International Conference of Building Officials as amended and adopted by the Washington state building code council and published as chapter 51-50 WAC, or successor laws;

(2) The International Mechanical Code, including chapter 22, Fuel Gas Piping, Appendix B, as published by the International Conference of Building Officials and the International Association of Plumbing and Mechanical Officials as amended and adopted by the Washington state building code council and published as chapter 51-52 WAC, or successor laws;

(3) The International Fire Code, and International Fire Code Standards, as published by the International Conference of Building Officials and the Western Fire Chiefs Association as amended and adopted by the Washington state building code council and published as chapter 51-54 WAC, or successor laws;

(4) The Uniform Plumbing Code, and Uniform Plumbing Code Standards, as published by the International Association of Plumbing and Mechanical Officials, as amended and adopted by the Washington state building code council and published as chapters 51-56 and 51-57 WAC, or successor laws;

(5) The Washington state ventilation and indoor air quality code, as adopted by the Washington state building code council and filed as chapter 51-13 WAC, or successor laws; and

(6) The Washington state energy code, as amended and adopted by the Washington state building code council and filed as chapter 51-11 WAC, or successor laws.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3520, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3540 Electrical codes and standards in new construction.

The nursing home must ensure that all electrical wiring complies with state and local electrical codes including chapter 296-46B WAC and the National Electric Code of the National Fire Protection Association (NFPA-70) as adopted by the Washington state department of labor and industries.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3540, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3560 Elevator codes in new construction.

The nursing home must ensure that elevators are installed in accordance with chapter 296-96 WAC.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3560, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3580 Local codes and ordinances in new construction.

The nursing home must:

(1) Follow all local ordinances relating to zoning, building, and environmental standards; and

(2) Obtain all local permits before construction and keep permits on file at the nursing home.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3580, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3600 Entrances and exits in new construction.

The nursing home must have the main entrances and exits sheltered from the weather and barrier free accessible in accordance with chapter 51-50 WAC.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3600, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3620 Lobbies in new construction.

The nursing home must have a lobby or area in close proximity to the main entrance that is barrier free accessible and includes:

(1) Waiting space with seating accommodations;

(2) A reception and information area;

(3) Space to accommodate persons in wheelchairs;

(4) A public restroom;

(5) A drinking fountain; and

(6) A public telephone.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3620, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3640 Interview space in new construction.

The nursing home must have interview spaces for private interviews relating to social service and admission.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3640, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3660 Offices in new construction.

The nursing home must provide:

(1) Office space convenient to the work area for the administrator, the director of nursing services, medical records staff, social services staff, activities director, and other personnel as appropriate;

(2) Work space for physicians and outside consultants;

(3) Space for locked storage of health records which provides for fire and water protection; and

(4) Space for the safe storage and handling of financial and business records.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3660, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3680 Inservice education space in new construction.

The nursing home must provide space for employee inservice education that will not infringe upon resident space.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3680, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3700 Staff areas in new construction.

The nursing home must ensure a lounge, lockers, and toilets are provided convenient to the work areas for employees and volunteers.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3700, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3720 Visiting and private space in new construction.

The nursing home must design a separate room or areas for residents to have family and friends visit and for residents to spend time alone. The nursing home must ensure these areas provide:

(1) Space which facilitates conversation and privacy; and

(2) Access to a common-use toilet facility.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3720, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3740 Outdoor recreation space and walkways in new construction.

A nursing home must provide a safe, protected outdoor area for resident use. The nursing home must ensure the outdoor area has:

(1) Shaded and sheltered areas to meet residents needs;

(2) Accessible walking surfaces which are firm, stable, and free from cracks and abrupt changes with a maximum of one inch between sidewalk and adjoining landscape areas;

(3) Sufficient space and outdoor furniture provided with flexibility in arrangement of the furniture to accommodate residents who use wheelchairs and mobility aids;

(4) Shrubs, natural foliage, and trees; and

(5) If used as a resident courtyard, the outdoor area must not be used for public or service deliveries.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3740, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3760 Pools in new construction.

The nursing home must ensure swimming pools, spas, and tubs which remain filled between uses meet the requirements in chapter 246-260 WAC.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3760, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3780 Pharmacies in new construction.

The nursing home must ensure that an on-site pharmacy meets the requirements of the Washington state board of pharmacy per chapters 18.64 RCW and 246-865 WAC.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3780, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3800 Elevators in new construction.

The nursing home must:

(1) Ensure that all buildings having residential use areas or service areas that are not located on the main entrance floor, have an elevator; and

(2) Have at least one elevator sized to accommodate a resident bed and attendant for each sixty beds on floors other than the main entrance floor.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3800, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3840 Walking surfaces in a new building or addition.

The nursing must ensure that:

(1) An abrupt change in the walking surface level including at door thresholds which are greater than one quarter inch are beveled to a one vertical in two horizontal; and

(2) Changes in the walking surface level greater than one half inch are accomplished by means of a ramp with a maximum slope of one vertical in twelve horizontal.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3840, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3860 Doors in new construction.

The nursing home must ensure doors to:

(1) Resident rooms provide a minimum of forty-four inches clear width;

(2) Resident bathrooms and toilet rooms are a minimum of thirty-two inches clear width for wheelchair access;

(3) All resident toilet rooms and bathing facilities open outward except if doors open directly into a resident occupied corridor;

(4) Toilet rooms and bathrooms have single action locks, and a means of unlocking doors from the outside;

(5) Occupied areas do not swing into corridors; and

(6) All passages are arranged so that doors do not open onto or obstruct other doors while maintaining resident dignity.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3860, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3880 Floor finishes in new construction.

The nursing home must ensure:

(1) Floors at all outside entrances have slip-resistant finishes both inside and outside the entrance even when wet; and

(2) All uncarpeted floors are smooth, nonabsorbent and easily cleanable.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3880, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3900 Carpets in new construction.

The nursing home must ensure that department of health, construction review approves of all carpet installation.

(1) Carpets may be used in all areas except: Toilet rooms, bathrooms, kitchen, laundry, utility rooms, medication rooms, maintenance, isolation rooms if provided, and areas subject to high moisture or flooding. Specifications for acceptable carpeting are:

(a) Pile yarn fibers are easily cleanable;

(b) Pile is looped texture in all resident use areas. Cut pile may be used in nonresident use areas;

(c) Average pile density of five thousand ounces per cubic yard in resident use areas and four thousand ounces per cubic yard in nonresident areas. The formula for calculating the density of the carpet is: Yarn weight in ounces times 36, divided by pile height in inches equals ounces per cubic yard of density; and

(d) A maximum pile height of .255 inches in resident use areas and .312 inches in nonresident use areas.

(2) Carpets must:

(a) Be cemented to the floor; and

(b) Have the edges covered and top set base with toe at all wall junctures.

(3) When recarpeting, the safety of residents must be assured during and after recarpeting installation within the room or area. The nursing home must ensure the room or area is:

(a) Well ventilated;

(b) Unoccupied; and

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3900, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3920 Coving in new construction.

The nursing home must ensure:

(1) Kitchens, restrooms, laundry, utility rooms, and bathing areas have integral coves of continuous commercial grade sheet vinyl, bullnose ceramic tile or sealed bullnose quarry tile at least six inches in height; and

(2) All other wall junctions have either integral coving or top set base with toe.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3920, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3940 Walls in new construction.

The nursing home must ensure:

(1) Wall finishes are easily cleanable;

(2) A water-resistant finish extends above the splash line in all rooms or areas subject to splash or spray, such as bathing facilities with tubs only, toilet rooms, janitors' closets, and can-wash areas; and

(3) Bathing facilities with showers have a water-resistant finish extending to the ceiling.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3940, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3960 Accessories in new construction.

The nursing home must provide the following accessories with the necessary backing, if required, for mounting:

(1) Usable countertop area and mirror at each handwashing sink in toilet rooms and resident rooms;

(2) Towel or robe hooks at each handwashing sink in resident rooms and at each bathing facility;

(3) A robe hook at each bathing facility, toilet room and in examination room or therapy area, including outpatient therapy rooms;

(4) A securely mounted toilet paper holder properly located within easy reach of the user at each toilet fixture;

(5) Sanitary seat covers at each public and employee use toilet;

(6) Open front toilet seats on all toilets;

(7) Dispensers for paper towels and handwashing soap at each handwashing sink, and bathing facility;

(8) Sanitary napkin dispensers and disposers in public and employee women's toilet rooms; and

(9) Grab bars that are easily cleanable and resistant to corrosion and securely mounted.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3960, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-3980 Miscellaneous in new construction.

The nursing home must ensure:

(1) Rooms and service areas are identified by visible and tactile signs, refer to WAC 388-97-2900(2) for possible exceptions; and

(2) Equipment and casework is designed, manufactured and installed for ease of proper cleaning and maintenance, and suitable for the functions of each area.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-3980, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-4000 Heating systems in new construction.

The nursing home must ensure:

(1) The heating system is capable of maintaining a temperature of seventy-five degrees Fahrenheit for areas occupied by residents and seventy degrees Fahrenheit for nonresident areas;

(2) Resident rooms have individual temperature control, except in a dementia care unit controls may be covered, locked, or placed in an inconspicuous place;

(3) The following is insulated within the building:

(a) Pipes conducting hot water which are exposed to resident contact; and

(b) Air ducts and casings with outside surface temperatures below ambient dew point.

(4) Insulation on cold surfaces includes an exterior vapor barrier; and

(5) Electric resistant wall heat units are prohibited in new construction.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4000, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-4020 Cooling systems in new construction.

The nursing home must have:

(1) A mechanical cooling system capable of maintaining a temperature of seventy-five degrees Fahrenheit for areas occupied by residents; and

(2) A cooling system that has mechanical refrigeration equipment to provide summer air conditioning to resident areas, food preparation areas, laundry, medication rooms, and therapy areas by either a central system with distribution ducts or piping, or packaged room or zonal air conditioners.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4020, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-4040 Ventilation systems in new construction.

The nursing home must ensure:

(1) Ventilation of all rooms is designed to prevent objectionable odors, condensation, and direct drafts on the residents;

(2) All habitable space is mechanically ventilated including:

(a) Air supply and air exhaust systems;

(b) Installation of air-handling duct systems according to the requirements of the International Mechanical Code and chapter 51-52 WAC;

(d) Installation of exhaust grilles on or near the ceiling; and

(e) Outdoor air intakes located a minimum of twenty-five feet from the exhaust from any ventilating system, combustion equipment, or areas which may collect vehicular exhaust and other noxious fumes, and a minimum of ten feet from plumbing vents. The nursing home must locate the bottom of outdoor air intakes serving central systems a minimum of three feet above adjoining grade level or, if installed through the roof, three feet above the highest adjoining roof level.

(3) Minimum ventilation requirements meet the pressure relationship and ventilation rates per ASHRAE 2007 HVAC Applications Chapter 7.11 Table 6, Pressure Relationships and Ventilation of Certain Areas of Nursing Homes.

TABLE 6

PRESSURE RELATIONSHIPS AND VENTILATION OF CERTAIN AREAS OF NURSING HOMES

| Function Area | Pressure Relationship To Adjacent Areas1,2 | Minimum Air Changes of Outdoor Air Per Hour Supplied To Room | Minimum Total Air Changes Per Hour Supplied To Room | All Air Exhausted Directly To Outdoors | Air Recirculated Within Room Units | | --- | --- | --- | --- | --- | --- | | RESIDENT CARE | | | | | | | Resident room (holding room) | ± | 2 | 4 | Optional | Optional | | Resident corridor | ± | Optional | 2 | Optional | Optional | | Toilet room | N | Optional | 10 | Yes | No | | Resident gathering (dining, activity) | ± | 2 | 4 | Optional | Optional | | DIAGNOSTIC AND TREATMENT | | | | | | | Examination room | ± | 2 | 6 | Optional | Optional | | Physical therapy3 | N | 2 | 6 | Optional | Optional | | Occupational therapy3 | N | 2 | 6 | Optional | Optional | | Soiled workroom or soiled holding | N | 2 | 10 | Yes | No | | Clean workroom or clean holding | P | 2 | 4 | Optional | Optional | | STERILIZING AND SUPPLY | | | | | | | Sterilizer exhaust room | N | Optional | 10 | Yes | No | | Linen and trash chute room | N | Optional | 10 | Yes | No | | Laundry, general3 | ± | 2 | 10 | Yes | No | | Soiled linen sorting and storage | N | Optional | 10 | Yes | No | | Clean linen storage | P | Optional | 2 | Yes | No | | SERVICE | | | | | | | Food preparation center3 | ± | 2 | 10 | Yes | Yes | | Warewashing room3 | N | Optional | 10 | Yes | Yes | | Dietary day storage | ± | Optional | 2 | Yes | No | | Janitor closet | N | Optional | 10 | Yes | No | | Bathroom | N | Optional | 10 | Yes | No | | Personal services (barber/salon) | N | 2 | 10 | Yes | No |

| 1/ | P=Positive N=Negative ±=Continuous directional control not required. | | --- | --- | | 2/ | Whether positive or negative, pressure must be a minimum of seventy cubic feet per minute (CFM). | | 3/ | The volume of air may be reduced up to fifty percent in these areas during periods of nonuse. The soiled holding area of the general laundry must maintain its full ventilation capacity at all times. |

(4) Individual exhaust systems meet the following requirements:

(a) Where individual mechanical exhaust systems are used to exhaust individual toilet rooms or bathrooms, the individual ventilation fans are interconnected with room lighting to ensure ventilation while room is occupied. The ventilation fan must have a time delay shutoff to ensure that the exhaust continues for a minimum of five minutes after the light switch is turned off; and

(b) The volume of air removed from the space by exhaust ventilation is replaced directly or indirectly by an equal amount of tempered/conditioned air.

(5) Central exhaust systems meet the following requirements:

(a) All fans serving central exhaust systems are located to prevent a positive pressure in the duct passing through an occupied area; and

(b) Fire and smoke dampers are located and installed in accordance with the International Building Code, Standards and amendments in chapter 51-50 WAC.

(6) Air filters meet the following requirements:

(a) All central ventilation or air-conditioning systems are equipped with filters per ASHRAE 2007 HVAC Applications Chapter 7.11 Table 5, Filter Efficiencies for Central Ventilation and Air Conditioning Systems in Nursing Homes and meet the following requirements:

| Table 5 | | | | --- | --- | --- | | Filter Efficiencies for Central Ventilation and Air-Conditioning Systems in Nursing Homes | | | | FUNCTION AREA | Minimum Number of Filter Beds | Filter Efficiency of Main Filter Bed, MERV* | | Resident care, treatment, diagnostic, and related areas | 1 | 15 | | Food preparation areas and laundries | 1 | 8 | | Administrative, bulk storage, and soiled holding areas | 1 | 6 | | *MERV = Minimum Efficiency Reporting Value | | |

(b) Central ventilation or air conditioning systems means any system serving more than a single room used by residents or by any group of rooms serving the same utility function (i.e., the laundry);

(c) Filter efficiency is warranted by the manufacturer and is based on atmospheric dust spot efficiency per ASHRAE Standard 52.2;

(d) The filter bed is located upstream of the air-conditioning equipment, unless a prefilter is employed. In which case, the prefilter is upstream of the equipment and the main filter bed may be located downstream;

(e) Filter frames are durable and provide an airtight fit with the enclosing duct work. All joints between filter segments and enclosing duct work are gasketed or sealed;

(f) All central air systems have a manometer installed across each filter bed with an alarm to signal high pressure differential; and

(g) Humidifiers, if provided, are a steam type.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4040, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-4060 Handwashing sinks in new construction.

The nursing home must provide a handwashing sink in each toilet room and exam room.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4060, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-4080 Drinking fountains in new construction.

Where drinking fountains are installed, the nursing home must ensure the fountains are of the inclined jet, sanitary type.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4080, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-4100 Mixing valves or mixing faucets in new construction.

The nursing home must provide each fixture, except toilet fixtures and special use fixtures, with hot and cold water through a mixing valve or mixing faucet.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4100, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-4120 Spouts in new construction.

The nursing home must ensure all lavatories and sinks in resident rooms, resident toilet rooms, and utility and medication areas have gooseneck spouts, without aerators in areas requiring infection control.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4120, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-4140 Faucet controls in new construction.

The nursing home must provide wrist blade, single-lever controls or their equivalent at all sinks and lavatories. The nursing home must:

(1) Provide at least four inch wrist blades and/or single-levers;

(2) Provide sufficient space for full open and closed operation; and

(3) Color-code and label faucet controls to indicate "hot" and "cold."

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4140, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-4160 Initial nursing home license.

(1) A complete nursing home license application must be:

(a) Submitted at least sixty days prior to the proposed effective date of the license on forms designated by the department;

(b) Signed by the proposed licensee or the proposed licensee's authorized representative;

(d) Reviewed by the department in accordance with this chapter.

(2) All information requested on the license application must be provided. At minimum, the nursing home license application will require the following information:

(a) The name and address of the proposed licensee, and any partner, officer, director, managerial employee, or owner of five percent or more of the proposed licensee;

(b) The names of the administrator, director of nursing services, and, if applicable, the management company;

(d) The number of beds to be licensed; and

(e) The name and address of all nursing homes that the proposed licensee or any partner, officer, director, managerial employee, or owner of five percent or more of the proposed licensee has been affiliated with in the past ten years.

(3) The proposed licensee must be:

(a) The individual or entity responsible for the daily operation of the nursing home;

(b) Denied the license if any individual or entity named in the application is found by the department to be unqualified.

(4) For initial licensure of a new nursing home, the proposed licensee must submit the annual license fee with the initial license application. The per bed license fee is established in the state's omnibus biennial appropriations act and any amendment or additions made to that act.

(5) If any information submitted in the initial license application changes before the license is issued, the proposed licensee must submit a revised application containing the changed information.

(6) If a license application is pending for more than six months, the proposed licensee must submit a revised application containing current information about the proposed licensee or any other individuals or entities named in the application.

(7) A license may not exceed twelve months in duration and expires on a date set by the department.

(8) A license must be issued only to the person who applied for the license.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 11-22-077, § 388-97-4160, filed 11/1/11, effective 12/2/11. Statutory Authority: RCW 18.51.050, 43.135.055, and 2010 c 37 § 206 (19)(a). WSR 10-21-037, § 388-97-4160, filed 10/12/10, effective 10/29/10. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4160, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-4166 Liability insurance required.

The nursing home must:

(1) Obtain liability insurance upon licensure and maintain the insurance as required in WAC 388-97-4167 and 388-97-4168; and

(2) Have evidence of liability insurance coverage available if requested by the department.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 10-02-021, § 388-97-4166, filed 12/29/09, effective 1/29/10.

Wash. Admin. Code § 388-97-4167 Liability insurance required—Commercial general liability insurance or business liability insurance coverage.

The nursing home must have commercial general liability insurance or business liability insurance that includes:

(1) Coverage for the acts and omissions of any employee and volunteer;

(2) Coverage for bodily injury, property damage, and contractual liability;

(3) Coverage for premises, operations, independent contractors, products-completed operations, personal injury, advertising injury, and liability assumed under an insured contract; and

(4) Minimum limits of:

(a) Each occurrence at one million dollars; and

(b) General aggregate at two million dollars.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 10-02-021, § 388-97-4167, filed 12/29/09, effective 1/29/10.

Wash. Admin. Code § 388-97-4168 Liability insurance required—Professional liability insurance coverage.

The nursing home must have professional liability insurance or errors and omissions insurance. The insurance must include:

(1) Coverage for losses caused by errors and omissions of the nursing home, its employees, and volunteers; and

(2) Minimum limits of:

(a) Each occurrence at one million dollars; and

(b) Aggregate at two million dollars.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 10-02-021, § 388-97-4168, filed 12/29/09, effective 1/29/10.

Wash. Admin. Code § 388-97-4180 Nursing home license renewal.

(1) All nursing home licenses must be renewed annually.

(2) License renewals must be:

(a) Submitted at least thirty days prior to the license's expiration date on forms designated by the department;

(b) Signed by the current licensee; and

(3) The current licensee must provide all information on the license renewal form or other information requested by the department.

(4) The application for a nursing home license renewal must be made by the individual or entity currently licensed and responsible for the daily operation of the nursing home.

(5) The nursing home license renewal fee must be submitted at the time of renewal. The per bed license fee is established in the state's omnibus biennial appropriations act and any amendment or additions made to that act.

(6) In unusual circumstances, the department may issue an interim nursing home license for a period not to exceed three months. The current licensee must submit the prorated nursing home license fee for the period covered by the interim license. The annual date of license renewal does not change when an interim license is issued.

(7) A change of nursing home ownership does not change the date of license renewal and fee payment.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 11-22-077, § 388-97-4180, filed 11/1/11, effective 12/2/11. Statutory Authority: RCW 18.51.050, 43.135.055, and 2010 c 37 § 206 (19)(a). WSR 10-21-037, § 388-97-4180, filed 10/12/10, effective 10/29/10. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4180, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-4200 Department review of initial nursing home license applications.

(1) All initial nursing home license applications must be reviewed by the department under this chapter.

(2) The department will not begin review of an incomplete license application.

(3) The proposed licensee must respond to any department request for additional information within five working days.

(4) When the application is determined to be complete, the department will consider the proposed licensee or any partner, officer, director, managerial employee, or owner of five percent or more of the proposed licensee, separately and jointly, in its review. The department will review:

(a) The information contained in the application;

(b) Survey and complaint investigation citations in every facility each individual and entity named in the application has been affiliated with during the past ten years;

(d) Financial assessments;

(e) Actions against the proposed licensee (i.e., revocation, suspension, refusal to renew, etc.);

(f) All criminal convictions, and relevant civil or administrative actions or findings including, but not limited to, findings, including professional disciplinary actions, and findings of abuse, neglect, exploitation, abandonment, or domestic violence resulting from a civil adjudication proceeding; and

(g) Other relevant information.

(5) The department will notify the proposed licensee of the results of the review.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 10-02-021, § 388-97-4200, filed 12/29/09, effective 1/29/10. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4200, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-4220 Reasons for denial, suspension, modification, revocation of, or refusal to renew a nursing home license.

(1) The department may deny, suspend, modify, revoke, or refuse to renew a nursing home license when the department finds the proposed or current licensee, or any partner, officer, director, managing employee, owner of five percent or more of the proposed or current licensee of the nursing home, owner of five percent or more of the assets of the nursing home, proposed or current administrator, or employee or individual providing nursing home care or services has:

(a) Failed or refused to comply with the:

(i) Requirements established by chapters 18.51, 74.42, or 74.46 RCW and by regulations adopted under these chapters; or

(ii) Medicaid requirements of Title XIX of the Social Security Act and medicaid regulations, including 42 C.F.R., Part 483.

(b) A history of significant noncompliance with federal or state regulations in providing nursing home care;

(d) Engaged in the illegal use of drugs or the excessive use of alcohol, unless automatically disqualifying under chapter 388-113 WAC;

(e) Unlawfully operated a nursing home, or long term care facility as defined in RCW 70.129.010, without a license or under a revoked or suspended license;

(f) Previously held a license to operate a hospital or any facility for the care of children or vulnerable adults, and that license has been revoked, or suspended, or the licensee did not seek renewal of the license following written notification of the licensing agency's initiation of revocation or suspension of the license;

(g) Obtained or attempted to obtain a license by fraudulent means or misrepresentation;

(h) Permitted, aided, or abetted the commission of any illegal act on the nursing home premises;

(i) Has a conviction or pending charge for a crime that is not automatically disqualifying under chapter 388-113 WAC, if the conviction or pending charge reasonably relates to the competency of the individual to own or operate a nursing home;

(j) Had a sanction, corrective, or remedial action taken by federal, state, county or municipal officials or safety officials related to the care or treatment of children or vulnerable adults;

(k) Failed to:

(i) Provide any authorization, documentation, or information the department requires in order to verify information contained in the application;

(ii) Meet financial obligations as the obligations fall due in the normal course of business;

(iii) Verify additional information the department determines relevant to the application;

(iv) Report abandonment, abuse, neglect or financial exploitation in violation of chapter 74.34 RCW; or in the case of a skilled nursing facility or nursing facilities, failure to report as required by 42 C.F.R. 483.13; or

(v) Pay a civil fine the department assesses under this chapter within ten days after assessment becomes final.

(l) Been certified pursuant to RCW 74.20A.320 as a person who is not in compliance with a child support order (license suspension only);

(m) Knowingly or with reason to know makes a false statement of a material fact in the application for a license or license renewal, in attached data, or in matters under department investigation;

(n) Refused to allow department representatives or agents to inspect required books, records, and files or portions of the nursing home premises;

(o) Willfully prevented, interfered with, or attempted to impede the work of authorized department representatives in the:

(i) Lawful enforcement of provisions under this chapter or chapters 18.51 or 74.42 RCW; or

(ii) Preservation of evidence of violations of provisions under this chapter or chapters 18.51 or 74.42 RCW.

(p) Retaliated against a resident or employee initiating or participating in proceedings specified under RCW 18.51.220; or

(q) Discriminated against medicaid recipients as prohibited under RCW 74.42.055.

(2) In determining whether there is a history of significant noncompliance with federal or state regulations under subsection (1)(b), the department may, at a minimum, consider:

(a) Whether the violation resulted in a significant harm or a serious and immediate threat to the health, safety, or welfare of any resident;

(b) Whether the proposed or current licensee promptly investigated the circumstances surrounding any violation and took steps to correct and prevent a recurrence of a violation;

(d) Repeated failure to comply with regulations;

(e) Inability to attain compliance with cited deficiencies within a reasonable period of time; and

(f) The number of violations relative to the number of facilities the proposed or current licensee, or any partner, officer, director, managing employee, employee or individual providing nursing home care or services has been affiliated within the past ten years, or owner of five percent or more of the proposed or current licensee or of the assets of the nursing home.

(3) The department must deny, suspend, revoke, or refuse to renew a proposed or current licensee's nursing home license if the proposed or current licensee or any partner, officer, director, managing employee, owner of five percent or more of the proposed or current licensee of the nursing home or owner of five percent or more of the assets of the nursing home, proposed or current administrator, or employee or individual providing nursing home care or services has:

(a) A conviction or pending charge for a crime that is automatically disqualifying under chapter 388-113 WAC; or

(b) One or more of the disqualifying negative actions listed under WAC 388-97-1820.

History

Statutory Authority: RCW 74.39A.056 and chapters 74.42, 18.51 RCW. WSR 14-14-027, § 388-97-4220, filed 6/24/14, effective 7/25/14. Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 10-02-021, § 388-97-4220, filed 12/29/09, effective 1/29/10. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4220, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-4240 Appeal of the department's licensing decision.

A proposed or current licensee contesting a department licensing decision must file a written request for an administrative hearing within twenty days of receipt of the decision.

The appeals process and requirements are set forth in WAC 388-97-4440.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4240, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-4260 Management agreements.

(1) The licensee is responsible for the daily operations of the nursing home.

(2) As used in this section:

(a) "Management agreement," means a written, executed, agreement between the licensee and another individual or entity regarding the provision of certain services in a nursing home; and

(b) "Manager" refers to the individual or entity providing services under a management agreement.

(3) The licensee may not give the manager responsibilities that are so extensive that the licensee is relieved of responsibility for the daily operations and provisions of services of the facility. If the licensee does so, then the department must determine that a change of ownership has occurred.

(4) The proposed licensee or the current licensee must notify the residents and their representatives sixty days before entering into a management agreement.

(5) The department must receive a written management agreement, including an organizational chart showing the relationship between the proposed or current licensee, management company, and all related organizations:

(a) Sixty days before:

(i) The proposed change of ownership date;

(ii) The initial licensure date; or

(iii) The effective date of the management agreement; or

(b) Thirty days before the effective date of any amendment to an existing management agreement.

(6) Management agreements, at minimum must:

(a) Create a principal/agent relationship between the licensee and the manager;

(b) Describe the responsibilities of the licensee and manager, including items, services, and activities to be provided;

(c) Require the licensee's governing body, board of directors, or similar authority to appoint the facility administrator;

(d) Provide for maintenance and retention of all records as applicable according to rules and regulations;

(e) Allow unlimited access by the department to documentation and records according to applicable laws or regulations;

(f) Require the licensee to participate in monthly oversight meetings and quarterly on-site visits to the facility;

(g) Require the manager to immediately send copies of surveys and notices of noncompliance to the licensee;

(h) State that the licensee is responsible for ensuring all licenses, certifications, and accreditations are obtained and maintained;

(i) State that the manager and licensee will review the management agreement annually and notify the department of changes according to applicable regulations;

(j) Acknowledge that the licensee is the party responsible for meeting state and federal licensing and certification requirements;

(k) Require the licensee to maintain ultimate responsibility over personnel issues relating to the operation of the nursing home and care of the residents, including but not limited to, staffing plans, orientation, and training;

(l) Require that, even if day-to-day management of the trust funds are delegated, the licensee:

(i) Retains all fiduciary and custodial responsibility for funds that have been deposited with the nursing home by the resident; and

(ii) Is directly accountable to the residents for such funds.

(m) Provide that if any responsibilities for the day-to-day management of the resident trust fund are delegated to the manager, then the manager must:

(i) Provide the licensee with a monthly accounting of the resident funds; and

(ii) Meet all legal requirements related to holding, and accounting for, resident trust funds; and

(n) State that the manager will not represent itself or give the appearance it is the licensee.

(7) Upon receipt of a proposed management agreement, the department may require:

(a) The licensee or manager to provide additional information or clarification;

(b) Any changes necessary to:

(i) Bring the management agreement into compliance with this section; and

(ii) Ensure that the licensee has not been relieved of the responsibility for the daily operations of the facility; and

(8) The licensee and manager must act in accordance with the terms of the management agreements. If the department determines that they are not, then the department may take action deemed appropriate.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4260, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-4280 Change of ownership.

(1) A change of ownership occurs when there is a substitution, elimination, or withdrawal of the licensee or a substitution of control of the licensee. "Control," as used in this section, means the possession, directly or indirectly, of the power to direct the management, operation, and policies of the licensee, whether through ownership, voting control, by agreement, by contract or otherwise. Events which constitute a change of ownership include, but are not limited to, the following:

(a) The form of legal organization of the licensee is changed (e.g., a sole proprietor forms a partnership or corporation);

(b) The licensee transfers ownership of the nursing home business enterprise to another party regardless of whether ownership of some or all of the real property and/or personal property assets of the facility is also transferred;

(d) Merger unless the licensee survives the merger and there is not a change in control of the licensee;

(e) If, during any continuous twenty-four month period, fifty percent or more of the entity is transferred, whether by a single transaction or multiple transactions, to:

(i) A different party (e.g., new or former shareholders); or

(ii) An individual or entity that had less than a five percent ownership interest in the nursing home at the time of the first transaction; or

(f) Any other event or combination of events that the department determines results in a:

(i) Substitution, elimination, or withdrawal of the licensee; or

(ii) Substitution of control of the licensee responsible for the daily operational decisions of the nursing home.

(2) Ownership does not change when the following, without more, occur:

(a) A party contracts with the licensee to manage the nursing home enterprise in accordance with the requirements of WAC 388-97-4260; or

(b) The real property or personal property assets of the nursing home are sold or leased, or a lease of the real property or personal property assets is terminated, as long as there is not a substitution or substitution of control of the licensee.

(3) When a change of ownership is contemplated, the current licensee must notify the department and all residents and their representatives at least sixty days prior to the proposed date of transfer. The notice must be in writing and contain the following information as specified in RCW 18.51.530:

(a) Name of the proposed licensee;

(b) Name of the managing entity;

(c) Names, addresses, and telephone numbers of department personnel to whom comments regarding the change may be directed;

(d) Names of all officers and the registered agent in the state of Washington if proposed licensee is a corporation; and

(e) Names of all general partners if proposed licensee is a partnership.

(4) The proposed licensee must comply with license application requirements. The operation or ownership of a nursing home must not be transferred until the proposed licensee has been issued a license to operate the nursing home.

(5) In the event of a change of ownership, the previously established license expiration date must not change.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 11-22-077, § 388-97-4280, filed 11/1/11, effective 12/2/11. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4280, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-4300 Licensed bed capacity.

A nursing home must not be licensed for a capacity that exceeds the number of beds permitted under:

(1) This chapter;

(2) Chapter 70.38 RCW and regulations thereunder; or

(3) Applicable local zoning, building or other such regulations.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4300, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-4320 Relocation of residents.

(1) In the event of license revocation or suspension, decertification, or other emergency closures the department will:

(a) Notify residents and, when appropriate, residents' emergency contacts of the action;

(b) Assist with residents' relocation and identify possible alternative living choices and locations; and

(2) When a resident's relocation occurs due to an emergency closure from a natural disaster, the nursing home may not be required to cease its business operations unless directed to do so by the department.

(3) When a resident's relocation occurs due to a nursing home's voluntary closure, or voluntary termination of its medicare or medicaid contract or both, the nursing home must:

(a) Notify the department and all residents and resident representatives in accordance with WAC 388-97-1640;

(b) Notify the Centers for Medicare and Medicaid Services and the public as required by 42 C.F.R. 489.52, or a successor regulation, if the closure or termination affects the provision of medicare services; and

(c) Provide appropriate discharge planning and coordination for all residents including a plan to the department for safe and orderly transfer or discharge of residents from the nursing home.

(4) The department may provide residents assistance with relocation.

History

Statutory Authority: RCW 18.20.090, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 25-16-099, s 388-97-4320, filed 8/6/25, effective 9/6/25. Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 10-02-021, § 388-97-4320, filed 12/29/09, effective 1/29/10. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4320, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-4340 License relinquishment.

(1) A nursing home licensee must voluntarily relinquish its license when:

(a) The nursing home ceases to do business as a nursing home; and

(b) Within twenty-four hours after the last resident is discharged from the facility.

(2) The nursing home may not be required to relinquish its license when residents must be relocated due to emergency closures from natural disasters.

(3) The relinquished license must be returned to the department.

(4) If a nursing home licensee fails to voluntarily relinquish its license when required, the department will revoke the license.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 10-02-021, § 388-97-4340, filed 12/29/09, effective 1/29/10. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4340, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-4360 Inspections and deficiency citation report.

(1) The department may inspect nursing homes at any time in order to determine compliance with the requirements of chapters 18.51 or 74.42 RCW and this chapter. Types of state inspections in nursing homes include preoccupancy, licensing, revisit, and complaint investigation. In the case of a medicaid or medicare contractor, or both, the department may also inspect medicare and medicaid certified nursing homes to determine compliance with the requirements of Title XVIII and/or XIX of the Social Security Act and federal medicare and medicaid regulations.

(2) The department will provide to the nursing home written documentation (notice) of the nursing home's deficiency(ies), the requirement that the deficiency(ies) violates, and the reasons for the determination of noncompliance with the requirements (RCW 18.51.091).

(3) The department may revisit the nursing home to confirm that corrections of deficiencies has been made. Revisits will be made:

(a) In accordance with RCW 74.39A.060 (5)(e);

(b) In the case of a medicare or medicaid contractor, or both, in accordance with the requirements of Title XVIII or XIX, or both of the Social Security Act and federal medicare and medicaid regulations; and

(4) The licensee or nursing home must:

(a) Ensure that department staff have access to the nursing home residents, staff and all resident records; and

(b) Not willfully interfere or fail to cooperate with department staff in the performance of official duties. Examples of willful interference or failure to cooperate include, but are not limited to, not allowing department staff to talk to residents or staff in private or not allowing department staff access to resident records.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4360, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-4361 Inspection timelines.

(1) In response to the COVID-19 pandemic, the governor suspended the requirement for the department to conduct general periodic inspections of nursing homes under RCW 18.51.091 and 18.51.230.

(2) During the suspension of the general periodic inspection requirements, the department continued to conduct complaint investigations in nursing homes when it became aware of information that indicated an immediate threat to resident health and safety may exist.

(3) The department must prioritize and resume general periodic inspections of nursing homes affected by the suspension of the inspection requirements by applying the following criteria collectively:

(a) The department has identified an ongoing threat to the health and safety of residents through one or more reported complaints, previous inspections, or previous investigations;

(b) Whether the nursing home has had a state or federal remedy imposed in the last 24 months;

(d) Any requirements imposed by the centers for medicare and medicaid services, including those for facilities designated as special focus facilities.

(4) The department must conduct a general period inspection for nursing homes licensed after the reinstatement of RCW 18.51.091 and 18.51.230 in accordance with the schedule set by RCW 18.51.091(1) and 18.51.230(1), and chapter 388-97 WAC.

History

Statutory Authority: RCW 18.20.090, 70.97.100, 70.97.230, 70.128.040, and 74.42.620. WSR 22-17-051, § 388-97-4361, filed 8/11/22, effective 9/11/22.

Wash. Admin. Code § 388-97-4380 Plan of correction.

(1) The licensee or nursing home must, within ten calendar days of notification of the cited deficiencies prepare, sign, date and provide to the department a detailed written plan of correction. Such plan of correction will provide notification to the department of the date by which the nursing home will complete the correction of cited deficiencies. The plan of correction must be completed regardless of whether the licensee requests an informal department review in accordance in WAC 388-97-4420.

(2) A plan of correction is not required for deficiencies at a severity level 1/isolated scope as described in WAC 388-97-4500, unless specifically requested by the department.

(3) In the case of actual or imminent threat to resident health or safety/immediate jeopardy (severity level 4 as described in WAC 388-97-4500), the department may require the licensee or nursing home to submit a document alleging that the imminent threat has been removed within a time frame specified by the department. The document must specify the steps the nursing home has taken or will take to correct the imminent harm. An allegation that the imminent harm has been removed does not substitute for the plan of correction as required by subsection (1) of this section but it will become a part of the completed plan of correction.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4380, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-4400 Acceptable and unacceptable plans of correction.

(1) A plan of correction must:

(a) Address how corrective action will be accomplished for those residents found to have been affected by the deficient practice;

(b) Address how the nursing home will identify other residents having the potential to be affected by the same deficient practice;

(c) Address what measures will be put into place or systemic changes made to ensure that the deficient practice will not recur;

(d) Indicate how the nursing home plans to monitor its performance to make sure that solutions are sustained, including how the plan of correction will be integrated into the nursing home's quality assurance system;

(e) Give the title of the person who is responsible for assuring lasting correction; and

(f) Give the date by which the correction will be made.

(2) The department will review the nursing home's plan of correction to determine whether it is acceptable.

(3) When deficiencies involve nursing home alterations, physical plant plan development, construction review, or other circumstances where extended time to complete correction may be required, the department's designated local aging and disability services administration field office or other department designee may accept a plan of correction as evidence of substantial compliance under the following circumstances:

(a) The plan of correction must include the steps that the nursing home needs to take, the time schedule for completion of the steps, and concrete evidence that the plan will be carried out as scheduled; and

(b) The nursing home must submit progress reports and/or updated plans to the department in accordance with a schedule specified by department.

(c) The department's acceptance of a plan of correction is solely at the department's discretion and does not rule out the imposition of optional remedies.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4400, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-4420 Informal department review.

(1) For medicare or medicaid certified nursing homes, the informal department review process described in this section is the only opportunity for the nursing home to dispute the federal deficiency citation report, unless a federal sanction is imposed.

(2) The nursing home licensee has the right to an informal department review of disputed state or federal citations, or both.

(3) A licensee must make a written request for an informal department review within ten calendar days of receipt of the department's written deficiency citation(s) report. The request must be directed to the department's designated local aging and disability services administration office and must identify the deficiencies that are being disputed.

(4) At the informal department review, the licensee or nursing home may provide documentation and verbal explanations related to the disputed federal or state deficiencies, or both.

(5) When modifications or deletions are made to the disputed federal or state deficiency citations, or both, the licensee or nursing home must modify or delete the relevant portions of the plan of correction within five days of receipt of the modified or deleted deficiency(ies). The licensee or nursing home may request from the department a clean copy of the revised deficiency citation report.

(6) If the licensee or nursing home is unwilling to provide the modified plan of correction, the department may impose a per day civil fine for failure to return the modified deficiency citation report to the department in accordance with this subsection.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4420, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-4425 Notice—Service complete.

Service of the department notices is complete when:

(1) Personal service is made;

(2) The notice is addressed to the facility or to the individual at his or her last known address, and deposited in the United States mail;

(3) The notice is faxed and the department receives evidence of transmission;

(4) Notice is delivered to a commercial delivery service with charges prepaid;

(5) Notice is delivered to a legal messenger service with charges prepaid; or

(6) Notice is sent electronically, including through the federal website.

History

Statutory Authority: RCW 74.42.620. WSR 19-21-006, § 388-97-4425, filed 10/3/19, effective 11/3/19. Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 10-02-021, § 388-97-4425, filed 12/29/09, effective 1/29/10.

Wash. Admin. Code § 388-97-4430 Notice—Proof of service.

The department may establish proof of service by any of the following:

(1) A declaration of personal service;

(2) An affidavit or certificate of mailing to the nursing home or to the individual to whom the notice is directed;

(3) A signed receipt from the person who accepted the certified mail, the commercial delivery service, or the legal messenger service package;

(4) Proof of fax transmission; or

(5) Proof of electronic transmission.

History

Statutory Authority: RCW 74.42.620. WSR 19-21-006, § 388-97-4430, filed 10/3/19, effective 11/3/19. Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 10-02-021, § 388-97-4430, filed 12/29/09, effective 1/29/10.

Wash. Admin. Code § 388-97-4440 Appeal rights.

(1) The appeal rights in this section apply to any appealable action taken by the department under chapters 18.51, 74.42 and 74.39A RCW. Notice and appeal requirements for resident protection program findings are described in WAC 388-97-0720 and 388-97-0740.

(2) The following actions may be appealed:

(a) Imposition of a penalty under RCW 18.51.060 or 74.42.580;

(b) A denial of a license under RCW 18.51.054, a license suspension under RCW 18.51.067 or a condition on a license under RCW 74.39A.050; or

(3) The appeal process will be governed by the Administrative Procedure Act (chapter 34.05 RCW), RCW 18.51.065 and 74.42.580, chapter 388-02 WAC and this chapter. If there is a conflict between chapter 388-02 WAC and this chapter, this chapter will govern.

(4) The purpose of an administrative hearing will be to review actions taken by the department under chapters 18.51, 74.42 or 74.39A RCW, and under this chapter.

(5) The office of administrative hearings must receive an administrative hearing request from the applicant, licensee, or nursing home within twenty days of receipt of written notification of the department's action listed in subsection (2) of this section. Further information about administrative hearings is available in chapter 388-02 WAC and at the office of administrative hearings (OAH) website: www.oah.wa.gov.

(6) Orders of the department imposing a stop placement, license suspension, emergency closure, emergency transfer of residents, temporary management, or conditions on a license are effective immediately upon verbal or written notice and must remain in effect until they are rescinded by the department or through the state administrative appeals process.

(7) Federal deficiencies cited on the federal survey report may not be appealed through the state administrative appeals process. If a federal remedy is imposed, the Centers for Medicare and Medicaid Services will notify the nursing facility of appeal rights under the federal administrative appeals process.

History

Statutory Authority: RCW 74.42.620. WSR 19-21-006, § 388-97-4440, filed 10/3/19, effective 11/3/19. Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 10-02-021, § 388-97-4440, filed 12/29/09, effective 1/29/10. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4440, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-4460 Remedies.

Mandatory Remedies

(1) In accordance with RCW 18.51.060 (5)(a), the department must impose a stop placement order when the department determines that the nursing home is not in substantial compliance with applicable laws or regulations and the cited deficiency(ies):

(a) Jeopardize the health and safety of the residents; or

(b) Seriously limit the nursing home's capacity to provide adequate care.

(2) When required by RCW 18.51.060(3), the health care authority must deny payment to a nursing home that is certified to provide medicaid services for any medicaid-eligible individual admitted to the nursing home. Nursing homes that are certified to provide medicare services or both medicare and medicaid services may be subject to a federal denial of payment for new admissions, in accordance with federal law.

(3) The department must deny, suspend, revoke or refuse to renew a proposed or current licensee's nursing home license in accordance with WAC 388-97-4220(3).

Optional Remedies

(4) When the department determines that a licensee has failed or refused to comply with the requirements under chapter 18.51, 74.39A or 74.42 RCW, or this chapter; or a medicaid contractor has failed or refused to comply with medicaid requirements of Title XIX of the Social Security Act or medicaid regulations, the department, or when appropriate, the health care authority, may impose any or all of the following optional remedies:

(a) Stop placement;

(b) Immediate closure of a nursing home, emergency transfer of residents or both;

(d) Appoint temporary management;

(e) Petition the court for appointment of a receiver in accordance with RCW 18.51.410;

(f) License denial, revocation, suspension or nonrenewal;

(g) Denial of payment for new medicaid admissions;

(h) Termination of the medicaid provider agreement (contract);

(i) Department on-site monitoring as defined under WAC 388-97-0001; and

(j) Reasonable conditions on a license as authorized by chapter 74.39A RCW. Examples of conditions on a license include but are not limited to training related to the deficiency(ies); consultation in order to write an acceptable plan of correction; demonstration of ability to meet financial obligations necessary to continue operation.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 11-22-077, § 388-97-4460, filed 11/1/11, effective 12/2/11. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4460, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-4480 Criteria for imposing optional remedies.

(1) The criteria set forth in this section implement the requirements under RCW 18.51.060(8). The criteria do not replace the standards for imposition of mandatory remedies under RCW 18.51.060 (3) and (5), or for the imposition of mandatory remedies in accordance with WAC 388-97-4460 (1), (2) and (3).

(2) The department must consider the imposition of one or more optional remedy(ies) when the nursing home has:

(a) A history of being unable to sustain compliance;

(b) One or more deficiencies on one inspection at severity level 2 or higher as described in WAC 388-97-4500;

(c) Been unable to provide an acceptable plan of correction after receiving assistance from the department about necessary revisions;

(d) One or more deficiencies cited under general administration and/or nursing services;

(e) One or more deficiencies related to retaliation against a resident or an employee for whistle blower activity under RCW 18.51.220, 74.34.180 or 74.39A.060 and WAC 388-97-1820;

(f) One or more deficiencies related to discrimination against a medicare or medicaid client under RCW 74.42.055, and Titles XVIII and XIX of the Social Security Act and medicare and medicaid regulations; or

(g) Willfully interfered with the performance of official duties by a long-term care ombuds.

(3) The department, in its sole discretion, may consider other relevant factors when determining what optional remedy or remedies to impose in particular circumstances.

(4) When the department imposes an optional remedy or remedies, the department will select more severe penalties for nursing homes that have deficiency(ies) that are:

(a) Uncorrected upon revisit;

(b) Recurring (repeated);

(d) Present a threat to the health, safety, or welfare of the residents.

(5) The department will consider the severity and scope of cited deficiencies in accordance with WAC 388-97-4500 when selecting optional remedy(ies). Such consideration will not limit the department's discretion to impose a remedy for a deficiency at a low level severity and scope.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW. WSR 14-12-040, § 388-97-4480, filed 5/29/14, effective 6/29/14. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4480, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-4500 Severity and scope of deficiencies.

(1) "Severity of a deficiency" means the seriousness of the deficiency. Factors the department will consider when determining the severity of a deficiency may include, but are not limited to:

(a) Whether harm to the resident has occurred, or could occur, including but not limited to a violation of resident's rights;

(b) The Impact of the actual or potential harm on the resident; and

(c) The degree to which the nursing home failed to meet the resident's highest practicable physical, mental, and psychosocial well-being as defined in WAC 388-97-0001.

(2) Severity levels

| (a) Severity level 4—Imminent harm or immediate jeopardy Level 4 means that a resident(s)' health or safety is imminently threatened or immediately jeopardized as a result of deficient nursing home practice. This level includes actual harm or potential harm, or both, to resident(s)' health or safety that has had or could have a severe negative outcome or critical impact on resident's well-being, including death or severe injury. Severity Level 4 requires immediate corrective action to protect the health and safety of resident(s). | | --- | | (b) Severity level 3—Actual harm Level 3 means that actual harm has occurred to resident(s) as the result of deficient nursing home practice. (i) "Serious harm" is harm that results in a negative outcome that significantly compromises the resident(s)' ability to maintain and/or reach the highest practicable physical, mental and psychosocial well-being. Serious harm does not constitute imminent danger/immediate jeopardy (Severity Level 4). (ii) "Moderate harm" is harm that results in a negative outcome that more than slightly but less than significantly compromises the resident(s)' ability to maintain and/or reach the highest practicable physical, mental and psychosocial well-being. (iii) "Minimal harm" is harm that results in a negative outcome that to a small degree compromises the resident(s)' ability to maintain and/or reach the highest practicable physical, mental well-being. | | (c) Severity level 2—Potential for harm Level 2, "potential for harm" means that if the deficient nursing home practice is not corrected, resident(s) may suffer actual harm. | | (d) Severity level 1—No harm or minimal impact Level 1 means a deficient nursing home practice that does not compromise the resident(s)' ability to maintain or reach, or both, the highest practicable physical, mental and psychosocial well-being. Deficiencies at level 1 are those that have no direct or potential for no more than minimal impact on the resident. Examples include certain structure deficiencies, certain physical environment deficiencies and process deficiencies. |

(3) "Scope of a deficiency" means the frequency, incidence, or extent of the occurrence of the deficiency.

(4) Scope categories

(a) "Isolated or limited scope" means a relatively few number of residents have been affected or have the potential to be affected, by the deficient nursing home practice.

(b) "Moderate or pattern scope" scope means more than an isolated and less than a widespread number of residents have been affected, or have the potential to be affected by the deficient nursing home practice.

(c) "Widespread" or "systemic scope" means most or all of the residents are affected or have the potential to be affected, by the deficient nursing home practice.

(5) Determination of scope will be made by the department in its sole discretion. Factors the department will consider may include:

(a) Size of the nursing home;

(b) Size of the sample;

(d) Whether the deficiency applies to all or a subset of the residents;

(e) Other factors relevant to the particular circumstances.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4500, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-4520 Separate deficiencies—Separate remedies.

(1) Each deficiency cited by the department for noncompliance with a statute or regulation is a separate deficiency subject to the assessment of a separate remedy.

(2) Each day upon which the same deficiency occurs is a separate deficiency subject to the assessment of a separate remedy.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4520, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-4540 Stop placement.

(1) The department must impose a stop placement order when required by RCW 18.51.060 (5)(a) and WAC 388-97-4460(1) and may impose a stop placement order as an optional remedy in accordance with WAC 388-97-4480. The department's stop placement order becomes effective upon verbal or written notice.

(2) The nursing home must:

(a) Publicly post any department issued notice of a stop placement order or limited stop placement order in a location visible to residents, visitors, and staff within the assisted living facility; and

(b) Leave the notice in place until the department has terminated the stop placement order or limited stop placement order.

(3) The nursing home has the right to an informal department review to refute the federal or state deficiencies, or both, cited as the basis for the stop placement and must request such review in accordance with WAC 388-97-4420(3).

(4) The department will not delay or suspend a stop placement order because the nursing home requests an administrative hearing or informal department review.

(5) The stop placement order must remain in effect until:

(a) The department terminates the stop placement order; or

(b) The stop placement order is terminated by a final agency order following appeal conducted in accordance with chapter 34.05 RCW.

(6) The department must terminate the stop placement when:

(a) The nursing home states in writing that the deficiencies necessitating the stop placement action have been corrected; and

(b) Within 15 working days of the nursing home's notification, department staff confirm by on-site revisit of the nursing home that:

(i) The deficiencies that necessitated the stop placement action have been corrected; and

(ii) The nursing home exhibits the capacity to maintain adequate care and services and correction of deficiencies.

(7) After lifting the stop placement, the department may continue to perform on site monitoring to verify that the nursing home has maintained correction of deficiencies.

(8) While a stop placement order is in effect, the department may approve a readmission to the nursing home from the hospital in accordance with RCW 18.51.060 (5)(b) and department guidelines for readmission decisions.

History

Statutory Authority: RCW 18.20.090, 18.51.070, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 26-05-046, s 388-97-4540, filed 2/12/26, effective 3/15/26. Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4540, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-4560 Amount of civil fine.

(1) Except as otherwise provided in statute, the range for a:

(a) Per day civil fine is fifty dollars to three thousand dollars; and

(b) Per instance civil fine is one thousand to three thousand dollars.

(2) In the event of continued noncompliance, nothing in this section must prevent the department from increasing a civil fine up to the maximum amount allowed by law.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4560, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-4580 Civil fine accrual and due dates and interest.

(1) Accrual of a per day civil fine begins on the first date the department verifies that the nursing home has or had a specific deficiency. Accrual of the per day civil fine will end on the date the department determines the nursing home corrected the deficiency.

(2) A per instance fine may be assessed for a deficiency, regardless of whether or not the deficiency had been corrected by the time the department first identified it.

(3) Civil fine(s) are due twenty days after the nursing home is notified of the civil fine(s) if the nursing home does not request a hearing.

(4) If the nursing home requests a hearing, the civil fine(s) including interest, if any, is due twenty days after:

(a) A hearing decision ordering payment of the fine(s) becomes final in accordance with chapter 388-02 WAC;

(b) The appeal is withdrawn;

(d) An order of dismissal is entered.

(5) Interest on the civil fine(s) begins to accrue at a rate of one percent per month, thirty days after the nursing home is notified of the fine, unless a settlement agreement includes other provisions for payment of interest. If the amount of the civil fine is reduced following an appeal, interest on the reduced civil fine(s) accrues from thirty days after the nursing home was notified of the original civil fine(s).

(6) When a nursing home fails to pay a civil fine when due under this chapter, the department may:

(a) Withhold an amount equal to the fine plus interest, if any, from the nursing home's medicaid payment;

(b) Impose an additional fine; or

(c) Suspend the nursing home license under WAC 388-97-570(1). Such license suspension must continue until the fine is paid.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4580, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-4600 Civil penalty fund.

(1) The department must deposit civil penalties collected under chapter 18.51 or 74.42 RCW into a special fund administered by the department to be applied to the protection of the health or property of residents of nursing homes found to be deficient.

(2) The funds must be administered by the department according to department procedures. Uses of the fund include, but are not limited to:

(a) Payment for the costs of relocation of residents to other facilities;

(b) Payment to maintain operation of a nursing home pending correction of deficiencies or closure; and

(c) Reimbursement of residents for personal funds or property lost when the resident's personal funds or property cannot be recovered from the nursing home or third party insurer.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4600, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-4620 Temporary management.

(1) When the department appoints a temporary manager, the department must order the licensee to:

(a) Cease operating the nursing home; and

(b) Immediately turn over to the temporary manager possession and control of the nursing home including, but not limited to, all patient care records, financial records, and other records necessary for continued operation of the nursing home while temporary management is in effect.

(2) The temporary manager will have authority to temporarily relocate some or all residents if the:

(a) Temporary manager determines the resident's health, security, or welfare is jeopardized; and

(b) Department concurs with the temporary manager's determination that relocation is necessary.

(3) The department's authority to order temporary management is discretionary in all cases.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4620, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-4640 Receivership.

(1) Receivership is authorized under RCW 18.51.400 through 18.51.520 and the following regulations.

(2) After receivership is established, the department may recommend to the court that all residents be relocated and the nursing home closed when:

(a) Problems exist in the physical condition of the premises which cannot be corrected in an economically prudent manner; or

(b) The department determines the former licensee or owner:

(i) Is unwilling or unable to manage the nursing home in a manner ensuring residents' health, safety, and welfare; and

(ii) Has not entered into an enforceable agreement to sell the nursing home within three months of the court's decision to grant receivership.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4640, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-4660 Temporary managers and receivers—Application.

(1) The department may recruit individuals, partnerships, corporations and other entities interested in serving as a temporary manager or receiver of a nursing home.

(2) Individuals, partnerships, corporations, or other entities interested in being appointed as a temporary manager or receiver must complete and submit to the department the required application on department forms.

(3) Individuals, partnerships, corporations, or other entities with experience in providing long-term health care and a history of satisfactory nursing home operation may submit an application to the department at any time. Applicants will be subject to the criteria established for licensees found in WAC 388-97-4220, except the department may waive the requirement that it have at least sixty days to review the application.

(4) The department must not appoint or recommend the appointment of a person (including partnership, corporation or other entity) to be a temporary manager or receiver if that person:

(a) Is the licensee, administrator, or partner, officer, director, managing employee, or owner of five percent or more of the licensee of the nursing home subject to temporary management or receivership;

(b) Is affiliated with the nursing home subject to temporary management or receivership; or

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4660, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-4680 Temporary managers and receivers—Considerations before appointment.

(1) The department's authority to appoint a temporary manager or to recommend appointment of a specific individual or entity to act as receiver is discretionary in all cases.

(2) The department, in appointing a temporary manager or recommending appointment of a receiver, may consider one or more of the following factors:

(a) Potential temporary manager's or receiver's willingness to serve as a temporary manager or receiver for the nursing home in question;

(b) Amount and quality of the potential temporary manager's or receiver's experience in long-term care;

(c) Quality of care, as determined by prior survey reports, provided under the potential temporary manager's or the potential receiver's supervision, management or operation;

(d) Potential temporary manager's or receiver's prior performance as a temporary manager or receiver;

(e) How soon the potential temporary manager or receiver is available to act as a temporary manager or receiver;

(f) Potential temporary manager's or receiver's familiarity and past compliance with Washington state and federal regulations applicable to nursing homes.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4680, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-4700 Duties and powers of temporary manager and receiver.

(1) The temporary manager or receiver must protect the health, security and welfare of the residents for the duration of the temporary management or receivership. The temporary manager or receiver must perform all acts reasonably necessary to ensure residents' needs are met. Such acts may include, but are not limited to:

(a) For receivers, the powers in RCW 18.51.490;

(b) Correcting cited deficiencies;

(c) Hiring, directing, and managing all consultants and employees and discharging them for just cause, discharging the administrator of the nursing home, recognizing collective bargaining agreement, and settling labor disputes;

(d) Receiving and expending in a prudent and business-like manner all current revenues of the home provided priority will be given to debts and expenditures directly related to providing care and meeting residents' needs;

(e) Making necessary purchases, repairs, and replacements, provided such expenditures in excess of five thousand dollars are approved by the department, or in the case of a receiver, approved by court;

(f) Entering into contracts necessary for the operation of the nursing home, provided that, the court must approve contracts extending beyond the period of receivership;

(g) Preparing all department-required reports;

(h) Overseeing facility closure, when appropriate;

(i) Planning required relocation with residents and residents' legal representative, family, or significant others in conjunction with home and community services division field staff;

(j) Meeting regularly with and informing staff, residents, and residents' families or significant others of:

(i) Plans for correcting the cited deficiencies;

(ii) Progress achieved in correction of deficiencies;

(iii) Plans for facility closure and relocation; and

(iv) Plans for continued operation of the nursing home, including training of staff.

(2) The temporary manager or receiver must make a detailed monthly accounting of all expenditures and liabilities to the department and to the owner of the nursing home, and to the court when required.

(3) The receiver must consult the court in cases of extraordinary or questionable debts incurred prior to the receiver's appointment and will not have the power to close the home or sell any of the nursing home's assets without prior court approval.

(4) The temporary manager or receiver must comply with all applicable state and federal laws and regulations. If the nursing home is certified and is providing care to medicaid clients, the temporary manager or receiver must become the medicaid contractor for the duration of the temporary management or receivership period.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4700, filed 9/24/08, effective 11/1/08.

Wash. Admin. Code § 388-97-4720 Termination of temporary management and receivership.

(1) The department will terminate temporary management:

(a) After three months unless good cause is shown to continue the temporary management. Good cause for continuing the temporary management exists when returning the nursing home to its former licensee would subject residents to a threat to health, safety, or welfare;

(b) When all residents are transferred and the nursing home is closed;

(c) When deficiencies threatening residents' health, safety, or welfare are eliminated and the former licensee agrees to department-specified conditions regarding the continued facility operation; or

(d) When a new licensee assumes control of the nursing home.

(2) The department may appoint an alternate temporary manager:

(a) When the temporary manager is no longer willing to serve as a temporary manager;

(b) If a temporary manager is not making acceptable progress in correcting the nursing home deficiencies or in closing the nursing home; or

(c) If the department determines the temporary manager is not operating the nursing home in a financially responsible manner.

(3) The receivership will terminate in accordance with RCW 18.51.450 and 18.51.460.

(4) The department may recommend to the court an alternate receiver be appointed:

(a) When the receiver is no longer willing to serve as a receiver; or

(b) If a receiver is not making acceptable progress in correcting the deficiencies in the nursing home.

History

Statutory Authority: Chapters 18.51 and 74.42 RCW and 42 C.F.R. 489.52. WSR 08-20-062, § 388-97-4720, filed 9/24/08, effective 11/1/08.

Chapter 388-101 Certified community residential services and supports.

Wash. Admin. Code § 388-101-3000 Definitions.

The definitions in this section apply throughout this chapter and chapter 388-101D WAC unless the context clearly indicates otherwise.

(1) "Abandonment" has the same meaning as defined in RCW 74.34.020.

(2) "Abuse" has the same meaning as defined in RCW 74.34.020.

(3) "Associated with the applicant" means any person listed on the application as a partner, officer, director, or majority owner of the applying entity, or who is the spouse or domestic partner of the applicant.

(4) "Case manager" means the developmental disabilities administration case resource manager or social worker assigned to a client.

(5) "Certification" means a process used by the department to determine if an applicant or service provider complies with the requirements of this chapter and is eligible to provide certified community residential services and support to clients.

(6) "Chaperone agreement" means a plan or agreement that describes who will supervise a community protection program client when service provider staff is not present. This plan or agreement is negotiated with other agencies and individuals who support the client, including the client's legal representative and family.

(7) "Chemical restraint" has the same meaning as defined in RCW 74.34.020.

(8) "Client" means a person who has a developmental disability as defined in RCW 71A.10.020(4) and has been determined eligible to receive services by the developmental disabilities administration under chapter 71A.16 RCW. For purposes of informed consent and decision making requirements, the term "client" includes the client's legal representative to the extent of the representative's legal authority.

(9) "Client services" means instruction and support services that service providers are responsible to provide as identified in the client's individual support plan.

(10) "Consent" means express written consent granted after the vulnerable adult or their legal representative has been fully informed of the nature of the services to be offered and that the receipt of services is voluntary.

(11) "Crisis diversion" means temporary crisis residential services and supports provided to clients at risk of psychiatric hospitalization and authorized by the developmental disabilities administration.

(12) "Crisis diversion bed services" means crisis diversion that is provided in a residence maintained by the service provider.

(13) "Crisis diversion support services" means crisis diversion that is provided in the client's own home.

"Department" means the Washington state department of social and health services.

(14) "Financial exploitation" has the same meaning as defined in RCW 74.34.020.

(16) "Functional assessment" means a comprehensive evaluation of a client's challenging behavior(s). This evaluation is the basis for developing a positive behavior support plan.

(17) "Group home" means a residence that is licensed as either an assisted living facility or an adult family home by the department under chapter 388-78A or 388-76 WAC. Group homes provide community residential instruction, supports, and services to two or more clients who are unrelated to the provider.

(18) "Group training home" means a certified nonprofit residential facility that provides full-time care, treatment, training, and maintenance for clients, as defined under RCW 71A.22.020(2).

(19) "Immediate" or "immediately" means within twenty-four hours for purposes of reporting abandonment, abuse, neglect, or financial exploitation of a vulnerable adult.

(20) "Immediate risk," "immediate threat," or "imminent danger" means serious physical harm to or death of a client or serious threat to a client's life, health, or safety.

(21) "Individual financial plan" means a plan describing how a client's funds will be managed when the service provider is responsible for managing any or all of the client's funds.

(22) "Individual instruction and support plan" means a plan developed by the service provider and the client. The individual instruction and support plan:

(a) Uses the information and assessed needs documented in the individual support plan to identify areas the client would like to develop;

(b) Includes client goals for instruction and support that will be formally documented during the year; and

(c) Must contain or refer to other applicable support or service information that describes how the client's health and welfare needs are to be met (such as, individual financial plan, positive behavior support plan, cross system crisis plan, individual support plan, individual written plan, client-specific instructions).

(23) "Individual support plan" means a document that authorizes and identifies the developmental disabilities administration paid services to meet a client's assessed needs.

(24) "Instruction" means goal oriented teaching that is designed for acquiring and enhancing skills.

(25) "Instruction and support services staff" means long-term care workers of the service provider whose primary job function is the provision of instruction and support services to clients. Instruction and support services staff must also include employees of the service provider whose primary job function is the supervision of instruction and support services staff. In addition, both applicants, prior to initial certification, and administrators, prior to assuming duties, who may provide instruction and support services to clients must be considered instruction and support services staff for the purposes of the applicable training requirements.

(26) "Legal representative" means a person's legal guardian, limited guardian when the subject matter is within the scope of the limited guardianship, attorney at law, attorney in fact, or any other person who is authorized by law to act for another person.

(27) "Long-term care workers" include all persons who provide paid, hands-on personal care services for the elderly or persons with disabilities, including but not limited to individual providers of home care services, direct care workers employed by home care agencies, providers of home care services to persons with developmental disabilities under Title 71A RCW, all direct care workers in state-licensed assisted living facilities, adult family homes, respite care providers, direct care workers employed by community residential service businesses, and any other direct care worker providing home or community-based services to the elderly or persons with functional disabilities or developmental disabilities.

(28) "Managing client funds" means that the service provider:

(1) Has signing authority for the client;

(2) Disperses the client's funds; or

(3) Limits the client's access to funds by not allowing funds to be spent.

(29) "Mechanical restraint" means any device attached or adjacent to the vulnerable adult's body that they cannot easily remove that restricts freedom of movement or normal access to their body. "Mechanical restraint" does not include the use of devices, materials, or equipment that are medically authorized and used in a manner that is consistent with federal or state licensing or certification requirements for facilities, hospitals, or programs authorized under chapter 71A.12 RCW.

(30) "Medication administration" means the direct application of a prescribed medication whether by injection, inhalation, ingestion, or other means, to the body of the client by an individual legally authorized to do so.

(31) "Medication assistance" means assistance with self-administration of medication rendered by a nonpractitioner to a client receiving certified community residential services and supports in accordance with chapter 69.41 RCW and chapter 246-888 WAC.

(32) "Medication service" means any service provided by a certified community residential services and support provider related to medication administration or medication assistance provided through nurse delegation and medication assistance.

(33) "Minimal" means a violation that results in little or no negative outcome or little or no potential harm for a client.

(34) "Moderate" means a violation that results in negative outcome or actual or potential harm for a client.

(35) "Negative outcome" includes any negative effect on the client's physical, mental, or psychosocial well-being, including but limited to the client's safety, quality of life, or quality of care.

(36) "Neglect" has the same meaning as defined in RCW 74.34.020.

(37) "Physical intervention" means the use of a manual technique intended to interrupt or stop a behavior from occurring. This includes using physical restraint to release or escape from a dangerous or potentially dangerous situation.

(38) "Physical restraint" means the application of physical force without the use of any device, for the purpose of restraining the free movement of a vulnerable adult's body. "Physical restraint" does not include briefly holding without undue force a vulnerable adult in order to calm or comfort them, or holding a vulnerable adult's hand to safely escort them from one area to another.

(39) "Psychoactive" means possessing the ability to alter mood, anxiety level, behavior, cognitive processes, or mental tension, usually applied to pharmacological agents.

(40) "Psychoactive medications" means medications prescribed to improve or stabilize mood, mental status or behavior. Psychoactive medications include antipsychotics/neuroleptics, atypical antipsychotics, antidepressants, stimulants, sedatives/hypnotics, and antimania and antianxiety drugs.

(41) "Qualified professional" means a person with at least three years' experience working with individuals with developmental disabilities and as required by RCW 71A.12.220(12).

(42) "Recurring" or "repeated" means that the department has cited the service provider for a violation of licensing laws or rules and one or more of the following is present:

(a) The department previously imposed an enforcement remedy for a violation of the same law, rule, or for substantially the same problem within the preceding twenty-four months; or

(b) The department cited a violation of the same law, rule, or for substantially the same problem on two occasions within the preceding twenty-four months.

(43) "Restrictive procedure" means any procedure that restricts a client's freedom of movement, restricts access to client property, requires a client to do something they do not want to do, or removes something the client owns or has earned.

(44) "Risk assessment" means an assessment done by a qualified professional and as required by RCW 71A.12.230.

(45) "Serious" means a violation that results in one or more negative outcomes and significant actual harm to a client that does not constitute imminent danger. It also means there is reasonable predictability of recurring actions, practices, situations, or incidents with potential for causing significant harm to a client.

(46) "Severity" means the seriousness of a violation as determined by the actual or potential negative outcomes for clients and subsequent actual or potential for harm. Negative outcomes include any negative effect on the client's physical, mental, or psychosocial well-being (such as, safety, quality of life, quality of care).

(47) "Service provider" means a person or entity certified by the department who delivers services and supports to meet a client's identified needs. The term includes the state operated living alternative (SOLA) program.

(48) "Support" means assistance a service provider gives a client based on needs identified in the individual support plan.

(49) "Supported living" means instruction, supports, and services provided by service providers to clients living in homes that are owned, rented, or leased by the client or their legal representative.

(50) "Treatment team" means the program participant and the group of people responsible for the development, implementation, and monitoring of the person's individualized supports and services. This group may include, but is not limited to, the case manager, therapist, service provider, employment/day program provider, and the person's legal representative or family, provided the person consents to the family member's involvement.

(51) "Uncorrected deficiency" means the department has cited a violation of WAC or RCW following any type of certification evaluation or complaint investigation and the violation remains uncorrected at the time the department makes a subsequent inspection for the specific purpose of verifying whether such violation has been corrected.

(52) "Vulnerable adult" has the same meaning as defined in RCW 74.34.020.

History

Statutory Authority: RCW 71A.12.030, 71A.12.080, 71A.26.040, and 74.34.165. WSR 22-06-008, § 388-101-3000, filed 2/18/22, effective 3/21/22. Statutory Authority: Chapters 71A.12 and 74.34 RCW. WSR 18-07-061, § 388-101-3000, filed 3/15/18, effective 4/15/18. Statutory Authority: Chapters 71A.12, 74.34, and 74.39A RCW. WSR 16-18-040, § 388-101-3000, filed 8/30/16, effective 9/30/16. Statutory Authority: RCW 71A.12.030 and [71A.12].080. WSR 14-10-028, § 388-101-3000, filed 4/28/14, effective 5/29/14
WSR 12-02-048, § 388-101-3000, filed 12/30/11, effective 1/30/12. Statutory Authority: RCW 71A.12.080, chapter 74.39A RCW. WSR 10-16-084, § 388-101-3000, filed 7/30/10, effective 1/1/11. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3000, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101-3010 Certified community residential services and supports.

In order for a person or entity to deliver client instruction and support services under this chapter the person or entity must:

(1) Be certified by the department; and

(2) Be granted a contract by the department.

History

Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3010, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101-3020 Compliance.

The service provider must comply with:

(1) All the requirements of this chapter and chapter 388-101D WAC, except that the licensing requirements for adult family homes and assisted living facilities supersede these chapters if the requirements under respective chapters 388-76 and 388-78A WAC conflict with these chapters;

(2) The laws governing this chapter, including chapter 71A.12, 71A.22, and 71A.26 RCW;

(3) The requirements of chapter 74.34 RCW;

(4) The department's residential services contract, except that, the requirements of this chapter supersede any conflicting requirements with the contract, or appendices to the contract; and

(5) Other relevant federal, state, county, tribal, territorial, local, and municipal statutes, rules, codes, requirements, and ordinances.

History

Statutory Authority: RCW 71A.12.030 and 71A.26.040. WSR 25-08-021, s 388-101-3020, filed 3/25/25, effective 4/25/25. Statutory Authority: RCW 71A.12.030, 71A.12.080, 71A.26.040, and 74.34.165. WSR 22-06-008, § 388-101-3020, filed 2/18/22, effective 3/21/22. Statutory Authority: RCW 71A.12.030 and [71A.12].080. WSR 14-10-028, § 388-101-3020, filed 4/28/14, effective 5/29/14. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3020, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101-30201 Infection control.

(1) To manage infection control the service provider must:

(a) Comply with nationally recognized infection control standards when providing client care and supports;

(b) Develop and implement sufficient procedures to identify, prevent, and control infections caused by communicable disease; and

(c) Provide staff with the necessary training, supplies, equipment, and protective clothing for preventing and controlling the spread of infections.

(2) Whenever an outbreak of suspected food poisoning or communicable disease occurs, the provider must:

(a) Follow local health jurisdiction directions and recommendations pertaining to infection control and prevention including measures to control, mitigate, and manage communicable disease outbreaks; and

(b) Restrict a staff person's contact with clients when the staff person has a known communicable condition in the infectious stage that is likely to be spread by casual contact.

History

Statutory Authority: RCW 71A.12.030 and 71A.26.040. WSR 25-08-021, s 388-101-30201, filed 3/25/25, effective 4/25/25.

Wash. Admin. Code § 388-101-3030 Application required.

(1) A person or entity must complete an application before the department will consider initial certification; and

(2) The service provider must complete an application before the department will consider a request for change of ownership as detailed in WAC 388-101-3060.

History

Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3030, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101-3050 Application for initial certification.

(1) To apply for initial certification an applicant must submit to the department:

(a) A letter of intent that includes:

(i) Contact information;

(ii) Geographical area of service; and

(iii) Type of service provided, including group home, supported living, community protection, or group training home.

(b) A completed and signed application on forms designated by the department;

(c) All attachments specified in the application and any other information the department may request including but not limited to:

(i) Administrator resumes;

(ii) Statements of financial stability;

(iii) Professional references;

(iv) Relevant experiences and qualifications of the individual or agency; and

(v) Assurances the applicant will not discriminate against any client or employee.

(d) A copy of the license if applying for certification as a group home;

(e) The name of the administrator of the program; and

(f) The department background authorization form for:

(i) The applicant;

(ii) Anyone associated with the applicant; and

(iii) The individual or individuals designated to serve as administrator of the proposed program.

(2) The applicant must submit a revised application, if any information on the application changes before the initial certification is issued.

(3) The department will only process a completed application.

(4) Each person named in the application for initial certification is considered separately and jointly by the department.

(5) Based on the documentation received, the department will notify the applicant in writing regarding the department's certification decision.

(6) The applicant must comply with additional requirements identified in this chapter if intending to support community protection clients.

History

Statutory Authority: RCW 71A.12.030 and [71A.12].080. WSR 12-02-048, § 388-101-3050, filed 12/30/11, effective 1/30/12. Statutory Authority: RCW 71A.12.080, chapter 74.39A RCW. WSR 10-16-084, § 388-101-3050, filed 7/30/10, effective 1/1/11. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3050, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101-3060 Change of ownership.

(1) To apply for a change of ownership, an applicant must submit an application and the required reports and documents to the department when there is a change of:

(a) The business entity ownership; or

(b) The form of legal organization.

(2) When applying for a change of ownership, an applicant may be required to provide any or all items listed in WAC 388-101-3050.

(3) For group homes, applicants must also meet the applicable change of ownership requirements found in:

(a) WAC 388-76-10105 for licensed adult family homes; or

(b) WAC 388-78A-2770 through 388-78A-2787 for licensed assisted living facilities.

(4) If the applicant is not a current service provider, the applicant must apply for initial certification.

History

Statutory Authority: RCW 71A.12.030 and [71A.12].080. WSR 14-10-028, § 388-101-3060, filed 4/28/14, effective 5/29/14. Statutory Authority: RCW 71A.12.080. WSR 10-03-065, § 388-101-3060, filed 1/15/10, effective 2/15/10. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3060, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101-3070 Notice for change of ownership.

The current service provider must notify:

(1) The department in writing sixty days before a change of ownership; and

(2) Clients or their legal representatives in writing thirty days before a change of ownership.

History

Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3070, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101-3080 The department may deny—Application.

Under WAC 388-101-3090, the department is required to deny an application for initial certification or change of ownership under certain circumstances. The department may also deny an application if any person named in the application has:

(1) Shown a lack of the understanding, character, ability, or emotional stability that is necessary to meet the identified needs of vulnerable adults;

(2) Had a contract terminated or a certification or license revoked or denied by the department, or has been subjected to department enforcement actions;

(3) Had an out-of-state contract or license involving the provision of services to children or vulnerable adults terminated, revoked or denied or has been the subject of an enforcement action related to the out-of-state contract or license;

(4) Obtained or attempted to obtain a license or certification by fraudulent means or misrepresentation;

(5) Relinquished or been denied a license or license renewal to operate a home or facility that was licensed for the care of children or vulnerable adults;

(6) Refused to permit authorized department representatives to interview clients or to have access to client records;

(7) Been convicted of a drug-related conviction within the past five years without evidence of rehabilitation, unless denial is required under WAC 388-101-3090; or

(8) Been convicted of an alcohol-related conviction within the past five years without evidence of rehabilitation; or

(9) Been convicted of any felony that the department determines is reasonably related to the competency of the person to be involved in the ownership or operation of the service provider.

History

Statutory Authority: Chapter 71A.12 RCW. WSR 14-14-030, § 388-101-3080, filed 6/24/14, effective 7/25/14. Statutory Authority: RCW 71A.12.080. WSR 10-03-065, § 388-101-3080, filed 1/15/10, effective 2/15/10. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3080, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101-3090 The department must deny—Application.

(1) The department must deny an application for initial certification or change of ownership if any person named in the application has:

(a) A disqualifying criminal conviction or pending criminal charge under chapter 388-113 WAC.

(b) Been convicted of a crime in any federal or state court, and the department determines that the conviction is equivalent to a disqualifying conviction under chapter 388-113 WAC.

(2) The department must also deny an application for initial certification or change of ownership if any person named in the application has a disqualifying negative action. The following are considered to be disqualifying negative actions:

(b) The person is a registered sex offender;

(c) The person is on a registry based upon a final finding of abuse, neglect or financial exploitation of a vulnerable adult, unless the finding was made by adult protective services prior to October 2003;

(d) A founded finding of abuse or neglect of a child was made against the person, unless the finding was made by child protective services prior to October 1, 1998;

(e) The individual was found in any dependency action to have sexually assaulted or exploited any child or to have physically abused any child;

(g) The person has had a contract or license denied, terminated, revoked, or suspended due to abuse, neglect, financial exploitation, or mistreatment of a child or vulnerable adult; or

History

Statutory Authority: Chapter 71A.12 RCW. WSR 14-14-030, § 388-101-3090, filed 6/24/14, effective 7/25/14. Statutory Authority: RCW 71A.12.080. WSR 10-03-065, § 388-101-3090, filed 1/15/10, effective 2/15/10. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3090, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101-3100 Certification—Initial.

(1) The department may approve the individual or entity for initial certification when the individual or entity complies with the requirements of this chapter. The department may:

(a) Grant initial certification for up to one hundred and eighty days of the effective date of the residential services contract; and

(b) Extend initial certification for an additional period up to one hundred and eighty days.

(2) If an applicant does not receive a residential services contract, initial certification will be valid for up to one year.

History

Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3100, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101-3110 Certification—Regular.

(1) The department may approve the service provider for regular certification when the service provider complies with the requirements of this chapter and the residential services contract. The department may:

(a) Grant certification to a service provider for up to two years; and

(b) Extend regular certification for an additional period up to one hundred and eighty days.

(2) If a service provider does not comply with the certification requirements, the department may provisionally certify or decertify a service provider.

History

Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3110, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101-3120 Certification fees.

The certified community residential services and supports provider must submit an annual certification fee. If the provider fails to pay the annual certification fee, the department may impose remedies outlined in WAC 388-101-4175.

History

Statutory Authority: Chapter 71A.12 RCW and RCW 71A.12.030. WSR 19-24-031, § 388-101-3120, filed 11/25/19, effective 12/26/19.

Wash. Admin. Code § 388-101-3130 Certification evaluation.

(1) The department may conduct an on-site certification evaluation of each service provider at any time.

(2) During certification evaluations the service provider's administrator or designee must:

(a) Cooperate with department representatives during the on-site visit;

(b) Provide all contractor records, client records, and other relevant information requested by the department representatives;

(c) Ensure the service provider's administrator or designee is available during any visit to respond to questions or issues identified by department representatives; and

(d) Ensure the service provider's administrator or designee is present at the exit conference.

History

Statutory Authority: RCW 71A.12.030 and 71A.12.080. WSR 22-23-115, § 388-101-3130, filed 11/17/22, effective 12/18/22. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3130, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101-31301 Certification evaluation timelines.

(1) In response to the COVID-19 pandemic, the department filed an emergency rule suspending the requirement for the department to conduct on-site certification evaluations of each service provider at least once every two years as authorized by RCW 71A.12.080 and required by WAC 388-101-3130.

(2) During the suspension of the certification evaluation requirements, the department continued to conduct complaint investigations in CCRSS settings (group homes, group training homes, and supported living client households) when it became aware of information indicating an immediate threat to client health and safety.

(3) The department must prioritize and resume certification evaluations of service providers affected by the suspension of the certification evaluation requirements by applying the following criteria collectively:

(a) The department has identified an ongoing threat to the health and safety of clients through one or more reported complaints, previous certification evaluations, or previous investigations;

(b) Whether the service provider has had an enforcement remedy imposed in the last 24 months; and

History

Statutory Authority: RCW 71A.12.030 and 71A.12.080. WSR 22-23-115, § 388-101-31301, filed 11/17/22, effective 12/18/22.

Wash. Admin. Code § 388-101-3140 Complaint investigation.

The department may conduct unannounced complaint investigations to determine the service provider's compliance with this chapter, the residential services contract, and applicable laws and requirements.

History

Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3140, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101-3150 State and federal access to program.

The service provider must:

(1) Allow any state or federal department or agency to conduct audits, evaluations, or complaint investigations related to this program or to clients served in this program;

(2) Allow department representatives to review a client's records and activities at any time to see if the service provider continues to address the clients' needs for instruction and support activities;

(3) Allow the department representatives' access to clients, the client's legal representative and family members;

(4) Cooperate with department representatives in the performance of official duties; and

(5) Allow access to clients and client records by an advocacy group if the advocacy group has access authority under state or federal law.

History

Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3150, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101-3160 Plan of correction.

The service provider must:

(1) Submit a signed plan of correction to the department according to established department processes and timelines; and

(2) Include in the plan of correction:

(a) What the service provider did or will do to correct each deficiency;

(b) How the service provider will prevent future problems of this type;

(d) When lasting correction will be achieved.

History

Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3160, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101-3165 Access to certification evaluation report and plan of correction.

The service provider must make the certification evaluation report and related plan of correction available to anyone upon request.

History

Statutory Authority: RCW 71A.12.080. WSR 10-03-065, § 388-101-3165, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-101-3170 Group training home.

After the effective date of this chapter a person or entity desiring to become a group training home must:

(1) Complete an application on forms and attachments designated by the department; and

(2) Currently be:

(a) Certified as a community residential services and support provider; and

(b) A nonprofit business in accordance with state and federal law.

History

Statutory Authority: Chapter 71A.22 RCW and RCW 70.128.030. WSR 18-22-041, § 388-101-3170, filed 10/30/18, effective 11/30/18. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3170, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101-3180 Department approval of group training home status.

The department will consider, at a minimum, the following when determining whether to approve or deny an application for group training home status:

(1) The needs of the program;

(2) Available funding;

(3) The information received from the applicant;

(4) The certification history of the applicant;

(5) The licensing history of the applicant; and

(6) The capacity of the home.

History

Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3180, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101-3230 Group homes.

A service provider who is a licensed adult family home or assisted living facility must:

(1) Provide care and services in accordance with this chapter and with licensing requirements under chapters 388-76 and 388-78A WAC respectively;

(2) Comply with client rights requirements in chapter 70.129 RCW and this chapter;

(3) Comply with the home's licensing requirements if there is a conflict with requirements in this chapter; and

(4) Comply with this chapter if the requirement is over and above the home's licensing requirements.

History

Statutory Authority: RCW 71A.12.030 and [71A.12].080. WSR 14-10-028, § 388-101-3230, filed 4/28/14, effective 5/29/14. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3230, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101-4150 Mandated reporting to the department.

Service providers, administrators, owners, and staff:

(1) Are mandated reporters and must meet the requirements of chapter 74.34 RCW;

(2) Must make mandated reports to the department's centralized toll free complaint telephone number or fax number immediately when:

(a) There is reasonable cause to believe that a vulnerable adult, as defined in chapter 74.34 RCW, has been abandoned, abused, neglected, or financially exploited; or

(b) There is a reason to suspect physical or sexual assault.

(3) Must also make written and oral reports to the department as specified in the provider's residential services contract;

(4) Must protect the alleged victim and others from further abuse, neglect, abandonment, and financial exploitation; and

(5) May have their certification and/or contract terminated if they fail to report such incidents.

History

Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-4150, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101-4160 Mandated reporting to law enforcement.

Service providers, administrators, owners, and staff must immediately report to the appropriate law enforcement agency if there is reason to suspect that any of the following has occurred:

(1) Sexual assault: Any alleged or suspected sexual assault;

(2) Physical assault (nonclient to client): Any suspected physical assault as well as any act that causes fear of imminent harm; and

(3) Physical assault (client to client): Any suspected physical assault that causes bodily injury requiring more than first aid, or in the event of:

(a) Injuries that appear on the back, face, head, neck, chest, breasts, groin, inner thigh, buttock, genital, or anal area;

(b) Fractures;

(d) Patterns of physical assault between the same vulnerable adults or involving the same vulnerable adults;

(e) A reasonable cause to believe that an act has caused fear of imminent harm; and

(f) Any incident, regardless of injury, if requested by the client, his/her legal representative, or family member.

History

Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-4160, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101-4170 Mandated reporting policies and procedures.

(1) The service provider must develop, train on and implement written policies and procedures for:

(a) Immediately reporting mandated reporting incidents to:

(i) The department and law enforcement;

(ii) Appropriate persons within the service provider's agency as designated by the service provider; and

(iii) The alleged victim's legal representative.

(b) Protecting clients;

(d) Initiating an outside review or investigation.

(2) The service provider must not have or implement any policies or procedures that interfere with a mandated reporter's obligation to report.

History

Statutory Authority: RCW 71A.12.080. WSR 10-03-065, § 388-101-4170, filed 1/15/10, effective 2/15/10. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-4170, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101-4175 Remedies—General.

(1) The department may take one or more of the following actions in any case which the department finds that a service provider is noncompliant with the requirements of this chapter, the department's residential services contract, the requirements of chapter 74.34 RCW or other relevant federal, state and local laws, requirements or ordinances:

(a) Require a service provider to implement a plan of correction approved by the department and to cooperate with subsequent monitoring of the service provider's progress;

(b) Impose reasonable conditions on a service provider's certification such as correction within a time specified in the statement of deficiency, training, and limits on the type of client the service provider may serve;

(d) Suspend the service provider from accepting clients with specified needs by imposing a limited suspension of department referrals (stop placement);

(e) Suspend department referrals (stop placement);

(f) Refuse to certify a prospective service provider;

(g) Decertify or refuse to renew the certification of the service provider.

(2) The enforcement actions and penalties authorized in this section are not exclusive or exhaustive and nothing in this section prohibits the department from taking any action authorized in statue or rule or under the terms of a contract with the service provider.

History

Statutory Authority: Chapters 71A.12, 74.34, and 74.39A RCW. WSR 16-18-040, § 388-101-4175, filed 8/30/16, effective 9/30/16.

Wash. Admin. Code § 388-101-4180 Remedies—Consideration for imposing remedies.

(1) The department may select enforcement actions proportional to the seriousness of harm or threat of harm to clients served by service providers.

(2) The department may select a more severe enforcement action for violations that are:

(a) Uncorrected;

(b) Repeated;

(d) Present a serious threat to the health, safety, or welfare of clients served by the service provider.

History

Statutory Authority: Chapters 71A.12, 74.34, and 74.39A RCW. WSR 16-18-040, § 388-101-4180, filed 8/30/16, effective 9/30/16.

Wash. Admin. Code § 388-101-4185 Remedies—Circumstances resulting in enforcement remedies.

The department may impose the enforcement remedies described in this chapter when the service provider:

(1) Failed or refused to comply with the health and safety related requirements of this chapter, chapter 74.34 RCW or the rules adopted under these chapters;

(2) Failed or refused to cooperate with the certification process;

(3) Prevented or interfered with a certification, inspection, or complaint investigation by the department;

(4) Failed to comply with any applicable requirements regarding vulnerable adults under chapter 74.34 RCW;

(5) Knowingly, or with reason to know, made a false statement of material fact related to certification or contracting with the department, or in any matter under investigation by the department;

(6) Failed to submit a plan of correction for approval by the department;

(7) Failed to implement the plan or plans of correction or failed to make a correction imposed under WAC; or

(8) Failed to cooperate with subsequent monitoring.

History

Statutory Authority: Chapters 71A.12, 74.34, and 74.39A RCW. WSR 16-18-040, § 388-101-4185, filed 8/30/16, effective 9/30/16.

Wash. Admin. Code § 388-101-4190 Remedies—Specific provisional certification.

(1) The department may impose a provisional certification, not to exceed one hundred eighty days, if any service provider does not comply with requirements of this chapter, other applicable laws and rules, or the residential services contract.

(2) At the end of provisional certification the department may:

(a) Approve the service provider for regular certification if the service provider has complied with certification requirements; or

(b) Decertify the service provider and terminate the residential services contract if the service provider has not complied with all certification requirements.

History

Statutory Authority: Chapters 71A.12, 74.34, and 74.39A RCW. WSR 16-18-040, § 388-101-4190, filed 8/30/16, effective 9/30/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-4190, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101-4200 Remedies—Specific—Decertification.

The department may decertify a service provider at any time for noncompliance with the requirements of this chapter, the department's residential services contract, the requirements of chapter 74.34 RCW, or other relevant federal, state and local laws, requirements or ordinances.

History

Statutory Authority: Chapters 71A.12, 74.34, and 74.39A RCW. WSR 16-18-040, § 388-101-4200, filed 8/30/16, effective 9/30/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-4200, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101-4205 Remedies—Specific—Suspend department referrals (stop placement).

(1) The department may suspend referrals to the service provider for noncompliance with the requirements of this chapter, the department's residential services contract, the requirements of chapter 74.34 RCW, or other relevant federal, state, and local laws.

(2) Once the department suspends referrals, the service provider may not admit new referrals until the department lifts its suspension.

(3) The department may lift its suspension if it finds the following:

(a) The service provider has corrected the deficiencies that necessitated the suspension of the department referrals; and

(b) The service provider has shown the capacity to maintain the corrective action addressed by the suspension of department referrals.

(4) After a department finding of a violation for which a suspension of department referrals has been imposed, the department must make an on-site revisit of the service provider within fifteen working days from the deficiency correction date documented on an acceptable plan of correction. If the deficiency correction date had occurred prior to the department being notified, the department must make an on-site revisit within fifteen working days from the date the department receives the acceptable plan of correction from the service provider.

(5) If during the service provider's suspension period, the department finds a new violation that it reasonably believes will result in a new suspension or limited suspension of department referrals, the service provider's current suspension will remain in effect until the department imposes the new suspension or limited suspension of department referrals.

History

Statutory Authority: Chapters 71A.12, 74.34, and 74.39A RCW. WSR 16-18-040, § 388-101-4205, filed 8/30/16, effective 9/30/16.

Wash. Admin. Code § 388-101-4215 Remedies—Specific—Limited suspension of department referrals (stop placement) for clients with specified needs.

(1) The department may order a limited suspension of department referrals and prohibit the accepting of clients with specified needs if the service provider is noncompliant with the requirements of this chapter, the department's residential services contract, chapter 74.34 RCW, or other relevant federal, state, and local laws.

(2) Once the department orders a limited suspension, the service provider may not accept any clients with specified needs, or at a specific site, until the department lifts its limited suspension.

(3) The department may lift the limited suspension of department referrals if it finds the following:

(a) The service provider has corrected the deficiencies that necessitated the limited suspension of department referrals; and

(b) The service provider has shown the capacity to maintain the corrective action addressed by the limited suspension of department referrals.

(4) After a department finding of a violation for which a limited suspension of department referrals has been imposed, the department must make an on-site revisit of the service provider within fifteen working days from the deficiency correction date documented on an acceptable plan of correction. If the deficiency correction date had occurred prior to the department being notified, the department must make an on-site revisit within fifteen working days from the date the department receives the acceptable plan of correction from the service provider.

History

Statutory Authority: Chapters 71A.12, 74.34, and 74.39A RCW. WSR 16-18-040, § 388-101-4215, filed 8/30/16, effective 9/30/16.

Wash. Admin. Code § 388-101-4225 Remedies—Specific—Civil penalties.

(1) The department may impose civil penalties if the service provider:

(a) Fails to implement the plan or plans of correction;

(b) Fails to make a correction when conditions have been placed on a service provider's certification; or

(2) The department may impose civil penalties from the compliance date identified in the approved plan of correction or the statement of deficiencies of:

(a) Up to one hundred dollars per day per violation; and

(b) Up to three thousand dollars per violation.

(3) If the service provider fails to submit a plan of correction for approval by the department, the department may impose civil penalties starting ten days after the service provider received the statement of deficiencies.

History

Statutory Authority: Chapters 71A.12, 74.34, and 74.39A RCW. WSR 16-18-040, § 388-101-4225, filed 8/30/16, effective 9/30/16.

Wash. Admin. Code § 388-101-4235 Remedies—Civil fine grid.

The department will consider the tiered sanction grid below when imposing civil fine remedies:

| NO HARM | MINIMAL or MODERATE HARM | SERIOUS HARM | IMMINENT DANGER and/or IMMEDIATE THREAT | | | | --- | --- | --- | --- | --- | --- | | Repeat/Uncorrected | Initial | Repeat/ Uncorrected | Initial | Repeat/ Uncorrected | Any Violation | | Civil fine of up to $100 per violation | Civil fine up to $100 per day per violation not to exceed $500 per violation | Civil fine up to $100 per day per violation not to exceed $1000 per violation | Civil fine up to $100 per day per violation not to exceed $2000 per violation | Civil fine up to $100 per day per violation not to exceed $3000 per violation | Civil fine up to $100 per day per violation not to exceed $3000 per violation |

History

Statutory Authority: Chapters 71A.12, 74.34, and 74.39A RCW. WSR 16-18-040, § 388-101-4235, filed 8/30/16, effective 9/30/16.

Wash. Admin. Code § 388-101-4240 Informal dispute resolution.

(1) When a service provider disagrees with the department's finding of a violation or certification action under this chapter, the service provider may request an informal dispute resolution meeting with the department.

(2) The service provider must make a written request to the department for an informal dispute resolution meeting within ten working days of receipt of the written notice of the department's final report of findings and/or certification action.

(3) The service provider must submit a written statement identifying the challenged action, and include specifically the issues and regulations involved.

(4) Except for the imposition of civil penalties, the effective date of enforcement actions may not be delayed or suspended pending any hearing or informal dispute resolution process.

History

Statutory Authority: Chapters 71A.12, 74.34, and 74.39A RCW. WSR 16-18-040, § 388-101-4240, filed 8/30/16, effective 9/30/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-4240, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101-4250 Administrative review.

(1) A service provider may request an administrative review of a certification action within twenty-eight days of receipt of the written notice of the department's certification action.

(2) The service provider must make the request in writing and must:

(a) Sign the request;

(b) Identify the challenged decision and the date it was made;

(d) Include with the request copies of any supporting documentation for the service provider's position.

History

Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-4250, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101-4260 Appeal rights.

(1) A service provider:

(a) May contest a decision made by the department pursuant to chapter 71A.12 RCW and according to the provisions of chapters 34.05 RCW and 388-02 WAC;

(b) Must file any request for a hearing with the office of administrative hearings at the mailing address specified in the notice of imposition of an enforcement remedy; and

(c) Must make the request within twenty-eight days of receipt of the written notice of the department's certification action.

(2) Except for the imposition of civil penalties, certification actions are effective immediately upon notice and will continue pending any hearing.

History

Statutory Authority: Chapters 71A.12, 74.34, and 74.39A RCW. WSR 16-18-040, § 388-101-4260, filed 8/30/16, effective 9/30/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-4260, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101-4265 Investigation of reports.

(1) The department may investigate allegations of abandonment, abuse, neglect, or financial exploitation of a client.

(2) The department investigation may include an investigation of allegations about one or more of the following:

(a) A service provider;

(b) Anyone associated with a service provider; or

History

Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-4265, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101-4269 Individual defined.

As used in WAC 388-101-4270 through 388-101-4340, the term "individual" means anyone used by the service provider to provide services to clients who is alleged to have abandoned, abused, neglected, or financially exploited a client. "Individual" includes but is not limited to administrators, employees, contractors, subcontractors, volunteers, and students.

History

Statutory Authority: RCW 71A.12.080. WSR 10-03-065, § 388-101-4269, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-101-4270 Notice to individual of preliminary findings.

(1) The department will serve notice of the preliminary finding as provided in WAC 388-101-4350.

(2) The department may establish proof of service as provided in WAC 388-101-4360.

History

Statutory Authority: RCW 71A.12.080. WSR 10-03-065, § 388-101-4270, filed 1/15/10, effective 2/15/10. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-4270, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101-4280 Notice to others of preliminary findings.

Consistent with confidentiality requirements concerning the client, witnesses, and reporter, the department may provide notification of a preliminary finding to:

(1) Other divisions within the department;

(2) The agency or program identified under RCW 74.34.068 with which the individual was associated as an employee, volunteer or contractor;

(3) The employer or program that is currently associated with the individual;

(4) Law enforcement;

(5) Other entities as authorized by law and this chapter including investigative authorities consistent with chapter 74.34 RCW; and

(6) The appropriate licensing agency.

History

Statutory Authority: RCW 71A.12.080. WSR 10-03-065, § 388-101-4280, filed 1/15/10, effective 2/15/10. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-4280, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101-4290 Disputing a preliminary finding.

(1) An individual may request an administrative hearing to challenge a preliminary finding made by the department.

(2) The request must be made in writing to the office of administrative hearings.

(3) The office of administrative hearings must receive the individual's written request for a hearing within thirty calendar days of the date written on the notice of the preliminary finding.

(4) The written request for a hearing must include:

(a) The full legal name, current address and phone number of the individual;

(b) A brief explanation of why the individual disagrees with the preliminary finding;

(c) A description of any assistance needed in the administrative appeal process by the individual, including a foreign language or sign language interpreter or any reasonable accommodation for a disability; and

(d) The individual's signature.

History

Statutory Authority: RCW 71A.12.080. WSR 10-03-065, § 388-101-4290, filed 1/15/10, effective 2/15/10. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-4290, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101-4300 Disclosure of investigative and finding information.

(1) Confidential information about clients and mandated reporters received from the department may only be used by the individual to challenge findings through the appeal process. It may only be shared with persons who are involved in the appeal.

(2) Confidential information such as the name and other personal identifying information of the reporter, witnesses, or the client will be redacted from documents unless release of that information is consistent with chapter 74.34 RCW and other applicable state and federal laws.

History

Statutory Authority: RCW 71A.12.080. WSR 10-03-065, § 388-101-4300, filed 1/15/10, effective 2/15/10. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-4300, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101-4310 Hearing procedures to dispute a preliminary finding.

(1) Chapters 34.05 and 74.34 RCW, chapter 388-02 WAC, and the provisions of this chapter govern any appeal regarding a preliminary finding. In the event of a conflict between the provisions of this chapter and chapter 388-02 WAC, the provisions of this chapter shall prevail.

(2) The administrative law judge shall determine whether the preliminary finding is supported by a preponderance of the evidence.

History

Statutory Authority: RCW 71A.12.080. WSR 10-03-065, § 388-101-4310, filed 1/15/10, effective 2/15/10. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-4310, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101-4320 Appeal of the initial order.

(1) If the individual or the department disagrees with the administrative law judge's decision, either party may challenge this decision by filing a petition for review with the department's board of appeals under chapters 34.05 RCW and 388-02 WAC.

(2) If the department appeals the administrative law judge's decision, the department will not modify the finding in the department's records until a final hearing decision is issued.

History

Statutory Authority: RCW 71A.12.080. WSR 10-03-065, § 388-101-4320, filed 1/15/10, effective 2/15/10. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-4320, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101-4330 Finalizing a preliminary finding.

(1) A preliminary finding becomes a final finding when:

(a) The department gives the individual notice of the preliminary finding under WAC 388-101-4270 and the individual does not request an administrative hearing;

(b) The administrative law judge:

(i) Dismisses the appeal following withdrawal of the appeal or default; or

(ii) Issues an initial order upholding the finding and the individual fails to appeal the initial order to the department's board of appeals; or

(2) The final finding is permanent and will only be removed from the department's records if it is rescinded following judicial review.

History

Statutory Authority: RCW 71A.12.080. WSR 10-03-065, § 388-101-4330, filed 1/15/10, effective 2/15/10. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-4330, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101-4340 Reporting final findings.

(1) The department will report a final finding of abandonment, abuse, neglect, or financial exploitation within ten working days to the following:

(a) The individual against whom the final finding was made;

(b) The service provider that was associated with the individual during the time of the incident;

(c) The service provider that is currently associated with the individual against whom the final finding was made, if known;

(d) The appropriate licensing, contracting, or certification authority; and

(e) Any federal or state registry or list of individuals found to have abandoned, abused, neglected, or financially exploited a vulnerable adult.

(2) The findings may be disclosed to the public upon request subject to applicable public disclosure laws.

History

Statutory Authority: RCW 71A.12.080. WSR 10-03-065, § 388-101-4340, filed 1/15/10, effective 2/15/10. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-4340, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101-4350 Notice—Service complete.

Service of the department notices is complete when:

(1) Personal service is made;

(2) The notice is addressed to the service provider or to the individual at his or her last known address, and deposited in the United States mail;

(3) The notice is faxed and the department receives evidence of transmission;

(4) Notice is delivered to a commercial delivery service with charges prepaid; or

(5) Notice is delivered to a legal messenger service with charges prepaid.

History

Statutory Authority: RCW 71A.12.080. WSR 10-03-065, § 388-101-4350, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-101-4360 Notice—Proof of service.

The department may establish proof of service by any of the following:

(1) A declaration of personal service;

(2) An affidavit or certificate of mailing to the service provider or to the individual to whom the notice is directed;

(3) A signed receipt from the person who accepted the certified mail, the commercial delivery service, or the legal messenger service package; or

(4) Proof of fax transmission.

History

Statutory Authority: RCW 71A.12.080. WSR 10-03-065, § 388-101-4360, filed 1/15/10, effective 2/15/10.

Chapter 388-101D Requirements for providers of residential services and supports.

Wash. Admin. Code § 388-101D-0020 Residential services contract.

(1) The service provider may request a department residential services contract after approval for initial certification or for change of ownership.

(2) The service provider must have a separate contract for each region where they receive referrals to serve clients.

(3) The service provider's residential services contract will be terminated by the department upon termination of certification.

History

WSR 16-14-058, recodified as § 388-101D-0020, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3040, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0025 Service provider responsibilities.

(1) Service providers must meet the requirements of:

(a) This chapter;

(b) Each contract and statement of work entered into with the department;

(c) Each client's individual support plan when the individual support plan identifies the service provider as responsible; and

(d) Each client's individual instruction and support plan.

(2) The service provider must:

(a) Have a designated administrator and notify the department when there is a change in administrator;

(b) Ensure that clients have immediate access to staff, or the means to contact staff, at all times;

(d) Not routinely involve clients in the unpaid instruction and support of other clients;

(e) Not involve clients receiving crisis diversion services in the instruction and support of other clients; and

(f) Retain all records and other material related to the residential services contract for six years after expiration of the contract.

History

Statutory Authority: RCW 71A.12.030, 71A.12.120 and 2018 c 299. WSR 19-09-033, § 388-101D-0025, filed 4/10/19, effective 5/11/19. WSR 16-14-058, recodified as § 388-101D-0025, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3190, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0030 Staffing requirements.

(1) The provider must ensure each of its employees:

(a) Has a high school diploma or GED equivalent, unless the employee was hired before September 1, 1991 or is exempt under subsection (2) of this section;

(b) Is age 18 or older when employed as a direct support professional who provides support services to a client;

(d) Has a clear understanding of job responsibilities and knowledge of individual support plans and client needs; and

(e) Satisfies department background check requirements under chapter 388-825-WAC.

(2) The provider may hire a person without a high school diploma or GED if while working directly with clients the employee has access to another employee or a volunteer who:

(a) Has a high school diploma or GED; or

(b) Was hired before September 1, 1991.

(3) If the provider hires a person under subsection (2) of this section, the provider must have a written plan that states when and how the person must contact another employee for assistance.

History

Statutory Authority: RCW 71A.12.030, 28 C.F.R. § 20.33(d), RCW 74.39A.056, 71A.12.040, and 71A.12.110. WSR 22-23-022, § 388-101D-0030, filed 11/4/22, effective 12/5/22. WSR 16-14-058, recodified as § 388-101D-0030, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3200, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0035 Liability insurance required.

The service provider must:

(1) Obtain liability insurance upon certification and maintain the insurance as required in WAC 388-101-3206 and 388-101-3207; and

(2) Have evidence of liability insurance coverage available if requested by the department.

History

WSR 16-14-058, recodified as § 388-101D-0035, filed 6/30/16, effective 8/1/16. Statutory Authority: RCW 71A.12.080. WSR 10-03-065, § 388-101-3205, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-101D-0040 Liability insurance required—Commercial general liability insurance or business liability insurance coverage.

The service provider must have commercial general liability insurance or business liability insurance that includes:

(1) Coverage for the acts and omissions of any employee and volunteer;

(2) Coverage for bodily injury, property damage, and contractual liability;

(3) Coverage for premises, operations, independent contractors, products-completed operations, personal injury, advertising injury, and liability assumed under an insured contract; and

(4) Minimum limits of:

(a) Each occurrence - One million dollars;

(b) General aggregate - Two million dollars; and

History

WSR 16-14-058, recodified as § 388-101D-0040, filed 6/30/16, effective 8/1/16. Statutory Authority: RCW 71A.12.080. WSR 10-03-065, § 388-101-3206, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-101D-0045 Liability insurance required—Professional liability insurance coverage.

If the service provider employs professional staff, the service provider must have professional liability insurance or errors and omissions insurance. The insurance must include:

(1) Coverage for losses caused by errors and omissions of the service provider, its employees, and volunteers; and

(2) Minimum limits of:

(a) Each occurrence - One million dollars; and

(b) General aggregate - Two million dollars.

History

WSR 16-14-058, recodified as § 388-101D-0045, filed 6/30/16, effective 8/1/16. Statutory Authority: RCW 71A.12.080. WSR 10-03-065, § 388-101-3207, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-101D-0050 Administrative documents.

The service provider must prepare and maintain written documents as follows:

(1) A mission statement;

(2) A program description;

(3) An organizational chart and description showing all supervisory relationships;

(4) Description of staff roles and responsibilities, including the person designated to act in the absence of the administrator; and

(5) Staffing schedules.

History

WSR 16-14-058, recodified as § 388-101D-0050, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3210, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0055 Administrator responsibilities and training.

(1) The service provider must ensure that the administrator delivers services to clients consistent with this chapter, and the department's residential services contract. This includes but is not limited to:

(a) Overseeing all aspects of staffing, such as recruitment, staff training, and performance reviews;

(b) Developing and maintaining policies and procedures that give staff direction to provide appropriate services and support as required by this chapter and the department contract; and

(2) Before assuming duties, an administrator must complete required instruction and support services staff training if the administrator may provide instruction and support services to clients or may supervise instruction and support services staff.

History

WSR 16-14-058, recodified as § 388-101D-0055, filed 6/30/16, effective 8/1/16. Statutory Authority: RCW 71A.12.030 and [71A.12].080. WSR 12-02-048, § 388-101-3220, filed 12/30/11, effective 1/30/12. Statutory Authority: RCW 71A.12.080, chapter 74.39A RCW. WSR 10-16-084, § 388-101-3220, filed 7/30/10, effective 1/1/11. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3220, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0060 Policies and procedures.

(1) The service provider must develop, implement, and train staff on policies and procedures to address what staff must do:

(a) Related to client rights, including a client's right to file a complaint or suggestion without interference;

(b) Related to soliciting client input and feedback on instruction and support received;

(d) To protect clients when there have been allegations of abuse, neglect, financial exploitation, or abandonment;

(e) In emergent situations that may pose a danger or risk to the client or others, such as in the event of death or serious injury to a client;

(f) In responding to missing persons and client emergencies;

(g) Related to emergency response plans for natural or other disasters;

(h) When accessing medical, mental health, and law enforcement resources for clients;

(i) Related to notifying a client's legal representative, and/or relatives in case of emergency;

(j) When receiving and responding to client grievances; and

(k) To respond appropriately to aggressive and assaultive clients.

(2) The service provider must develop, implement, and train staff on policies and procedures in all aspects of the medication support they provide, including but not limited to:

(a) Supervision;

(b) Client refusal;

(c) Services related to medications and treatments provided under the delegation of a registered nurse consistent with chapter 246-840 WAC;

(d) The monitoring of a client who self-administers their own medications;

(e) Medication assistance for clients needing this support; and

(f) What the service provider will do in the event they become aware that a client is no longer safe to take their own medications.

(3) The service provider must maintain current written policies and procedures and make them available to all staff; and to clients and legal representatives upon request.

History

WSR 16-14-058, recodified as § 388-101D-0060, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3240, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0065 Background check—General.

(1) A provider must follow background check requirements under this chapter and chapters 388-113 and 388-825 WAC.

(2) Nothing in this chapter requires the employment of a person against the better judgment of the provider.

History

Statutory Authority: RCW 71A.12.020, 71A.12.030, 71A.12.040, 71A.12.050, 71A.12.110, 71A.12.161, 43.20A.710, and 43.43.837. WSR 23-07-130, § 388-101D-0065, filed 3/22/23, effective 4/22/23. WSR 16-14-058, recodified as § 388-101D-0065, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 14-14-030, § 388-101-3245, filed 6/24/14, effective 7/25/14. Statutory Authority: RCW 71A.12.030 and [71A.12].080. WSR 12-02-048, § 388-101-3245, filed 12/30/11, effective 1/30/12. Statutory Authority: RCW 71A.12.080, chapter 74.39A RCW. WSR 10-16-084, § 388-101-3245, filed 7/30/10, effective 1/1/11.

Wash. Admin. Code § 388-101D-0070 Background checks—National fingerprint background checks.

(1) An applicant as defined in WAC 388-113-0010 hired on or after January 1, 2016, who is not disqualified by the Washington state name and date of birth background check, must complete a national fingerprint background check and follow department procedures.

(2) After receiving the results of the national fingerprint background check the provider must prevent an administrator, employee, volunteer, student, or subcontractor from having unsupervised access to a client if the person has a:

(a) Disqualifying criminal conviction or pending charge for a disqualifying crime under chapter 388-113 WAC; or

(b) Disqualifying negative action under WAC 388-78A-2470 or WAC 388-76-10180.

History

Statutory Authority: RCW 71A.12.030, 28 C.F.R. § 20.33(d), RCW 74.39A.056, 71A.12.040, and 71A.12.110. WSR 22-23-022, § 388-101D-0070, filed 11/4/22, effective 12/5/22. WSR 17-03-062, recodified as § 388-101D-0070, filed 1/10/17, effective 2/1/17. Statutory Authority: Chapters 71A.12, 74.34, and 74.39A RCW. WSR 16-18-040, § 388-101-3202, filed 8/30/16, effective 9/30/16.

Wash. Admin. Code § 388-101D-0075 Background checks—Requirements for service providers.

(1) Service providers must follow the background check requirements described in chapter 388-113 WAC and in this chapter. In the event of an inconsistency, this chapter applies.

(2) The service provider must obtain background checks from the department for all administrators, employees, volunteers, students, and subcontractors who may have unsupervised access to clients.

(3) The service provider must not allow the following persons to have unsupervised access to clients until the service provider receives the department's background check results:

(a) Administrators;

(b) Employees;

(d) Subcontractors.

(4) If the department's background check results show that an administrator, employee, volunteer, student, or subcontractor has any of the following, then the service provider must prevent that person from having unsupervised access to clients:

(a) A disqualifying conviction or pending criminal charge under chapter 388-113 WAC; or

(b) A disqualifying negative action under chapter 388-113 WAC.

(5) If the background check results show any of the following, then the service provider must conduct a character, suitability, and competence review before allowing the person unsupervised access to clients:

(a) The person has a conviction or pending criminal charge, but the conviction or criminal charge is not disqualifying under chapter 388-113 WAC;

(b) The person has a conviction or pending criminal charge that meets one of the exceptions listed in WAC 388-113-0025; or

(6) When a service provider receives the results of a person's background check, the service provider must:

(a) Inform the person of the results of the background check;

(b) Inform the person that they may request a copy in writing of the results of the background check. If requested, a copy of the background check results must be provided within 10 working days of the request; and

(c) Notify the department and other appropriate licensing or certification agency of any person resigning or terminated as a result of having a conviction record.

(7) The service provider must renew the Washington state background check for each administrator, employee, volunteer, student, or subcontractor of a service provider. The service provider must at least every 36 months keep current background check results for each administrator, employee, volunteer, student, or subcontractor of a service provider.

(8) Licensed assisted living facilities or adult family homes must adhere to the current regulations in this chapter and in the applicable licensing laws.

(9) All applicants for certification must have a background check.

History

Statutory Authority: RCW 71A.12.030, 28 C.F.R. § 20.33(d), RCW 74.39A.056, 71A.12.040, and 71A.12.110. WSR 22-23-022, § 388-101D-0075, filed 11/4/22, effective 12/5/22. WSR 17-03-062, recodified as § 388-101D-0075, filed 1/10/17, effective 2/1/17. Statutory Authority: Chapter 71A.12 RCW. WSR 14-14-030, § 388-101-3250, filed 6/24/14, effective 7/25/14. Statutory Authority: RCW 71A.12.030 and [71A.12].080. WSR 12-02-048, § 388-101-3250, filed 12/30/11, effective 1/30/12. Statutory Authority: RCW 71A.12.080, chapter 74.39A RCW. WSR 10-16-084, § 388-101-3250, filed 7/30/10, effective 1/1/11. Statutory Authority: RCW 71A.12.080. WSR 10-03-065, § 388-101-3250, filed 1/15/10, effective 2/15/10. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3250, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0080 Background checks—Provisional hire—Pending results.

Each provider applicant or employee who has lived in Washington state less than three years, or who is otherwise required to complete a national fingerprint-based background check, may be hired for a 120-day provisional period when:

(1) The person is not disqualified based on the initial results of the background check from the department; and

(2) A national fingerprint-based background check is pending.

History

Statutory Authority: RCW 71A.12.030, 28 C.F.R. § 20.33(d), RCW 74.39A.056, 71A.12.040, and 71A.12.110. WSR 22-23-022, § 388-101D-0080, filed 11/4/22, effective 12/5/22. WSR 17-03-062, recodified as § 388-101D-0080, filed 1/10/17, effective 2/1/17. Statutory Authority: Chapter 71A.12 RCW. WSR 14-14-030, § 388-101-3255, filed 6/24/14, effective 7/25/14. Statutory Authority: RCW 71A.12.030 and [71A.12].080. WSR 12-02-048, § 388-101-3255, filed 12/30/11, effective 1/30/12. Statutory Authority: RCW 71A.12.080, chapter 74.39A RCW. WSR 10-16-084, § 388-101-3255, filed 7/30/10, effective 1/1/11.

Wash. Admin. Code § 388-101D-0085 Training requirements.

The service provider must ensure that individuals identified under WAC 388-101-3302 have met the training requirements under WAC 388-101-3260 through 388-101-3300.

History

WSR 16-14-058, recodified as § 388-101D-0085, filed 6/30/16, effective 8/1/16. Statutory Authority: RCW 71A.12.030 and [71A.12].080. WSR 12-02-048, § 388-101-3258, filed 12/30/11, effective 1/30/12. Statutory Authority: RCW 71A.12.080, chapter 74.39A RCW. WSR 10-16-084, § 388-101-3258, filed 7/30/10, effective 1/1/11.

Wash. Admin. Code § 388-101D-0087 Long-term care worker requirements.

Beginning January 1, 2016, all staff employed as long-term care workers as defined by RCW 74.39A.009 (17)(a) are required to meet all the training requirements in the following:

(1) Chapter 388-112 WAC, if the service provider is also licensed as an adult family home or assisted living facility.

(2) Chapter 388-829 WAC, if the service provider is certified only.

History

WSR 17-03-062, recodified as § 388-101D-0087, filed 1/10/17, effective 2/1/17. Statutory Authority: Chapters 71A.12, 74.34, and 74.39A RCW. WSR 16-18-040, § 388-101-3259, filed 8/30/16, effective 9/30/16.

Wash. Admin. Code § 388-101D-0090 Staff training.

The service provider must:

(1) Provide and document required training to staff;

(2) Within the first six months, ensure that staff receives a minimum of thirty-two total hours of training that meets the training requirements of this chapter;

(3) Provide staff training sooner if required by the client's identified needs; and

(4) Meet state and federal laws regarding training; such as, bloodborne pathogens training referenced in WAC 296-823-120.

History

WSR 16-14-058, recodified as § 388-101D-0090, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3260, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0095 Staff training before working alone with clients.

The service provider must train staff in the following before the employee works alone with clients:

(1) Current individual instruction and support plans of each client with whom the employee works;

(2) Emergency procedures for clients;

(3) The reporting requirements for abuse and neglect under chapter 74.34 RCW; and

(4) Client confidentiality.

History

WSR 16-14-058, recodified as § 388-101D-0095, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3270, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0100 Staff training within four weeks of employment.

The service provider must provide training within the first four weeks of employing a staff person to include:

(1) The service provider's mission statement;

(2) Policies and procedures; and

(3) On-the-job training.

History

WSR 16-14-058, recodified as § 388-101D-0100, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3280, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0110 Staff training to be current.

The service provider must ensure that each employee keeps their first-aid training, CPR certification, and bloodborne pathogens training current.

History

WSR 16-14-058, recodified as § 388-101D-0110, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3300, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0115 Certified community residential services and supports—General training requirements.

(1) The service provider must ensure the following instruction and support services staff meet the training requirements of this chapter:

(a) Administrators who may provide instruction and support services to clients or may supervise instruction and support services staff; and

(b) Instruction and support services staff including their supervisors.

(2) Applicants for initial certification and applicants for change of ownership that are not current providers, who may provide instruction and support services to clients or may supervise instruction and support services staff must meet the training requirements of this chapter.

History

WSR 16-14-058, recodified as § 388-101D-0115, filed 6/30/16, effective 8/1/16. Statutory Authority: RCW 71A.12.030 and [71A.12].080. WSR 12-02-048, § 388-101-3302, filed 12/30/11, effective 1/30/12. Statutory Authority: RCW 71A.12.080, chapter 74.39A RCW. WSR 10-16-084, § 388-101-3302, filed 7/30/10, effective 1/1/11.

Wash. Admin. Code § 388-101D-0125 Client rights.

Clients have the same legal rights and responsibilities guaranteed to all other individuals by the United States Constitution, federal and state law unless limited through legal processes. Service providers must promote and protect all of the following client rights, including but not limited to:

(1) The right to be free from discrimination;

(2) The right to be reasonably accommodated in accordance with state and federal law;

(3) The right to privacy, including the right to receive and send private mail and telephone calls;

(4) The right to participate in an appropriate program of publicly supported education;

(5) The right to be free from harm, including unnecessary physical restraint, isolation, excessive medication, abuse, neglect, abandonment, and financial exploitation; and

(6) The right to refuse health services, medications, restraints, and restrictions.

History

WSR 16-14-058, recodified as § 388-101D-0125, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3320, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0130 Treatment of clients.

Service providers must treat clients with dignity and consideration, respecting the client's civil and human rights at all times.

History

WSR 16-14-058, recodified as § 388-101D-0130, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3330, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0135 Subcontracting.

The service provider must not subcontract any service without prior written approval from the department. The service provider must ensure that all required terms, conditions, assurances and certifications are included in all subcontracts.

History

WSR 16-14-058, recodified as § 388-101D-0135, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3340, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0140 Residential guidelines.

The service provider must use the following department residential guidelines when providing services to each client:

(1) Health and safety;

(2) Personal power and choice;

(3) Competence and self-reliance;

(4) Positive recognition by self and others;

(5) Positive relationships; and

(6) Integration in the physical and social life of the community.

History

WSR 16-14-058, recodified as § 388-101D-0140, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3350, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0145 Client services.

Service providers must provide each client instruction and/or support to the degree the individual support plan identifies the service provider as responsible. Instruction and/or support to the client may include but are not limited to the following categories:

(1) Home living activities;

(2) Community living activities;

(3) Life-long learning activities;

(4) Health and safety activities;

(5) Social activities;

(6) Employment;

(7) Protection and advocacy activities;

(8) Exceptional medical support needs; and

(9) Exceptional behavioral support needs.

History

WSR 16-14-058, recodified as § 388-101D-0145, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3360, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0150 Client health services support.

The service provider must provide instruction and/or support as identified in the individual support plan and as required in this chapter to assist the client with:

(1) Accessing health, mental health, and dental services;

(2) Medication management, administration, and assistance;

(3) Maintaining health records;

(4) Arranging appointments with health professionals;

(5) Monitoring medical treatment prescribed by health professionals;

(6) Communicating directly with health professionals when needed; and

(7) Receiving an annual physical and dental examination unless the appropriate medical professional gives a written exception.

History

WSR 16-14-058, recodified as § 388-101D-0150, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3370, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0155 Medical devices.

(1) For purposes of this section the term "medical device" means any piece of medical equipment used to treat a client's assessed need.

(2) Use of some medical devices poses a safety risk for clients. Examples of medical devices with known safety risks are transfer poles, helmets, straps and belts on wheelchairs or beds, and bed side rails.

(3) Medical devices with known safety risks must not be used by the service provider:

(a) As a restraint; or

(b) For staff convenience.

(4) Before using medical devices with known safety risks for any client, the service provider must:

(a) Review the client's assessment to identify the client's need;

(b) Identify and implement interventions that might decrease the need for the use of a medical device;

(d) Provide the client and client's family or legal representative with information about the anticipated benefits and safety risks of using the device to enable them to make an informed decision about whether or not to use the device;

(e) Obtain a current physician's order that describes the medical necessity for use of the device and the anticipated duration of use; and

(f) Provide written instructions to staff regarding safe and proper use of the device.

History

WSR 16-14-058, recodified as § 388-101D-0155, filed 6/30/16, effective 8/1/16. Statutory Authority: RCW 71A.12.080. WSR 10-03-065, § 388-101-3372, filed 1/15/10, effective 2/15/10.

Wash. Admin. Code § 388-101D-0160 Nurse delegation.

(1) Service provider staff must not perform a delegated nursing task for the client before the delegating nurse has obtained consent from the client or person authorized to give consent.

(2) The service provider must not allow an employee to perform any nursing task that violates applicable statutes and rules, including:

(a) Chapter 18.79 RCW, Nursing care;

(b) Chapter 18.88A RCW, Nursing assistants;

(d) Chapter 246-841 WAC, Nursing assistants; and

(e) Chapter 246-888 WAC, Medication assistance.

History

WSR 16-14-058, recodified as § 388-101D-0160, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3375, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0165 Client transportation.

(1) The service provider must meet the client's transportation needs by:

(a) Not charging the client for transportation costs except as specified in the client's individual support plan;

(b) Using the client's medicaid coupons for covered transportation, if available; and

(2) The service provider must provide transportation or ensure that clients have a way to get to and from:

(a) Emergency medical care;

(b) Medical appointments; and

(3) As specified in the client's individual support plan, the service provider must provide necessary assistance with transportation to and from:

(a) School or other publicly funded services;

(b) Work;

(d) Client-requested activities.

(4) A vehicle that the service provider uses to transport clients must be insured as required by chapters 46.29 and 46.30 RCW.

(5) The service provider must maintain a business automobile insurance policy on service provider owned vehicles used to transport clients.

(6) The service provider must maintain nonowned vehicle insurance coverage for vehicles not owned by the service provider but used to transport clients.

(7) Service providers, employees, subcontractors, and volunteers who transport clients must have a valid driver's license as required by chapter 46.20 RCW.

History

WSR 16-14-058, recodified as § 388-101D-0165, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3380, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0170 Physical and safety requirements.

(1) Crisis diversion support service providers are exempt from the requirements in this section.

(2) The service provider must ensure that the following home safety requirements are met for each client unless otherwise specified in the client's individual support plan:

(a) A safe and healthy environment;

(b) Accessible telephone equipment and a list of emergency contact numbers;

(d) Unblocked door and window for emergency exit;

(e) A safe storage area for flammable and combustible materials;

(f) An operating smoke detector, with a light alarm for clients with hearing impairments;

(g) An accessible flashlight or other safe accessible light source in working condition; and

(h) Basic first-aid supplies.

(3) The service provider must assist clients in regulating household water temperature unless otherwise specified in the client's individual support plan as follows:

(a) Maintain water temperature in the household no higher than one hundred and twenty degrees Fahrenheit;

(b) Check water temperature when the client first moves into the household and at least once every three months from then on; and

(c) Regulate water temperature for clients who receive twenty-four hour support, and for other clients as specified in the individual support plan.

(4) The service provider must document and keep records that indicate that physical safety requirements are met for each client.

(5) A client may independently document these requirements are met when the client's individual support plan specifies this level of client involvement.

History

WSR 16-14-058, recodified as § 388-101D-0170, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3390, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0175 Services to nonclients.

Before providing services to nonclients in the same household with clients, the service provider must:

(1) Provide the department with a written description of the household composition;

(2) Obtain written approval from the division of developmental disabilities; and

(3) Obtain written consent from each client in the household or the client's legal representative if the client is unable to consent.

History

WSR 16-14-058, recodified as § 388-101D-0175, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3400, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0180 Community protection clients and other clients in the same household.

Before allowing a community protection program client to live in the same household with supported living clients who are not in the community protection program, the service provider must:

(1) Provide the department with a written description of the household composition;

(2) Participate with the treatment team during the household composition review;

(3) Obtain written approval from the division of developmental disabilities; and

(4) Obtain written consent from each client in the household or the client's legal representative if the client is unable to consent.

History

WSR 16-14-058, recodified as § 388-101D-0180, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3410, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0185 Client refusal to participate in services.

(1) The service provider must notify the case manager if the client's health and safety is adversely affected by the client's refusal to participate in services.

(2) Service providers must document each client's refusal to participate in:

(a) Physical and safety requirements, as outlined in WAC 388-101-3390; and

(b) Client health services support under WAC 388-101-3370.

(3) Service providers must document the following:

(a) A description of events relating to the client's refusal to participate in these services;

(b) That the client was informed of the benefits of these services and the possible risks of refusal;

(d) Any health or safety concerns that the refusal may pose.

(4) The service provider must:

(a) Review this documentation with the client or the client's legal representative at least every six months; and

(b) Request that the client or client's legal representative sign and date the document after reviewing it.

History

WSR 16-14-058, recodified as § 388-101D-0185, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3420, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0190 What must a provider do if a client experiences a change in support needs?

If a client experiences a change in support needs, the provider must:

(1) Coordinate with the client to the maximum extent possible to:

(a) Review the client's individual instruction and support plan (IISP) to determine whether the IISP meets the client's needs and requirements under chapter 388-101D WAC, and update if needed;

(b) Review the client's positive behavior support plan (PBSP), if the client has one, to determine whether the PBSP meets the client's needs and requirements under chapter 388-101D WAC, and update if needed;

(c) Review the client's person-centered service plan (PCSP) and, if necessary, notify DDA that changes to the PCSP may be needed;

(d) Participate in a significant change assessment, if one occurs, unless requested by the client not to do so; and

(e) Implement the new PCSP, if updated.

(2) Contact the resource manager if the provider believes additional resources or a rate assessment are needed.

History

Statutory Authority: RCW 71A.12.030 and 71A.26.030. WSR 24-02-042, § 388-101D-0190, filed 12/27/23, effective 1/27/24. WSR 16-14-058, recodified as § 388-101D-0190, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3430, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0195 What must a provider do when a client's support needs remain unmet?

(1) If the client's support needs remain unmet after following the procedures in WAC 388-101D-0190, the provider must submit a written request to the client's case manager for assistance with addressing the unmet need.

(2) No more than five working days after receipt of the provider's request, DDA must respond to address the unmet need, which might include identification of a critical case.

History

Statutory Authority: RCW 71A.12.030 and 71A.26.030. WSR 24-02-042, § 388-101D-0195, filed 12/27/23, effective 1/27/24. WSR 16-14-058, recodified as § 388-101D-0195, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3440, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0196 What is the client critical case protocol?

(1) The client critical case protocol is a formal, person-centered process for addressing unmet residential support needs for a client receiving services from a contracted supported living provider, which, if unaddressed might result in a disruption in residential services.

(2) DDA must include in the client critical case protocol:

(a) The client, if they choose to participate;

(b) The client's legal representative, if the client has one, and if they choose to participate;

(d) DDA.

(3) The steps of the client critical case protocol include DDA:

(a) Identifying the client's unmet need as a critical case;

(b) Notifying parties in subsection (2) of this section that a critical case has been identified;

(d) Identifying action steps through a critical case conference; and

(e) Distributing an outcome summary to participants for review and correction.

History

Statutory Authority: RCW 71A.12.030 and 71A.26.030. WSR 24-02-042, § 388-101D-0196, filed 12/27/23, effective 1/27/24.

Wash. Admin. Code § 388-101D-0197 Who may request a client critical case protocol and when is it initiated?

(1) A client, the client's legal representative, or the provider may request a critical case protocol if:

(a) The client is at risk of losing their home;

(b) The client is at risk of losing their supported living provider;

(d) The client's person-centered service plan or positive behavior support plan cannot be implemented as written; or

(e) There is other indication of a critical case.

(2) DDA must respond to the request for a critical case protocol no more than five working days after receiving the request.

(3) A client critical case protocol may be initiated by DDA when requested by:

(a) The client or legal representative, if the client has one; or

(b) The supported living provider.

(4) DDA must initiate a client critical case protocol if the provider suspends the client's services or DDA learns that the client is at risk of losing residential supports from the provider.

History

Statutory Authority: RCW 71A.12.030 and 71A.26.030. WSR 24-02-042, § 388-101D-0197, filed 12/27/23, effective 1/27/24.

Wash. Admin. Code § 388-101D-0198 Who must attend a critical case conference and when must the conference occur?

(1) The client's critical case conference must be attended by:

(a) The client, if the client chooses to attend;

(b) The client's legal representative, if the client has one, and if the legal representative chooses to attend;

(d) DDA.

(2) If requested, DDA must invite other people identified by the client or the client's legal representative, if the client has one.

(3) The client may identify people whom the client does not want to attend a critical case conference.

(4) The critical case conference must occur no more than 10 business days after identification of a critical case.

(5) If the client, or the client's legal representative, if the client has one, does not attend the first critical case conference within the 10-day timeframe:

(a) The conference may occur as scheduled;

(b) A follow-up conference must be offered to the client and their legal representative, if the client has one; and

(c) The outcome summary must be shared with the client and their legal representative, if the client has one, for review and correction.

History

Statutory Authority: RCW 71A.12.030 and 71A.26.030. WSR 24-02-042, § 388-101D-0198, filed 12/27/23, effective 1/27/24.

Wash. Admin. Code § 388-101D-0200 When may a provider terminate a client's services?

(1) A provider must not terminate a client's services unless the provider determines and documents that:

(a) The provider cannot meet the client's needs;

(b) The client's safety or the safety of other people in the residence is endangered;

(d) The provider ceases to operate.

(2) Before a provider may terminate a client's services, the provider must:

(a) Engage in the client critical case protocol and attend a critical case conference if the client receives services from a contracted supported living provider; and

(b) At least 60 days before the termination date, send written notice to:

(i) The client and the client's legal representative or necessary supplemental accommodation; and

(ii) DDA.

(3) The notice to the client must state the:

(a) Reason for the termination;

(b) Circumstances that led to the termination;

(d) Effective date of the termination.

(4) The terminating provider must participate in transition meetings when requested by DDA, the client, or the new provider.

(5) Crisis diversion service providers are exempt from the requirements in this section.

History

Statutory Authority: RCW 71A.12.030 and 71A.26.030. WSR 24-02-042, § 388-101D-0200, filed 12/27/23, effective 1/27/24. WSR 16-14-058, recodified as § 388-101D-0200, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3450, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0201 When may the provider suspend a client's services?

(1) A contracted supported living provider may immediately suspend a client's services if:

(a) The provider cannot safely meet the client's needs;

(b) The actions or continued presence of the client endangers the health or safety of the client, other clients, those working with the client, or member of the public; and

(i) Hospital;

(ii) Jail;

(iii) Health care facility; or

(iv) Other setting that can address the client's needs.

(2) The provider must give written notice to the client, their legal representative, if they have one, and DDA before suspending the client's services.

(3) The notice must specify the provider's reasons for suspending the client's services.

(4) While the client's services are suspended, the provider must engage in the client critical case protocol to determine the client's support needs and if the client will choose to:

(a) Resume services with the provider and the provider agrees;

(b) Transition to a new provider; or

(5) The suspension status must be addressed at a critical case conference. The provider must inform the client and DDA if the status of the suspension changes.

(6) Crisis diversion service providers are exempt from the requirements in this section.

History

Statutory Authority: RCW 71A.12.030 and 71A.26.030. WSR 24-02-042, § 388-101D-0201, filed 12/27/23, effective 1/27/24.

Wash. Admin. Code § 388-101D-0205 Individual support plan.

The service provider must use the client's current individual support plan in the development of the individual instruction and support plan.

History

WSR 16-14-058, recodified as § 388-101D-0205, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3460, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0210 Development of the individual instruction and support plan.

(1) The service provider must develop and implement an individual instruction and support plan for each client that incorporates the department's residential guidelines in developing instruction and support activities.

(2) In developing the individual instruction and support plan, the service provider must:

(a) Work with the client to develop goals based on the individual support plan that will be worked on during the implementation of the individual instruction and support plan for the upcoming year;

(b) Identify how the instruction and/or support activities will be provided to meet the assessed needs of the client as described in the individual support plan;

(c) Ensure that the individual instruction and support plan contains or refers to other applicable support and/or service information; and

(d) Include the participation and agreement of the client and other individuals the client wants included.

(3) The service provider must send a copy of the individual instruction and support plan goals together with a list of applicable support and service information and where the information is located to the case manager for review.

History

WSR 16-14-058, recodified as § 388-101D-0210, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3470, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0215 Documentation of the individual instruction and support plan.

For each client the service provider must:

(1) Develop and keep a written record of the individual instruction and support plan that includes the elements required in WAC 388-101-3470;

(2) Include a section or page in the individual instruction and support plan that provides or references all applicable support or service information pertaining to the client;

(3) Review and update the plan to reflect changes in the assessed needs as described in the individual support plan;

(4) Sign and date the plan's documents; and

(5) Document the client's agreement with the plan as well as the client's legal representative if applicable.

History

WSR 16-14-058, recodified as § 388-101D-0215, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3480, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0220 Implementation of the individual instruction and support plan.

The service provider must:

(1) Oversee the progress made on each client's individual instruction and support plan;

(2) Coordinate with other staff, and other providers serving the client, and other interested persons as needed, in implementing the individual instruction and/or support plan; and

(3) Revise and update the plan as the client's assessed needs change.

History

WSR 16-14-058, recodified as § 388-101D-0220, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3490, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0225 Accessibility of the individual instruction and support plan.

The service provider must make the individual instruction and support plan accessible at all times to:

(1) Staff to provide direction on what they are to do to instruct and/or support the client;

(2) The client receiving service;

(3) The client's legal representative; and

(4) Representatives of the department.

History

WSR 16-14-058, recodified as § 388-101D-0225, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3500, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0230 Ongoing updating of the individual instruction and support plan.

The service provider must:

(1) Review and revise the individual instruction and support plan as goals are achieved or as client assessed needs change in order to reflect the client's current needs, goals, and preferences:

(a) At least semi-annually; and

(b) At any time requested by the client or the client's legal representative.

(2) Send an updated copy of the instruction and support goals of the individual instruction and support plan and the list of applicable support and service information and where the information is located to the case manager for review.

History

WSR 16-14-058, recodified as § 388-101D-0230, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3510, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0235 Shared expenses and client related funds.

(1) For purposes of this section "common household expenses" means costs for rent, shared food and household supplies, and utilities, including but not limited to water, garbage, cable television/radio, telephone, and electricity.

(2) The service provider must ensure that common household expenses are shared equitably among all clients living in the household.

(3) If the service provider receives funds for the client from any source, the service provider must be able to show that all the funds received are:

(a) Given to the client or the client's legal representative;

(b) Deposited to the client's account; or

History

WSR 16-14-058, recodified as § 388-101D-0235, filed 6/30/16, effective 8/1/16. Statutory Authority: RCW 71A.12.080. WSR 10-03-065, § 388-101-3520, filed 1/15/10, effective 2/15/10. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3520, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0240 Individual financial plan.

(1) The service provider must develop and implement an individual financial plan with client participation when the client's individual support plan:

(a) Identifies that the client needs support to manage funds; and

(b) Designates the service provider as responsible for that support; or

(2) The service provider must obtain signatures from the client and the client's legal representative on the individual financial plan.

(3) The service provider must include the following in the client's individual financial plan:

(a) Client funds and income managed by the service provider;

(b) Client funds and income managed by the client and the client's legal representative;

(d) A description of how the client's funds will be spent during a typical month;

(e) Money management instruction or support provided to the client; and

(f) If applicable, asset management including such things as personal property, burial plan, retirement funds, stock, and vehicles.

(4) The service provider must review the individual financial plan with the client at least every twelve months.

(5) The service provider must send a copy of each client's individual financial plan to:

(a) The client's legal representative; and

(b) The client's case manager upon request.

History

WSR 16-14-058, recodified as § 388-101D-0240, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3530, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0245 Managing client funds.

(1) Before managing a client's funds the service provider must either:

(a) Obtain written consent from the client or the client's legal representative; or

(b) Become the representative payee.

(2) For any client funds managed by the service provider, the service provider must:

(a) Separately track each client's money, even when several clients reside together;

(b) Maintain a current running balance of each client account;

(d) Prevent the client's bank account from being overdrawn;

(e) Ensure that client cash funds do not exceed seventy-five dollars per client unless specified differently in the individual financial plan; and

(f) Retain receipts for each purchase over twenty-five dollars.

(3) Social Security Administration requirements for managing the client's Social Security income take precedence over these rules if:

(a) The service provider is the client's representative payee; and

(b) The Social Security Administration requirement conflicts with these rules.

(4) When the service provider manages the client's funds and receives a check made out to the client, the service provider must:

(a) Get the client's signature and designation "for deposit only"; or

(b) Get the client's "x" mark in the presence of a witness and cosign the check with the designation "for deposit only"; and

(5) If a check for the client is made out to a payee other than the client, the service provider must ask the payee to sign the check.

(6) The service provider must not ask the client to sign a blank check.

(7) The service provider may only assist the client to make purchases by check when the client signs the check at the time of the purchase unless:

(a) Otherwise specified in the client's individual financial plan; or

(b) The service provider is the client's representative payee.

(8) The service provider must document in the client's record the name of each staff that may assist the client with financial transactions.

History

WSR 16-14-058, recodified as § 388-101D-0245, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3540, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0250 Using client funds for health services.

The service provider must document all denials for client health services from the health care authority, the department, and medical insurance companies. The service provider:

(1) Must notify the case manager of the denial in writing; and

(2) May use client funds for the client's health services if no other funding is available.

History

WSR 16-14-058, recodified as § 388-101D-0250, filed 6/30/16, effective 8/1/16. Statutory Authority: RCW 71A.12.030 and [71A.12].080. WSR 12-02-048, § 388-101-3545, filed 12/30/11, effective 1/30/12. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3545, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0255 Reconciling and verifying client accounts.

(1) For any client funds managed by the service provider, the service provider must:

(a) Reconcile the client's bank accounts to the client's bank statements each month;

(b) Reconcile the client's cash account each month; and

(2) The service provider must not allow the same staff person to do both the verification and reconciliation of the client's account.

(3) The service provider must ensure that the verification or reconciliation is done by a staff person who did not:

(a) Make financial transactions on the client's behalf; or

(b) Assist the client with financial transactions.

History

WSR 16-14-058, recodified as § 388-101D-0255, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3550, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0260 Combining service provider and client funds.

The service provider must not combine client funds with any service provider funds, such as agency operating funds.

History

WSR 16-14-058, recodified as § 388-101D-0260, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3560, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0265 Client bankbooks and bankcards.

(1) For clients who manage their own funds, the service provider must document in the client's record when the client asks the provider to hold the client's bankbooks and bankcards.

(2) When the service provider holds the client's bankcards or bankbooks as requested by the client:

(a) It is not assumed that the service provider is managing the client's funds; and

(b) The client must continue to have access to his or her own funds.

History

WSR 16-14-058, recodified as § 388-101D-0265, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3570, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0270 Client financial records.

(1) For client funds that the service provider manages, the service provider must retain documentation including documentation for bank and cash accounts.

(2) The service provider must also keep the following documentation for client financial transactions:

(a) Monthly bank statements and reconciliations;

(b) Checkbook registers and bankbooks;

(d) Receipts for purchases over twenty-five dollars;

(e) A ledger showing deposits, withdrawals, and interest payments to each client; and

(f) A control journal for trust accounts.

(3) The service provider must keep the following documentation for cash and debit transactions:

(a) A detailed ledger signed by the staff who withdrew any of the client's money;

(b) A detailed accounting of the funds received on behalf of the client including:

(i) Cash received from writing checks over the purchase amount; and

(ii) A list of where the money was spent.

History

WSR 16-14-058, recodified as § 388-101D-0270, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3580, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0275 Transferring client funds.

(1) When the service provider manages a client's funds and the client changes service providers, the previous service provider must transfer all of the client's funds, except funds necessary to pay unpaid bills, to the client or designee as soon as possible but no longer than thirty days.

(2) When transferring funds, the previous provider must:

(a) Have an agreement with the client regarding the amount of money to be withheld to pay bills;

(b) Inform the client's case manager about any agreement in subsection (2)(a) of this section;

(d) When applicable, give the new service provider a written accounting of all transferred client funds;

(e) Obtain a written receipt from the client and legal representative for all transferred funds; and

(f) When applicable, obtain the new service provider's written receipt for the transferred funds.

(3) When the client moves to another living arrangement without supported living services or the client's whereabouts are unknown, the service provider must transfer the client's funds within one hundred eighty days to:

(a) The client's legal representative;

(b) The department; or

(4) When the client dies, the service provider must transfer the client's funds within ninety days to:

(a) The client's legal representative;

(b) The requesting governmental entity; or

(5) Social Security Administration requirements for managing the client's Social Security income take precedence over these rules for transferring client funds if:

(a) The service provider is the client's representative payee; and

(b) The Social Security Administration requirement conflicts with these rules.

History

WSR 16-14-058, recodified as § 388-101D-0275, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3590, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0280 Client loans.

(1) The service provider may loan funds to a client from the service provider's funds and collect the debt from the client in installments.

(2) The client's service provider must not:

(a) Charge the client interest for any money loaned; or

(b) Borrow funds from the client.

(3) The provider must keep the following loan documentation for each loan:

(a) A loan agreement signed by the client or the client's legal representative;

(b) Amount of the loan;

(d) The current balance owed.

History

WSR 16-14-058, recodified as § 388-101D-0280, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3600, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0285 Client reimbursement.

The service provider must pay the client the total amount involved when:

(1) The service provider or staff has stolen, misplaced, or mismanaged client funds; or

(2) Service charges are incurred on a trust account that the service provider manages for the client.

History

WSR 16-14-058, recodified as § 388-101D-0285, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3610, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0290 Client payment.

When the client performs work for the service provider, the service provider must pay the client:

(1) At least the current minimum wage; and

(2) According to state and federal requirements.

History

WSR 16-14-058, recodified as § 388-101D-0290, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3620, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0295 Medication services—General.

(1) If the service provider supports a client with a prescribed or over-the-counter medication, as identified in the client's person-centered service plan, the service provider must do all of the following:

(a) Have systems in place to ensure that medications are given as ordered and in a manner that safeguards the client's health and safety.

(b) Ensure that each client receives their medication as prescribed, except as provided for in the medication refusal section or in the medication assistance section regarding altering medication.

(i) Pharmacist-prepared label; or

(ii) Manufacturer label with the name of the client for whom the medication is prescribed added to the container.

(2) Group homes licensed as an assisted living facility or adult family home must meet the medication management requirements of chapter 388-78A or 388-76 WAC. For any difference in requirements the assisted living facility or adult family home medication rules take precedence over the medication rules of this chapter.

History

Statutory Authority: RCW 71A.12.030 and 71A.12.120. WSR 24-13-066, § 388-101D-0295, filed 6/14/24, effective 7/15/24. WSR 16-14-058, recodified as § 388-101D-0295, filed 6/30/16, effective 8/1/16. Statutory Authority: RCW 71A.12.030 and [71A.12].080. WSR 14-10-028, § 388-101-3630, filed 4/28/14, effective 5/29/14. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3630, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0300 Medication—Types of support.

The service provider must provide medication support as specified in the client's individual support plan. Types of client support include:

(1) Self-administration of medication;

(2) Medication assistance;

(3) Nurse delegated medication administration; and

(4) Medication administration by a practitioner.

History

WSR 16-14-058, recodified as § 388-101D-0300, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3640, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0305 Medication—Self-administration.

If a client is assessed as independent in self-administration of medications the service provider must inform the client's case manager if they have a reason to suspect that the client is no longer safe to self-administer medications.

History

WSR 16-14-058, recodified as § 388-101D-0305, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3650, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0310 Medication assistance.

If the client is assessed as needing assistance with medication, the service provider may assist the client to take medications in any of the following ways:

(1) Communicating the prescriber's order to the client in such a manner that the client self-administers his/her medication properly;

(2) Reminding or coaching the client when it is time to take a medication;

(3) Opening the client's medication container;

(4) Handing the client the medication container;

(5) Placing the medication in the client's hand;

(6) Transferring medication from one container to another for the purpose of an individual dose (e.g., pouring a liquid medication from the container to a calibrated spoon or medication cup or using adaptive devices);

(7) Altering a medication by crushing or mixing:

(a) Only if the client is aware that the medication is being altered or added to food or beverage; and

(b) A pharmacist or other qualified practitioner has determined it is safe to alter medication; and

(8) Guiding or assisting the client to apply or instill skin, nose, eye and ear preparations. Hand-over-hand administration is not allowed; and

(9) For group homes that have an assisted living facility or adult family home license, refer to chapter 388-78A or 388-76 WAC for additional tasks that may be allowed.

History

WSR 16-14-058, recodified as § 388-101D-0310, filed 6/30/16, effective 8/1/16. Statutory Authority: RCW 71A.12.030 and [71A.12].080. WSR 14-10-028, § 388-101-3660, filed 4/28/14, effective 5/29/14. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3660, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0315 Medication administration—Nurse delegation.

If a client is assessed as requiring medication administration and the service provider is not a practitioner, the service provider must ensure the assistance is provided by a licensed health care professional or under nurse delegation as per chapters 246-840 WAC and 18.79 RCW.

History

WSR 16-14-058, recodified as § 388-101D-0315, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3670, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0320 Medication administration.

(1) If a service provider is a licensed health care professional, the licensed professional may administer the client's medication.

(2) Service providers may only administer medication under the order of a physician or a health care professional with prescriptive authority.

History

WSR 16-14-058, recodified as § 388-101D-0320, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3680, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0325 Medication refusal.

(1) When a client who is receiving medication support from the service provider chooses to not take his or her medications, the service provider must:

(a) Respect the client's right to choose not to take the medication(s) including psychoactive medication(s); and

(b) Document the time, date and medication the client did not take.

(2) The service provider must take the appropriate action, including notifying the prescriber or primary care practitioner, when the client chooses to not take his or her medications and the client refusal could cause harm to the client or others.

History

WSR 16-14-058, recodified as § 388-101D-0325, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3690, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0330 Storage of medications.

(1) The service provider must keep a client's medications so they are not readily available to other clients.

(2) The service provider must store medications:

(a) Under proper conditions for sanitation, temperature, moisture, and ventilation, and separate from food or toxic chemicals; and

(b) In the original medication container with a pharmacist-prepared label, a manufacturer's label in accordance with WAC 388-101D-0295, or in a medication organizer clearly labeled with the:

(i) Name of the client for whom the medication is prescribed;

(ii) Name of each medication;

(iii) Medication dose and frequency to be given; and

(iv) Route each medication is to be administered.

(3) Group homes must:

(a) Keep all medications in locked storage; and

(b) Use medication organizers only when filled by a pharmacist.

History

Statutory Authority: RCW 71A.12.030 and 71A.12.120. WSR 24-13-066, § 388-101D-0330, filed 6/14/24, effective 7/15/24. WSR 16-14-058, recodified as § 388-101D-0330, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3700, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0335 Medication organizers.

(1) Service providers may allow medication organizers maintained by the individual when the organizers are filled by:

(a) The client;

(b) A licensed pharmacist;

(d) The client's legal representative or a family member.

(2) Service providers providing medication assistance or administration to a client must ensure that the medication organizers are labeled.

(3) The client, a pharmacist, an RN, or the client's legal representative or family member may label the medication organizer.

(4) When there is a change in medications by the prescriber, the individual filling the medication organizers must replace labels with required updated information immediately.

History

WSR 16-14-058, recodified as § 388-101D-0335, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3710, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0340 Medications—Documentation.

The service provider must maintain a written record of all medications administered to, assisted with, monitored, or refused by the client.

History

WSR 16-14-058, recodified as § 388-101D-0340, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3720, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0345 Disposal of medications.

(1) The service provider or his/her designee must properly dispose of all medications that are discontinued, out of date, or superseded by another.

(2) When disposing client medications the service provider must list the:

(a) Medication;

(b) Amount; and

(3) Two people, one of whom may be the client, must verify the disposal by signature.

(4) For group homes that have an assisted living facility or adult family home license, refer to chapters 388-78A or 388-76 WAC for medication disposal requirements.

History

WSR 16-14-058, recodified as § 388-101D-0345, filed 6/30/16, effective 8/1/16. Statutory Authority: RCW 71A.12.030 and [71A.12].080. WSR 14-10-028, § 388-101-3730, filed 4/28/14, effective 5/29/14. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3730, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0350 Psychoactive medication assessment.

If a client displays symptoms of mental illness and/or persistent challenging behavior, the service provider must:

(1) Refer the client for a professional assessment;

(2) Prior to the referral, prepare a psychiatric referral summary, including the frequency and severity of the symptoms or behaviors, and take or send this document to the treatment professional conducting the assessment;

(3) Respect the client's preference to visit the treatment professional independently; and

(4) If drugs are prescribed, have the prescribing professional assess the client at least annually to review the continued need for the medication(s) and possible dosage reduction.

History

WSR 16-14-058, recodified as § 388-101D-0350, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3740, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0355 What must a client record contain if the client is prescribed a psychotropic medication?

(1) If the client is prescribed psychotropic medication, the client's record must contain:

(a) The date the client met with the prescriber;

(b) Whether the provider was present when the prescriber examined the client;

(d) Any instructions the provider received from the prescriber;

(e) The drug information sheet obtained from the prescriber or dispensing pharmacy for the psychotropic medication prescribed;

(f) The date the provider sent the client's legal representative a copy of the psychotropic drug information sheet, if requested; and

(g) Any documentation required under WAC 388-101D-0340.

(2) If the provider does not attend the appointment, the provider must document in the client record whether the client attended the appointment independently or with a third party.

(3) The provider must report to the prescriber if:

(a) The medication does not appear to have the prescriber's intended effects; or

(b) Any changes in the client's behavior or health might be an adverse side effect of the medication.

History

Statutory Authority: RCW 71A.12.030 and 71A.12.120. WSR 21-12-061, § 388-101D-0355, filed 5/27/21, effective 6/27/21. WSR 16-14-058, recodified as § 388-101D-0355, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3750, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0365 Psychoactive medications—Other.

If psychoactive medications are used for diagnoses other than mental illness or persistent challenging behavior, the service provider must follow the general medication requirements in WAC 388-101-3630 through 388-101-3730.

History

WSR 16-14-058, recodified as § 388-101D-0365, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3770, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0370 Confidentiality of client records.

(1) The service provider must:

(a) Keep all client record information confidential;

(b) Ensure the department's right to have access to and copies of any records as requested or needed; and

(c) Provide access to and copies of client records to the client, or the client's legal representative upon their request.

(2) The service provider must have an authorized release of information form for any transfer or inspection of records, other than those specified in subsection (1) of this section. The authorization form must:

(a) Be specific to the type of information about the transfer or inspection; and

(b) Be signed by the client or client's legal representative.

(3) A signed release of information is valid for up to one year from the date of signature.

History

WSR 16-14-058, recodified as § 388-101D-0370, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3780, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0375 Charging for searching and duplicating records.

(1) The service provider:

(a) Must not charge the department or the client for any searching or duplication of records requested or needed; and

(b) May charge the client's legal representative acting on behalf of the client for searching and duplication of records at a cost not to exceed twenty-five cents a page.

(2) The service provider must not charge the client's legal representative acting on behalf of the client for searching and duplication of records if the client is incapable of making the request.

History

WSR 16-14-058, recodified as § 388-101D-0375, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3790, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0380 Retention of client records.

(1) While supporting a client, a service provider must keep all of the client's records for at least four years.

(2) After a client's participation with a service provider ends, the service provider must keep the client's records for at least six years.

History

WSR 16-14-058, recodified as § 388-101D-0380, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3800, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0385 Contents of client records.

(1) Crisis diversion service providers are exempt from the client record requirements specified in this section.

(2) Service providers must keep, in each client's record, information including but not limited to the following:

(a) Client's name, address, and Social Security number;

(b) Name, address, and telephone number of the client's involved family members, guardian or legal representative;

(d) Client health records, including:

(i) Name, address, and telephone number of the client's physician, dentist, mental health service provider, and any other current health care service provider;

(ii) Current health care service providers' instructions about health care needed, including appointment dates and date of next appointment if appropriate;

(iii) Written documentation that the health care service providers' instructions have been followed; and

(iv) Record of major health events and surgeries when known.

(e) Copy of the client's most recent individual support plan;

(f) Client's individual instruction and support plan including:

(i) Instruction and support activities for each client as a basis for review and evaluation of client's progress;

(ii) Semiannual review of the individual instruction and support plan;

(iii) Consultation with other service providers and other interested persons;

(iv) Individual instruction and support plan revisions and changes; and

(v) Other activities relevant to the client that the client wants included.

(g) Progress notes and incident reports;

(h) The client's financial records for funds managed by the service provider, including:

(i) Receipts, ledgers and records of the client's financial transactions; and

(ii) Client's related bankbooks, checkbooks, bank registers, tax records and bank statements.

(i) Burial plans and wills.

History

WSR 16-14-058, recodified as § 388-101D-0385, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3810, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0390 Client's property records.

(1) Crisis diversion support service providers are exempt from the requirements in this section.

(2) The service provider must assist clients in maintaining current, written property records unless otherwise specified in the individual support plan. The record must consist of:

(a) A list of personal possessions with a value of at least twenty-five dollars that the client owns when moving into the program;

(b) A list of personal possessions with a value of seventy-five dollars or more per item after the client moves into the program;

(d) The date the client purchased the items after moving into the program;

(e) The date and reason for addition or removal from the record; and

(f) The signature of the staff or client making the entry.

History

WSR 16-14-058, recodified as § 388-101D-0390, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3820, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0395 Record entries.

The service provider must ensure that all record entries are:

(1) Documented in ink;

(2) Written legibly at the time of or immediately following the occurrence of the event recorded; and

(3) Signed and dated by the person making the entry.

History

WSR 16-14-058, recodified as § 388-101D-0395, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3830, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0400 Positive behavior support.

Positive behavior support means a recognized approach to supporting clients with challenging behaviors. Positive behavior support focuses on changing the client's environment, skills, and other factors that contribute to the client's challenging behavior(s). Positive behavior support uses a functional assessment to help build respectful plans for clients with challenging behavior(s).

History

WSR 16-14-058, recodified as § 388-101D-0400, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3840, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0405 When is a functional assessment required?

(1) The provider must complete a functional assessment of a client's behavior if:

(a) The exceptional behavior support needs section of the client's person-centered service plan indicates extensive support is necessary to prevent:

(i) Self-injury;

(ii) Sexual aggression;

(iii) Suicide attempt;

(iv) Emotional outburst;

(v) Property destruction;

(vi) Assault or injury to others; or

(vii) A behavior identified in the client's person-centered service plan under "prevention of other serious behavior problem(s)-specify";

(b) The client is prescribed a psychotropic medication on a pro re nata (PRN or as needed) basis to change a target behavior; or

(2) Target behavior means a behavior identified by the provider that needs to be modified or replaced to meet the client's health and safety needs.

(3) The client's functional assessment must:

(a) Be based on two or more of the following:

(i) Direct observation;

(ii) Interview with anyone who has personal knowledge of the client;

(iii) Questionnaire; or

(iv) Record review;

(b) Describe:

(i) Client history and antecedents pertinent to the target behavior;

(ii) The client's current status;

(iii) The target behavior; and

(iv) The apparent function of the target behavior; and

(i) In draft form before the effective date of the client being added to the provider's contract; and

(ii) In final form no later than forty-five calendar days after the effective date of the client being added to the provider's contract.

(4) A draft functional assessment must define the target behavior and its apparent function.

(5) The provider may revise a functional assessment written by another provider. The provider must identify the adapted functional assessment as its own.

(6) If the provider identifies a new target behavior for a client, the provider must complete a functional assessment for that behavior within forty-five days.

(7) The provider may use a community protection participant's risk assessment in place of a functional assessment if it was completed in the past eighteen months and describes:

(a) The client's history pertinent to the target behavior;

(b) The client's current status;

(d) The apparent function of the target behavior.

(8) A functional assessment is required for any target behavior not included in the client's community protection program risk assessment.

History

Statutory Authority: RCW 71A.12.030 and 71A.12.120. WSR 21-12-061, § 388-101D-0405, filed 5/27/21, effective 6/27/21. WSR 16-14-058, recodified as § 388-101D-0405, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3850, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0410 When is a positive behavior support plan required?

(1) If a client requires a functional assessment under WAC 388-101D-0405, the provider must train to and implement a written individualized positive behavior support plan based on that functional assessment.

(2) The client's positive behavior support plan must:

(a) Describe:

(i) The target behavior;

(ii) Actions that may be taken to prevent the target behavior;

(iii) Actions that may be taken in response to the target behavior;

(iv) Actions that may be taken if the target behavior increases in frequency, duration, or impact;

(v) The replacement behavior that matches the target behavior's function;

(vi) How to teach the replacement behavior;

(vii) How to respond to the replacement behavior; and

(viii) Benchmarks to evaluate the positive behavior support plan's effectiveness; and

(b) Exist:

(i) In draft form before the effective date of the client being added to the provider's contract; and

(ii) In final form no later than sixty calendar days after the effective date of the client being added to the provider's contract.

(3) A draft positive behavior support plan must include direction to direct-support professionals on how to respond to target behaviors.

(4) The provider may revise a positive behavior support plan written by another provider. The provider must identify the adapted positive behavior support plan as its own.

(5) If the provider identifies a new target behavior for a client, the provider must implement a positive behavior support plan addressing that behavior within sixty days.

(6) The provider must collect data on:

(a) The target behavior's:

(i) Frequency;

(ii) Duration;

(iii) Impact; and

(b) The replacement behavior's:

(i) Frequency;

(ii) Duration; and

(iii) Impact.

(7) The provider must analyze the data collected under subsection (6) of this section at least every six months to determine the effectiveness of the positive behavior support plan.

(8) If the analysis under subsection (7) of this section indicates the target behavior is not decreasing in frequency, duration, or impact, the provider must:

(a) Revise the positive behavior support plan; or

(b) Document the reason revising the support plan is not indicated.

History

Statutory Authority: RCW 71A.12.030 and 71A.12.120. WSR 21-12-061, § 388-101D-0410, filed 5/27/21, effective 6/27/21. WSR 16-14-058, recodified as § 388-101D-0410, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3860, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0415 Client protection.

While the functional assessment and positive behavior support plan are being developed, the service provider must:

(1) Protect the client and others; and

(2) Document in the client's record how the protection is being done.

History

WSR 16-14-058, recodified as § 388-101D-0415, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3870, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0420 Group home providers.

(1) When considering restrictive procedures, group home providers licensed as assisted living facilities must comply with all requirements in chapter 388-78A WAC regarding restraints.

(2) When considering restrictive procedures, group home providers licensed as adult family homes must comply with all requirements in chapter 388-76 WAC regarding restraints.

History

WSR 16-14-058, recodified as § 388-101D-0420, filed 6/30/16, effective 8/1/16. Statutory Authority: RCW 71A.12.030 and [71A.12].080. WSR 14-10-028, § 388-101-3880, filed 4/28/14, effective 5/29/14. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3880, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0425 Restrictive procedures.

(1) The service provider may:

(a) Only use restrictive procedures for the purpose of protecting the client, others, or property; and

(b) Not use restrictive procedures for the purpose of changing behavior in situations where no need for protection is present.

(2) The service provider must have documentation on the proposed intervention strategy before implementing restrictive procedures including:

(a) A description of the behavior(s) that the restrictive procedures address;

(b) A functional assessment of the challenging behavior(s);

(d) A description of the restrictive procedure that will be used including:

(i) When and how it will be used; and

(ii) Criteria for termination of the procedure; and

(e) A plan to document the use of the procedure and its effect.

(3) The service provider must terminate implementation of the restrictive procedures as soon as the need for protection is over.

History

WSR 16-14-058, recodified as § 388-101D-0425, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3890, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0430 Restrictive procedures approval.

(1) The service provider must have documentation of the proposed intervention strategy that:

(a) Lists the risks of the challenging behavior(s);

(b) Lists the risks of the proposed restrictive procedure(s);

(d) Indicates nonrestrictive alternatives to the recommendation that have been tried but were unsuccessful; and

(e) Includes space for the client and/or the client's legal representative to write comments and opinions regarding the plan and the date of those comments.

(2) The service provider must consult with the division of developmental disabilities if:

(a) The client and/or the client's legal representative disagree with parts of the proposed restrictive procedure; and

(b) An agreement cannot be reached.

(3) Before the service provider implements restrictive procedures they must be approved in writing by:

(a) The service provider's administrator; or

(b) Someone designated by the service provider to have approval authority; and

(c) Someone designated by the division of developmental disabilities, when required by the residential services contract.

History

WSR 16-14-058, recodified as § 388-101D-0430, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3900, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0435 Physical intervention systems.

Service providers who are using physical interventions with clients must have a physical intervention techniques system that includes at least the following:

(1) Discussion of the need for positive behavior support;

(2) Communication styles that help the client to calm down and resolve problems;

(3) Techniques to prevent escalation of behavior before it reaches the stage of physical assault;

(4) Techniques for staff to use in response to clients and their own fear, anger, aggression, or other negative feelings;

(5) Cautions that physical intervention technique(s) may not be changed except as needed for individual disabilities, medical, health, and safety issues. A health care professional and a program trainer must approve all modifications;

(6) Evaluation of the safety of the physical environment;

(7) Issues of respect and dignity of the client;

(8) Use of the least restrictive physical interventions depending upon the situation;

(9) Identification of division of developmental disabilities approved and prohibited physical intervention techniques;

(10) The need to release clients from physical restraint as soon as possible;

(11) Instruction on how to support physical interventions as an observer, recognizing signs of:

(a) Distress by the client; and

(b) Fatigue by the staff; and

(12) Discussion of the importance of complete and accurate documentation.

History

WSR 16-14-058, recodified as § 388-101D-0435, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3910, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0440 Physical interventions.

(1) The service provider must use the least restrictive intervention needed to protect each client, others, and property.

(2) The service provider may only use physical interventions with a client when positive or less restrictive techniques have been tried and determined to be insufficient to:

(a) Protect the client;

(b) Protect others; or

(3) The service provider must:

(a) Terminate the intervention for the client as soon as the need for protection is over; and

(b) Only use restrictive physical interventions for the client as part of a positive behavior support plan except:

(i) In an emergency when a client's behavior presents an immediate risk to the health and safety of the client or others, or a threat to property; or

(ii) When an unknown, unpredicted response from a client jeopardizes the client's or others safety.

History

WSR 16-14-058, recodified as § 388-101D-0440, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3920, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0445 Restrictive physical interventions.

Prior to implementing restrictive physical interventions with a client, the provider must:

(1) Provide documentation to the division of developmental disabilities regarding the proposed intervention;

(2) Involve the client and the client's legal representative in discussion regarding the need for physical intervention;

(3) Determine the kind of notification the client's legal representative wants to receive when physical interventions are used; and

(4) Comply with the requirements defined under WAC 388-101-3890.

History

WSR 16-14-058, recodified as § 388-101D-0445, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3930, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0450 Physical intervention training.

(1) Before using physical interventions with a client, the provider must train all staff who will be implementing those interventions in:

(a) The use of physical interventions;

(b) Crisis prevention techniques; and

(2) Each staff designated to supervise or observe restraint use must be trained in:

(a) The observation and supervision of physical restraints; and

(b) The recognition of potential risks or negative outcomes related to the use of physical restraints.

(3) The service provider must ensure that staff receiving physical intervention techniques training:

(a) Complete the course of instruction;

(b) Demonstrate competency before being authorized to use the techniques with clients; and

History

WSR 16-14-058, recodified as § 388-101D-0450, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3940, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0455 Mechanical and chemical restraints.

(1) The service provider must protect each client's right to be free from mechanical and chemical restraints and involuntary seclusion.

(2) The service provider must use the least restrictive alternatives needed to protect the client, others, or property.

(3) If needed, mechanical restraints may only be used for needed medical or dental treatment and only under the direction of a licensed physician or dentist.

(4) Restraints used as allowed by subsection (3) of this section must be justified and documented in the client's record.

History

WSR 16-14-058, recodified as § 388-101D-0455, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3950, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0460 Monitoring physical and mechanical restraints.

(1) The service provider must ensure that any client who is being physically or mechanically restrained is continuously observed to ensure that risks to the client's health and safety are minimized.

(2) The service provider must keep documentation that includes:

(a) A description of events immediately preceding the client's behavior which led to the use of the restraint;

(b) The type of restraint used;

(d) The client's reaction to the restraint;

(e) Staff that were involved; and

(f) Injuries sustained by anyone during the intervention.

History

WSR 16-14-058, recodified as § 388-101D-0460, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3960, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0465 Community protection—Approval.

In order to provide support to community protection clients, the community protection service provider must, in addition to the other requirements in this chapter:

(1) Be approved by the division of developmental disabilities to serve community protection clients;

(2) Have security precautions reasonably available to enhance protection of neighbors, children, vulnerable adults, animals, and others;

(3) Have for each client an integrated treatment plan with goals, objectives, and therapeutic interventions to assist the client to avoid offending or reoffending; and

(4) Collaborate and coordinate between division of developmental disabilities staff, the treatment team, and community agencies and members.

History

WSR 16-14-058, recodified as § 388-101D-0465, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3970, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0470 Community protection—Policies and procedures.

A community protection service provider must, in addition to other policy and procedure requirements listed in this chapter, develop, train to, and implement the following procedures:

(1) Client security and supervision;

(2) Use of a chaperone agreement that describes who will supervise the client when the client is not under the direct supervision of the community protection service provider;

(3) Compliance with state laws requiring sex offender registration with law enforcement;

(4) Reporting to the division of developmental disabilities the client's refusal to comply with the treatment plan; and

(5) Reporting to the division of developmental disabilities and law enforcement client actions that violate the law or a court order.

History

WSR 16-14-058, recodified as § 388-101D-0470, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3980, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0475 Community protection—Treatment team meetings.

The community protection service provider must participate in treatment team meetings quarterly or more frequently as needed.

History

WSR 16-14-058, recodified as § 388-101D-0475, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-3990, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0480 Community protection—Staff training.

In addition to the staff training requirements in this chapter and the residential services contract, the community protection service provider must ensure that community protection program staff receive training specific to:

(1) Community protection within ninety calendar days of working with a community protection client; and

(2) The needs, supports, and services for clients to whom they are assigned.

History

WSR 16-14-058, recodified as § 388-101D-0480, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-4000, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0485 How does a provider use a treatment plan when developing restrictive procedures?

WAC 388-101D-0485

A provider must use the treatment plan, if available, when gathering information for a functional assessment related to a target behavior. To implement a restrictive procedure based on the recommendations in a treatment plan, the provider must still meet the requirements in WAC 388-101D-0430.

History

Statutory Authority: RCW 71A.12.030 and 71A.12.280. WSR 26-17-092, s 388-101D-0485, filed 8/18/26, effective 9/18/26. WSR 16-14-058, recodified as § 388-101D-0485, filed 6/30/16, effective 8/1/16. Statutory Authority: RCW 71A.12.080. WSR 10-03-065, § 388-101-4010, filed 1/15/10, effective 2/15/10. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-4010, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0490 Community protection—Client records.

WAC 388-101D-0490

In addition to all other client record requirements in this chapter, community protection service providers must include the following in the client's record:

(1) Psychosexual or psychological evaluations or both and risk assessments;

(2) Plans and assessments including:

(a) The written individual plan;

(b) The functional assessment;

(d) A therapist approved treatment plan, if available.

(3) The client's sex offender registration with law enforcement authorities when required by law;

(4) Notice to the division of developmental disabilities of the client's sex offender registration; and

(5) Agreements, requirements, and plans, including the chaperone agreement, with individuals who support the client.

History

Statutory Authority: RCW 71A.12.030 and 71A.12.280. WSR 26-17-092, s 388-101D-0490, filed 8/18/26, effective 9/18/26. WSR 16-14-058, recodified as § 388-101D-0490, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-4020, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0495 Community protection—Client transportation.

In addition to the other client transportation requirements defined in this chapter, community protection service providers must provide or ensure supervised transportation as needed, including but not necessarily limited to, medical emergencies, appointments, to and from the day program site, and community activities.

History

WSR 16-14-058, recodified as § 388-101D-0495, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-4030, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0500 Community protection—Client home location.

(1) When assisting a client in selecting a home, the provider must conduct and document site checks of the proposed residence at different days and times of the week.

(2) After selecting a home, and before the client moves into the home, the provider must document and provide to DDA:

(a) The address of the home;

(b) The reasons the home is appropriate considering the client's specific risk factors;

(d) Approval from the provider's administrator.

History

Statutory Authority: RCW 71A.12.030 and 71A.12.280. WSR 21-19-050, § 388-101D-0500, filed 9/13/21, effective 11/1/21. WSR 16-14-058, recodified as § 388-101D-0500, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-4040, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0505 Community protection—Reducing a client's restrictions.

The community protection service provider must participate in any treatment team meetings held to review and consider a reduction in client restrictions.

History

WSR 16-14-058, recodified as § 388-101D-0505, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-4050, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0510 Community protection—Leaving the program against treatment team advice.

(1) The community protection service provider must immediately notify the division of developmental disabilities when the client leaves the community protection program against treatment team advice; and

(2) Document the client's departure in the client's record.

History

WSR 16-14-058, recodified as § 388-101D-0510, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-4060, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0515 Crisis diversion—Access to services.

The crisis diversion services provider must:

(1) Be approved by the department to provide crisis diversion services; and

(2) Make crisis diversion services available to clients twenty-four hours per day.

History

WSR 16-14-058, recodified as § 388-101D-0515, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-4070, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0520 Crisis diversion bed services—Location.

The crisis diversion bed services provider must:

(1) Provide those services in a residence that is maintained by the crisis diversion bed services provider;

(2) Provide a private, furnished bedroom for each crisis diversion client; and

(3) Support only one client in each residence.

History

WSR 16-14-058, recodified as § 388-101D-0520, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-4080, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0525 Crisis diversion bed services—Services and activities.

The crisis diversion bed services provider must provide the following services and activities:

(1) Support staff, twenty-four hour per day, seven days a week, to meet the client's needs as identified in the client's assessment;

(2) Access to the instruction and support services identified in the client's individual support plan;

(3) Three meals per day plus snacks;

(4) The following items at no cost to the client:

(a) Toiletries and personal care items;

(b) Bedding and towels;

(d) Access to local telephone calls.

(5) Therapeutic interventions aimed at improving the client's functioning;

(6) Medication monitoring as needed;

(7) Transportation to and from the crisis diversion bed location and other necessary appointments or services;

(8) Referral to health care services as needed;

(9) Supports for performing personal hygiene routines and activities of daily living if needed by the client; and

(10) An accessible site for clients with physical disabilities.

History

WSR 16-14-058, recodified as § 388-101D-0525, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-4090, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0530 Crisis diversion bed services—Treatment plan.

(1) Crisis diversion bed services providers must develop a crisis services treatment plan within forty-eight hours of the client's placement.

(2) The treatment plan must include:

(a) The supports and services that must be provided; and

(b) Client discharge goals.

History

WSR 16-14-058, recodified as § 388-101D-0530, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-4100, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0535 Crisis diversion bed and support service providers—Client records.

(1) Crisis diversion bed and support service providers must keep the following information in client records:

(a) Client's name, address, and Social Security number;

(b) Name, address, and telephone number of the client's relative or legal representative; and

History

WSR 16-14-058, recodified as § 388-101D-0535, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-4110, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0540 Crisis diversion bed services—Client records.

(1) Crisis diversion bed services providers must maintain a record for each client admitted to the crisis diversion bed.

(2) The client record must include the following information when available:

(a) Basic demographic information;

(b) Referral process and intake information;

(d) Psychiatric records;

(e) Crisis diversion bed services provider notes;

(f) The crisis services treatment plan;

(g) Cross systems crisis plan;

(h) Disposition at the client's discharge;

(i) Dates of admission and discharge;

(j) Incident reports;

(k) Copies of legal representative and guardianship papers;

(l) Health records including the name, address, and telephone number of the client's:

(i) Physician;

(ii) Dentist;

(iii) Mental health service provider; and

(iv) Any other health care service providers.

(m) Health care service providers' instructions, if any, about health care tasks and date of next appointment;

(n) Written documentation that the health care service providers' instructions have been followed; and

(o) A record of known major health events, including surgeries.

History

WSR 16-14-058, recodified as § 388-101D-0540, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-4120, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0545 Crisis diversion support services—Location.

The crisis diversion support services provider must provide those services in the client's own home.

History

WSR 16-14-058, recodified as § 388-101D-0545, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-4130, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0550 Crisis diversion support services—Services and activities.

The crisis diversion support services provider must provide the following services and activities:

(1) Therapeutic interventions to help stabilize the client's behavioral symptoms;

(2) Assistance with referral to mental health services if needed; and

(3) Technical assistance to the client's caregivers on support strategies.

History

WSR 16-14-058, recodified as § 388-101D-0550, filed 6/30/16, effective 8/1/16. Statutory Authority: Chapter 71A.12 RCW. WSR 08-02-022, § 388-101-4140, filed 12/21/07, effective 2/1/08.

Wash. Admin. Code § 388-101D-0560 What is a group training home?

"Group training home" means a nonprofit facility certified under this chapter and chapter 388-101 WAC. A group training home provides twenty-four-hour community-based instruction and support services to two or more adults.

History

Statutory Authority: RCW 71A.12.030, 71A.12.120, 71A.12.040 and 71A.22.010. WSR 18-23-101, § 388-101D-0560, filed 11/20/18, effective 1/1/19.

Wash. Admin. Code § 388-101D-0565 What are the physical requirements for a group training home bedroom?

(1) The group training home must ensure each client's bedroom:

(a) Is a private room, unless the client requests to share a room;

(b) Has a window or door that provides natural light, is covered with a screen, and allows for emergency exit;

(d) Has a locking door, unless the client's person-centered service plan indicates that it is unsafe for the client to have a locking door;

(e) Has direct, unrestricted access to common areas;

(f) Has adequate space for mobility aids, such as a wheelchair, walker, or lifting device; and

(g) Is at least eighty square feet of usable floor space for a single-occupancy room, one hundred and forty square feet for a double-occupancy room.

(2) For a group training home licensed as an adult family home January 1, 2019, a double bedroom must be at least one hundred and twenty square feet of usable floor space.

(3) Unless the client chooses to provide their own bed, the home must provide each client:

(a) A clean, comfortable bed that meets the client's needs; and

(b) A waterproof mattress cover if needed or requested by the client.

History

Statutory Authority: RCW 71A.12.030, 71A.12.120, 71A.12.040 and 71A.22.010. WSR 18-23-101, § 388-101D-0565, filed 11/20/18, effective 1/1/19.

Wash. Admin. Code § 388-101D-0570 What are the physical requirements for a group training home bathroom?

(1) The group training home must provide handwashing sinks with hot and cold running water in the ratio of one for every five clients.

(2) The group training home must provide toilets in the ratio of one for every five clients.

(3) The group training home must provide bathing options, with hot and cold running water, for clients that meet the needs identified in their person-centered service plans.

(4) A client must have access to a toilet and shower or tub without going through another client's room.

History

Statutory Authority: RCW 71A.12.030, 71A.12.120, 71A.12.040 and 71A.22.010. WSR 18-23-101, § 388-101D-0570, filed 11/20/18, effective 1/1/19.

Wash. Admin. Code § 388-101D-0575 How must a group training home manage food and maintain its kitchen?

A group training home must manage food and maintain its kitchen under chapter 246-215 WAC if the group training home:

(1) Supports more than six clients; and

(2) Was certified after January 1, 2019.

History

Statutory Authority: RCW 71A.12.030, 71A.12.120, 71A.12.040 and 71A.22.010. WSR 18-23-101, § 388-101D-0575, filed 11/20/18, effective 1/1/19.

Wash. Admin. Code § 388-101D-0580 Must the group training home adapt the home to suit a client's needs?

If a client's needs change, the group training home must make a reasonable attempt to adapt the home to meet the needs identified in the client's person-centered service plan.

History

Statutory Authority: RCW 71A.12.030, 71A.12.120, 71A.12.040 and 71A.22.010. WSR 18-23-101, § 388-101D-0580, filed 11/20/18, effective 1/1/19.

Wash. Admin. Code § 388-101D-0585 What building codes apply to group training homes?

(1) A group training home must meet state and local building codes in effect at the time of their:

(a) Initial licensure as an adult family home or assisted living facility; or

(b) Initial certification as a group training home.

(2) A group training home may be required to modify the home to meet current building code requirements if the building poses a health or safety risk to a client.

(3) If a group training home makes any construction changes to the home, the construction must meet current state and local building codes.

History

Statutory Authority: RCW 71A.12.030, 71A.12.120, 71A.12.040 and 71A.22.010. WSR 18-23-101, § 388-101D-0585, filed 11/20/18, effective 1/1/19.

Wash. Admin. Code § 388-101D-0590 When must a group training home be inspected by a local building official?

The group training home must be inspected by a local building official:

(1) Before initial certification; and

(2) After any construction that:

(a) Affects a client's ability to enter or exit the home; or

(b) Makes a significant structural change to the home.

History

Statutory Authority: RCW 71A.12.030, 71A.12.120, 71A.12.040 and 71A.22.010. WSR 18-23-101, § 388-101D-0590, filed 11/20/18, effective 1/1/19.

Wash. Admin. Code § 388-101D-0595 What steps must be taken before moving a client out of the home during construction?

(1) Before moving a client out of the group training home during planned construction, the home must provide thirty days' written notice to the client, the client's guardian if they have one, DDA, and residential care services.

(2) The notice must include:

(a) The client's temporary address;

(b) A plan for delivering services to the client while temporarily out of the home;

(d) The projected completion date for the construction project.

History

Statutory Authority: RCW 71A.12.030, 71A.12.120, 71A.12.040 and 71A.22.010. WSR 18-23-101, § 388-101D-0595, filed 11/20/18, effective 1/1/19.

Wash. Admin. Code § 388-101D-0600 Who is responsible for cleaning and maintaining a group training home?

(1) The group training home's fixtures, furnishings, exterior, and interior, including the client's bedroom, must be safe, sanitary, and well maintained.

(2) The group training home staff must provide housekeeping instruction and support to a client in accordance with the client's person-centered service plan.

History

Statutory Authority: RCW 71A.12.030, 71A.12.120, 71A.12.040 and 71A.22.010. WSR 18-23-101, § 388-101D-0600, filed 11/20/18, effective 1/1/19.

Wash. Admin. Code § 388-101D-0605 How must a group training home protect clients from risks associated with bodies of water?

(1) Any body of water at the group training home over twenty-four inches deep must be enclosed by a fence at least forty-eight inches high.

(2) Any door or gate that directly leads to the body of water must have an audible alarm.

History

Statutory Authority: RCW 71A.12.030, 71A.12.120, 71A.12.040 and 71A.22.010. WSR 18-23-101, § 388-101D-0605, filed 11/20/18, effective 1/1/19.

Wash. Admin. Code § 388-101D-0610 What requirements must a group training home's fireplaces, heaters, and stoves meet?

(1) The group training home must not use a space heater unless it has an underwriters laboratories (UL) rating.

(2) Any hot surface, such as a fireplace or wood-burning or pellet stove, must have a stable barrier that prevents accidental client contact.

History

Statutory Authority: RCW 71A.12.030, 71A.12.120, 71A.12.040 and 71A.22.010. WSR 18-23-101, § 388-101D-0610, filed 11/20/18, effective 1/1/19.

Wash. Admin. Code § 388-101D-0615 What requirements must the group training home's smoke detectors and fire extinguishers meet?

(1) The group training home must install approved automatic smoke detectors:

(a) In every client's bedroom;

(b) On every floor of the home; and

(2) The approved smoke detectors must:

(a) Be in working condition at all times; and

(b) Meet the specific needs of all clients living in the home.

(3) The group training home must have a five-pound 2A:10B-C fire extinguisher on each floor of the home, unless the local fire authority requires a different type of fire extinguisher.

(4) Each fire extinguisher must be:

(a) Installed according to manufacturer recommendations;

(b) Annually replaced or inspected and serviced;

(d) Readily available for use at all times.

(5) The group training home must be located in an area with public fire protection.

(6) A group training home that was a licensed assisted living facility before January 1, 2019 must:

(a) Meet requirements under subsections (1) through (5); or

(b) Annually demonstrate they have passed inspection by the state fire marshal.

History

Statutory Authority: RCW 71A.12.030, 71A.12.120, 71A.12.040 and 71A.22.010. WSR 18-23-101, § 388-101D-0615, filed 11/20/18, effective 1/1/19.

Wash. Admin. Code § 388-101D-0620 How must a group training home prepare for emergency evacuations?

(1) The group training home must display an emergency evacuation plan in a common area on every floor of the home.

(2) The emergency evacuation plan must include:

(a) A floor plan of the home with clearly marked exits;

(b) Emergency evacuation routes; and

(3) The group training home must be able to evacuate all clients to a safe location outside the home in five minutes or less.

(4) A group training home that was a licensed assisted living facility before January 1, 2019 must:

(a) Meet requirements under subsection (3); or

(b) Annually demonstrate they have passed inspection by the state fire marshal.

(5) If a client requires assistance during an evacuation, the group training home must ensure the client's primary evacuation route does not require the client to evacuate:

(a) Through another person's bedroom; or

(b) Using stairs, an elevator, chairlift, or platform lift.

History

Statutory Authority: RCW 71A.12.030, 71A.12.120, 71A.12.040 and 71A.22.010. WSR 18-23-101, § 388-101D-0620, filed 11/20/18, effective 1/1/19.

Wash. Admin. Code § 388-101D-0625 How much emergency food and drinking water must be kept in the group training home?

(1) The group training home must keep an emergency food supply on-site to meet the needs of the clients and staff for at least seventy-two hours. The food supply must meet the dietary needs of each client.

(2) The group training home must keep at least three gallons of water on-site for each client and staff member, which must be:

(a) In sealed, food-grade containers;

(b) Stored in a cool, dry location away from direct sunlight; and

(3) Chlorinated water must be replaced every six months.

History

Statutory Authority: RCW 71A.12.030, 71A.12.120, 71A.12.040 and 71A.22.010. WSR 18-23-101, § 388-101D-0625, filed 11/20/18, effective 1/1/19.

Wash. Admin. Code § 388-101D-0630 What must a group training home consider when providing nutritional services?

(1) The group training home must:

(a) Serve breakfast, lunch, and dinner each day;

(b) Provide twenty-four hour access to snacks and beverages, including nutritious options and options preferred by the client;

(c) Provide a special diet, if ordered by a healthcare professional, such as low sodium, general diabetic, and mechanical soft food diets;

(d) Provide prescribed nutrient concentrates and supplements when prescribed in writing by a healthcare practitioner; and

(e) Maintain a sufficient supply of food at all times.

(2) The group training home must plan meals that accommodate the client's preferences and support the client's choice.

(3) The group training home must provide meals, snacks, and beverages that, if applicable, address each client's:

(a) Nutritional needs;

(b) Food allergies and sensitivities; and

History

Statutory Authority: RCW 71A.12.030, 71A.12.120, 71A.12.040 and 71A.22.010. WSR 18-23-101, § 388-101D-0630, filed 11/20/18, effective 1/1/19.

Wash. Admin. Code § 388-101D-0635 What requirements must an employee or volunteer meet to prepare meals and snacks in a group training home?

(1) If a group training home employee prepares food for clients, the employee must:

(a) Complete safe food handling training requirements under chapter 388-829 WAC;

(b) Prepare food for clients in a safe and sanitary manner; and

(2) If a group training home volunteer prepares food for clients, the volunteer must:

(a) Prepare food for clients in a safe and sanitary manner; and

(b) Have a food worker card under chapter 246-217 WAC.

(3) The group training home staff must provide meal preparation instruction and support to the client in accordance with the client's person-centered service plan.

History

Statutory Authority: RCW 71A.12.030, 71A.12.120, 71A.12.040 and 71A.22.010. WSR 18-23-101, § 388-101D-0635, filed 11/20/18, effective 1/1/19.

Wash. Admin. Code § 388-101D-0640 When may a pet live in a group training home?

A pet living in the group training home must:

(1) Not compromise any client rights, preferences, or medical needs;

(2) Be clean and healthy with proof of current vaccinations; and

(3) Pose no significant health or safety risks to any client residing in the home.

History

Statutory Authority: RCW 71A.12.030, 71A.12.120, 71A.12.040 and 71A.22.010. WSR 18-23-101, § 388-101D-0640, filed 11/20/18, effective 1/1/19.

Wash. Admin. Code § 388-101D-0645 What infection control practices must a group training home implement?

(1) The group training home must implement occupational safety and health administration (OSHA) universal precautions to limit the spread of infections when:

(a) Providing client care and services;

(b) Cleaning the home;

(d) Managing infectious waste.

(2) The group training home must:

(a) Provide staff with the supplies, equipment, and protective clothing necessary for limiting the spread of infections;

(b) Restrict a staff person's contact with clients when the staff person has an illness that is likely to spread in the group training home by casual contact; and

(3) If a client has a positive tuberculosis test result, the group training home must ensure the client:

(a) Has a chest X-ray no more than seven days after the positive test result;

(b) Is evaluated for signs and symptoms of tuberculosis; and

History

Statutory Authority: RCW 71A.12.030, 71A.12.120, 71A.12.040 and 71A.22.010. WSR 18-23-101, § 388-101D-0645, filed 11/20/18, effective 1/1/19.

Wash. Admin. Code § 388-101D-0650 What must a group training home do to detect and manage tuberculosis?

To detect and manage tuberculosis, a group training home must:

(1) Ensure each employee has a tuberculin test no more than three days after beginning to work with clients unless otherwise exempt under this chapter;

(2) Implement policies and procedures that comply with tuberculosis standards set by the Centers for Disease Control and Prevention and applicable state laws;

(3) Comply with the Washington Industrial Safety and Health Act (WISHA) standards for respiratory protection; and

(4) Comply with chapter 296-842 WAC requirements to protect the health and safety of clients who may come into contact with people who have infectious tuberculosis.

History

Statutory Authority: RCW 71A.12.030, 71A.12.120, 71A.12.040 and 71A.22.010. WSR 18-23-101, § 388-101D-0650, filed 11/20/18, effective 1/1/19.

Wash. Admin. Code § 388-101D-0655 What type of tuberculin test must a group training home employee complete?

(1) A group training home employee required to complete a tuberculin test must complete:

(a) A tuberculin skin test with results read by a qualified medical professional between forty-eight and seventy-two hours after placing the test; or

(b) Another FDA-approved tuberculin test.

(2) A group training home employee must complete a blood test for tuberculosis if the employee declines a skin test.

History

Statutory Authority: RCW 71A.12.030, 71A.12.120, 71A.12.040 and 71A.22.010. WSR 18-23-101, § 388-101D-0655, filed 11/20/18, effective 1/1/19.

Wash. Admin. Code § 388-101D-0660 When is a group training home employee not required to complete a tuberculin test?

(1) A group training home employee is not required to complete a tuberculin test if the employee:

(a) Has documentation of an FDA-approved tuberculin test with negative results from within the last twelve months;

(b) Has documentation of a positive FDA-approved tuberculin test with documented evidence of:

(i) Adequate therapy for active disease; or

(ii) Completion of treatment for latent tuberculosis infection preventive therapy;

(2) If a group training home employee self-reports a history of positive test results with chest X-ray results from the last twelve months, the employee must:

(a) Provide a copy of the normal X-ray results to the group training home; and

(b) Be evaluated for signs and symptoms of tuberculosis.

(3) If a group training home employee self-reports a history of positive test results without chest X-ray results, the employee must:

(a) Be referred to a medical provider;

(b) Complete a chest X-ray within seven days; and

(c) Be cleared by a medical professional before returning to work if the X-ray is abnormal and consistent with tuberculosis.

(4) A group training home volunteer working less than four hours a month is exempt from tuberculin test requirements.

History

Statutory Authority: RCW 71A.12.030, 71A.12.120, 71A.12.040 and 71A.22.010. WSR 18-23-101, § 388-101D-0660, filed 11/20/18, effective 1/1/19.

Wash. Admin. Code § 388-101D-0665 When must a group training home employee complete a one-step tuberculin test?

A group training home employee must complete a one-step tuberculin test if the employee:

(1) Has a documented history of a negative result from a previous two-step skin test; or

(2) Is tested using an FDA-approved tuberculin test that does not require a two-step testing process.

History

Statutory Authority: RCW 71A.12.030, 71A.12.120, 71A.12.040 and 71A.22.010. WSR 18-23-101, § 388-101D-0665, filed 11/20/18, effective 1/1/19.

Wash. Admin. Code § 388-101D-0670 When must a group training home employee complete a two-step tuberculin test?

A group training home employee must complete a two-step tuberculosis skin test if the employee:

(1) Has never had a tuberculosis skin test;

(2) Cannot demonstrate proof of a previous negative two-step skin test; or

(3) Completed a one-step skin test more than twelve months ago.

History

Statutory Authority: RCW 71A.12.030, 71A.12.120, 71A.12.040 and 71A.22.010. WSR 18-23-101, § 388-101D-0670, filed 11/20/18, effective 1/1/19.

Wash. Admin. Code § 388-101D-0675 What happens if a group training home employee receives a positive tuberculin test result?

If a group training home employee receives a positive result to tuberculosis skin or blood testing, the group training home must:

(1) Ensure the employee completes a chest X-ray within seven days;

(2) Evaluate the employee for signs and symptoms of tuberculosis immediately and annually thereafter; and

(3) Follow the recommendations of the employee's medical provider.

History

Statutory Authority: RCW 71A.12.030, 71A.12.120, 71A.12.040 and 71A.22.010. WSR 18-23-101, § 388-101D-0675, filed 11/20/18, effective 1/1/19.

Wash. Admin. Code § 388-101D-0680 Must a group training home employee complete follow-up testing?

A group training home employee with negative tuberculin test results may be required by a public health provider or licensing authority to complete follow-up testing:

(1) After exposure to active tuberculosis;

(2) When tuberculosis symptoms are present; or

(3) Periodically as determined by the public health provider.

History

Statutory Authority: RCW 71A.12.030, 71A.12.120, 71A.12.040 and 71A.22.010. WSR 18-23-101, § 388-101D-0680, filed 11/20/18, effective 1/1/19.

Wash. Admin. Code § 388-101D-0685 What must a group training home do when a client or employee has tuberculosis symptoms or receives a positive chest X-ray result?

If a group training home client or employee has tuberculosis symptoms or receives a positive chest X-ray result, the group training home must:

(1) Report the client or employee with tuberculosis symptoms or a positive chest X-ray to an appropriate medical provider or public health provider;

(2) Follow the infection control and safety measures ordered by the client or employee's medical provider or a public health provider;

(3) Implement appropriate infection control measures;

(4) Apply living or work restrictions if the client or employee poses an infection risk to others; and

(5) Ensure an employee caring for a client who has active tuberculosis complies with the Washington Industrial Safety and Health Act (WISHA) standards for respiratory protection under chapter 296-842 WAC.

History

Statutory Authority: RCW 71A.12.030, 71A.12.120, 71A.12.040 and 71A.22.010. WSR 18-23-101, § 388-101D-0685, filed 11/20/18, effective 1/1/19.

Wash. Admin. Code § 388-101D-0690 What records must a group training home maintain related to tuberculin testing?

A group training home must:

(1) Keep the records of tuberculin test results, reports of X-ray findings, and any medical provider or public health provider orders in the group training home;

(2) Provide the records to a public health provider or licensing agency upon request;

(3) Retain the records for at least two years after the date the employee quits or is terminated; and

(4) Provide an employee a copy of the employee's tuberculin test results.

History

Statutory Authority: RCW 71A.12.030, 71A.12.120, 71A.12.040 and 71A.22.010. WSR 18-23-101, § 388-101D-0690, filed 11/20/18, effective 1/1/19.

Wash. Admin. Code § 388-101D-0695 What rights and protections does a client living in a group training home have?

(1) In addition to the client rights under WAC 388-101D-0125 and 388-823-1095, a client living in a group training home has the right to:

(a) A locking bedroom door, unless it is unsafe for the client and is documented in their person-centered service plan;

(b) Share their bedroom only if they consent;

(d) Retain and use personal possessions, including furniture and clothing, as space permits;

(e) Control their own schedule, with support if indicated in their person-centered service plan;

(f) Meet privately at any time with visitors of their choosing;

(g) Access and review the group training home's certification review results and corrective action plans;

(h) View copies of the group training home's policies and procedures at any time;

(i) View copies of the certification results, inspection reports, and the group training home's plans of correction at any time;

(j) Receive written notice from the group training home of enforcement action that places a hold on referrals for new clients or is related to provisional certification; and

(k) A setting that meets requirements under 42 C.F.R. 441.301 (c)(4).

(2) Each client must sign a written agreement with the group training home. The written agreement must include the client's notice rights for termination of services. The notice rights must not conflict with requirements under WAC 388-101D-0200.

History

Statutory Authority: RCW 71A.12.030, 71A.12.120, 71A.12.040 and 71A.22.010. WSR 18-23-101, § 388-101D-0695, filed 11/20/18, effective 1/1/19.

Wash. Admin. Code § 388-101D-0700 What notice requirements must a group training home meet?

If a client's group training home services are terminated and the client is evicted, before evicting the client the group training home must follow:

(1) Notice requirements under WAC 388-101D-0200; and

(2) Applicable legal processes, such as unlawful detainer under chapters 59.12 or 59.16 RCW.

History

Statutory Authority: RCW 71A.12.030, 71A.12.120, 71A.12.040 and 71A.22.010. WSR 18-23-101, § 388-101D-0700, filed 11/20/18, effective 1/1/19.

Wash. Admin. Code § 388-101D-0705 What requirements under this chapter is a group training home provider exempt from?

A group training home provider contracted with DDA before January 1, 2019 is exempt from requirements under WAC 388-101D-0565, 388-101D-0575, 388-101D-0605, 388-101D-0615.

History

Statutory Authority: RCW 71A.12.030, 71A.12.120, 71A.12.040 and 71A.22.010. WSR 18-23-101, § 388-101D-0705, filed 11/20/18, effective 1/1/19.

Chapter 388-102 Online registry of continuing care retirement communities (CCRC).

Wash. Admin. Code § 388-102-0100 Online registry.

(1) The department of social and health services will establish an online registry as required by chapter 18.390 RCW.

(2) To be eligible to be registered as a continuing care retirement community (CCRC) and listed on the department's CCRC online registry, an entity must:

(a) Complete the application; and

(b) Pay the registration fee.

(3) A CCRC must reapply with the state and pay the required fee every two years before its current registration expires.

(4) At the time of the application for or renewal of a CCRC registration, the entity must pay a registration fee. Beginning July 1, 2017, the registration fee must be established in the omnibus appropriations act and any amendment or additions made to that act.

(5) An applicant may appeal agency denials of an application for CCRC registration.

(a) Appeals to the department must be made in writing within thirty days of the department's denial.

(b) Appeals must be sent to the office of administrative hearings.

History

Statutory Authority: RCW 43.17.060, 18.390.40 [18.390.040] and 2016 c 183. WSR 17-10-044, § 388-102-0100, filed 4/28/17, effective 5/29/17.

Chapter 388-103 Adult protective services.

Wash. Admin. Code § 388-103-0001 What definitions apply to this chapter?

In addition to the definitions found in chapter 74.34 RCW, the following definitions apply to this chapter:

(1) With respect to "abuse", the following definitions apply:

(a) Intentional. A person's action or inaction is intentional when the person's objective or purpose is to inflict injury, unreasonable confinement, intimidation, or punishment on a vulnerable adult.

(b) Willful. Willful is synonymous to knowing. A person's action or inaction is knowing when the person is aware that his or her action or inaction would inflict injury, unreasonable confinement, intimidation, or punishment on a vulnerable adult.

(c) Reckless. A person is reckless or acts recklessly when he or she knows of and disregards a substantial risk that his or her action or inaction is likely to inflict injury, unreasonable confinement, intimidation, or punishment on a vulnerable adult, and his or her disregard of such substantial risk is a gross deviation from conduct that a reasonable person would exercise in the same situation.

(2) "Adult family home" is defined under chapter 70.128 RCW.

(3) "Alleged perpetrator" means the person who is alleged to have abandoned, abused, financially exploited, neglected, or misappropriated the property of, an alleged victim; and the department has received a report of, is investigating, or has made an initial substantiated finding about such allegation.

(4) "Alleged victim" means:

(a) The person who is alleged to have been abandoned, abused, financially exploited, neglected, or had their property misappropriated by an alleged perpetrator; and the department has received a report of, is investigating, or has made an initial substantiated finding about such allegation; or

(b) The person who is alleged to be neglecting themselves; and the department has received a report of, is investigating, or has made an initial substantiated finding about the self-neglect.

(5) "Assisted living facility" is defined under chapter 18.20 RCW.

(6) "Basic necessities of life" means food, water, shelter, clothing, and medically necessary health care, including but not limited to health-related treatment or activities, hygiene, oxygen, and medication.

(7) "Facility" means a residence licensed or required to be licensed under:

(a) Chapter 18.20 RCW, assisted living facilities;

(b) Chapter 18.51 RCW, nursing homes;

(d) Chapter 72.36 RCW, soldiers' homes;

(e) Chapter 71A.20 RCW, residential habilitation centers;

(f) Chapter 70.97 RCW, enhanced services facilities; or

(g) Any other facility licensed or certified by the department.

(8) "Final substantiated finding" means an initial substantiated finding of abandonment, abuse, financial exploitation, misappropriation of resident property, or neglect that:

(a) Has been upheld through the administrative hearing process described in WAC 388-103-0090 through 388-103-0160; or

(b) Is not timely appealed to the office of administrative hearings as required under WAC 388-103-0100.

(9) "Initial substantiated finding" means a finding by the department that, more likely than not, the alleged abandonment, abuse, financial exploitation, misappropriation of resident property, neglect, or self-neglect occurred.

(10) "Legal representative" means a guardian or conservator appointed under either chapter 11.88 RCW or chapter 11.130 RCW; or an agent granted authority under a power of attorney as described under chapter 11.125 RCW.

(11) "Nursing assistant" means as it is defined under chapter 18.88A RCW.

(12) "Nursing facility" means a nursing home, or any portion of a hospital, veterans' home, or residential habilitation center, that is certified to provide nursing services to medicaid recipients under section 1919(a) of the Social Security Act (42 U.S.C. Sec. 1396r).

(13) "Nursing home" means any facility licensed to operate under chapter 18.51 RCW.

(14) "Person with a duty of care," in the context of abandonment and neglect, includes:

(a) A guardian or conservator appointed under chapter 11.88 RCW or chapter 11.130 RCW;

(b) An agent granted authority under a power of attorney as described under chapter 11.125 RCW; or

(i) The person is employed by or on behalf of the vulnerable adult; or

(ii) The person voluntarily agrees to provide, or has been providing, the basic necessities of life to the vulnerable adult on a continuing basis.

(15) "Skilled nursing facility" means a nursing home, a portion of a nursing home, or a long-term care wing or unit of a hospital that has been certified to provide nursing services to medicare recipients under section 1819(a) of the Social Security Act (42 U.S.C. Sec. 1395i-3).

(16) "Vulnerable adult abuse registry" means the registry, established and maintained by the department as required under RCW 74.39A.056, that contains identifying information about people who have final substantiated findings of abandonment, abuse, financial exploitation, misappropriation of resident property, or neglect of a vulnerable adult.

History

Statutory Authority: RCW 74.34.068, 74.34.165, 42 U.S.C. Sec. 1396r (g)(1)(D), and 42 U.S.C. Sec. 1395i-3 (g)(1)(D). WSR 22-13-144, § 388-103-0001, filed 6/21/22, effective 7/22/22
WSR 21-11-108, § 388-103-0001, filed 5/19/21, effective 7/1/21.

Wash. Admin. Code § 388-103-0002 What additional definitions apply when the facility is a nursing facility or skilled nursing facility?

(1) This section incorporates those definitions under 42 C.F.R. Sec. 488.301 into this chapter.

(2) In addition to the definitions in WAC 388-103-0001 and RCW 74.34.020, the definitions in this section apply to this chapter when:

(a) The alleged victim is a resident of a nursing facility or skilled nursing facility; and

(b) The alleged perpetrator is an individual used by such facility to provide services to residents.

(3) Abuse.

(a) Abuse is the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain or mental anguish. Abuse also includes the deprivation by an individual, including a caretaker, of goods or services that are necessary to attain or maintain physical, mental, and psychosocial well-being.

(b) Instances of abuse of all residents, irrespective of any mental or physical condition, cause physical harm, pain or mental anguish.

(c) Abuse includes verbal abuse, sexual abuse, physical abuse, and mental abuse including abuse facilitated or enabled through the use of technology.

(d) Willful, as used in this definition of abuse, means the individual must have acted deliberately, not that the individual must have intended to inflict injury or harm.

(4) "Individual" means a person used by a nursing facility or skilled nursing facility to provide services to residents of such facility.

(5) "Misappropriation of resident property" means the deliberate misplacement, exploitation, or wrongful, temporary or permanent use of a resident's belongings or money without the resident's consent.

(6) "Neglect" means the failure of an individual to provide goods and services to a resident that are necessary to avoid physical harm, pain, mental anguish, or emotional distress.

History

Statutory Authority: RCW 74.34.068, 74.34.165
42 U.S.C. Sec. 1396r (g)(1)(D), 42 U.S.C. Sec. 1395i3 (g)(1)(D). WSR 21-11-108, § 388-103-0002, filed 5/19/21, effective 7/1/21.

Wash. Admin. Code § 388-103-0010 What is the purpose of an adult protective services investigation?

The purpose of an adult protective services investigation is to:

(1) Investigate allegations of abandonment, abuse, financial exploitation, misappropriation of resident property, neglect, or self-neglect.

(2) Provide protective services to the alleged victim, with the consent of the alleged victim or their legal representative, when the protective services could assist in ending or preventing of the harm to the alleged victim.

History

Statutory Authority: RCW 74.34.068, 74.34.165
42 U.S.C. Sec. 1396r (g)(1)(D), 42 U.S.C. Sec. 1395i3 (g)(1)(D). WSR 21-11-108, § 388-103-0010, filed 5/19/21, effective 7/1/21.

Wash. Admin. Code § 388-103-0020 When does adult protective services respond to a report?

The department will initiate a response to a report of suspected abandonment, abuse, financial exploitation, misappropriation of resident property, neglect, or self-neglect of a vulnerable adult when the alleged facts and circumstances reasonably fit the definition of abandonment, abuse, financial exploitation, misappropriation of resident property, neglect, or self-neglect as defined in RCW 74.34.020 or this chapter.

History

Statutory Authority: RCW 74.34.068, 74.34.165
42 U.S.C. Sec. 1396r (g)(1)(D), 42 U.S.C. Sec. 1395i3 (g)(1)(D). WSR 21-11-108, § 388-103-0020, filed 5/19/21, effective 7/1/21.

Wash. Admin. Code § 388-103-0030 What state-only funded services may be offered to an alleged victim?

(1) Subject to available funding, adult protective services (APS) may arrange for, and provide referrals to, state-only funded services for an alleged victim.

(2) Services may include:

(a) In-home personal care, household services, or both; and

(b) Emergency referral options for a department-licensed and -contracted adult family home, assisted living facility, or nursing home.

(3) Services may be offered if:

(a) The person is the alleged victim in an open APS investigation;

(b) The services would help protect the alleged victim from harm;

(c) APS cannot identify alternative resources or options for payment for services available to the alleged victim at the time the services are needed;

(d) Services are provided in the least restrictive and cost effective manner and setting available to meet the needs of the alleged victim;

(e) APS is pursuing service alternatives or resolution of the issues that resulted in the need for the services; and

(f) The services are temporary and provided with the consent of the alleged victim, or their legal representative, only until the situation has stabilized.

(4) Service limitations.

(a) State-only funded protective services are provided by APS on a discretionary basis, are not a benefit, and are not an entitlement.

(b) There is no right to notice over an approval, denial, change, termination, or any other action regarding services.

(c) There is no right to an administrative hearing over an approval, denial, change, termination, or any other action regarding services.

(d) All services are limited to a cumulative maximum total of ninety days in any twelve-month period, with nursing home services limited to thirty days in the twelve-month period. An exception to rule requested under chapter 388-440 WAC will not be accepted.

(e) In-home personal care, household services, or both, are provided based on assessed need and limited to one hundred forty-three hours per calendar month.

History

Statutory Authority: RCW 74.34.068, 74.34.165
42 U.S.C. Sec. 1396r (g)(1)(D), 42 U.S.C. Sec. 1395i3 (g)(1)(D). WSR 21-11-108, § 388-103-0030, filed 5/19/21, effective 7/1/21.

Wash. Admin. Code § 388-103-0040 When does adult protective services notify the alleged perpetrator of an initial substantiated finding?

(1) Adult protective services (APS) will notify the alleged perpetrator in writing on or before the tenth working day after making an initial substantiated finding.

(2) APS may notify the alleged perpetrator after the tenth working day if time is needed to translate the notification letter, or if time is needed to provide for the safety of the alleged victim.

History

Statutory Authority: RCW 74.34.068, 74.34.165
42 U.S.C. Sec. 1396r (g)(1)(D), 42 U.S.C. Sec. 1395i3 (g)(1)(D). WSR 21-11-108, § 388-103-0040, filed 5/19/21, effective 7/1/21.

Wash. Admin. Code § 388-103-0050 How will adult protective services give the alleged perpetrator notice of the initial substantiated finding?

(1) Adult protective services (APS) will notify the alleged perpetrator of the initial substantiated finding using one of the following methods:

(a) Personal service of the notice as described under RCW 4.28.080; or

(b) Sending a copy of the notice by first-class mail and certified mail, return receipt requested, to the alleged perpetrator's last known mailing address.

(2) If APS knows the alleged perpetrator no longer receives mail at their last known mailing address, then APS will give notice by personal service.

History

Statutory Authority: RCW 74.34.068, 74.34.165
42 U.S.C. Sec. 1396r (g)(1)(D), 42 U.S.C. Sec. 1395i3 (g)(1)(D). WSR 21-11-108, § 388-103-0050, filed 5/19/21, effective 7/1/21.

Wash. Admin. Code § 388-103-0060 When is notice to the alleged perpetrator complete?

Notice is complete when:

(1) Personal service is made; or

(2) First-class mail and certified mail, return receipt requested, are both properly stamped, addressed, and deposited in the United States mail.

History

Statutory Authority: RCW 74.34.068, 74.34.165
42 U.S.C. Sec. 1396r (g)(1)(D), 42 U.S.C. Sec. 1395i3 (g)(1)(D). WSR 21-11-108, § 388-103-0060, filed 5/19/21, effective 7/1/21.

Wash. Admin. Code § 388-103-0070 What proves that adult protective services provided notice of the initial substantiated finding to the alleged perpetrator?

Adult protective services may prove notice was provided to the alleged perpetrator by any of the following:

(1) A sworn statement, certification, or declaration of personal service;

(2) A sworn statement, certification, or declaration of mailing; or

(3) The certified mail receipt confirming the notice was delivered.

History

Statutory Authority: RCW 74.34.068, 74.34.165
42 U.S.C. Sec. 1396r (g)(1)(D), 42 U.S.C. Sec. 1395i3 (g)(1)(D). WSR 21-11-108, § 388-103-0070, filed 5/19/21, effective 7/1/21.

Wash. Admin. Code § 388-103-0080 Will adult protective services notify anyone other than the alleged perpetrator of the initial substantiated finding?

(1) Facilities.

(a) If the incident occurred in a facility, adult protective services (APS) will inform the facility owner, manager, or administrator of the initial substantiated finding.

(b) If abuse, neglect, or misappropriation of resident property occurred in a nursing home, APS will inform the administrator of the nursing home of the initial substantiated finding.

(2) Agencies or programs.

(a) If the alleged perpetrator is an employee, contractor, volunteer, or otherwise related to an agency or program described in RCW 74.34.068, APS may inform such agency or program of the initial substantiated finding; and

(b) APS may also inform appropriate state or local governmental authorities responsible for licensing or certification of such agency or program.

(3) APS may inform law enforcement of the initial substantiated finding.

(4) APS may inform the long-term care ombuds, the developmental disabilities ombuds, or both, of the initial substantiated finding.

(5) Other authorities.

(a) If an alleged perpetrator is professionally licensed, certified, or registered under title 18 RCW, APS may inform the proper authority of the initial substantiated finding.

(b) APS may inform other investigative authorities of the initial substantiated finding.

History

Statutory Authority: RCW 74.34.068, 74.34.165
42 U.S.C. Sec. 1396r (g)(1)(D), 42 U.S.C. Sec. 1395i3 (g)(1)(D). WSR 21-11-108, § 388-103-0080, filed 5/19/21, effective 7/1/21.

Wash. Admin. Code § 388-103-0090 May an alleged perpetrator challenge an initial substantiated finding?

An alleged perpetrator may request an administrative hearing to challenge an initial substantiated finding.

History

Statutory Authority: RCW 74.34.068, 74.34.165
42 U.S.C. Sec. 1396r (g)(1)(D), 42 U.S.C. Sec. 1395i3 (g)(1)(D). WSR 21-11-108, § 388-103-0090, filed 5/19/21, effective 7/1/21.

Wash. Admin. Code § 388-103-0100 How does an alleged perpetrator request an administrative hearing to challenge an initial substantiated finding?

(1) To request an administrative hearing, the alleged perpetrator must send, deliver, or fax a written request to the office of administrative hearings (OAH).

(a) OAH must receive the written request no later than the earlier of:

(i) 5:00 p.m. on the thirtieth calendar day after the mailing date on adult protective services' (APS's) letter of notice; or

(ii) 5:00 p.m. on the thirtieth calendar day after the date APS's letter of notice was personally served upon the alleged perpetrator.

(b) Days are counted as described under WAC 388-02-0035.

(2) The minimum information required to make a request is given by:

(a) Completing the adult protective services administrative hearing request form (DSHS 27-178); or

(b) A written request that includes:

(i) The full legal name, current address, and phone number of the alleged perpetrator;

(ii) A brief explanation of why the alleged perpetrator disagrees with the initial substantiated finding; and

(iii) A description of assistance needed in the administrative appeal process, if any, by the alleged perpetrator, such as a foreign or sign language interpreter, or accommodation for a disability.

(3) Good cause, as described under WAC 388-02-0020, does not apply to the requirements of this section.

History

Statutory Authority: RCW 74.34.068, 74.34.165
42 U.S.C. Sec. 1396r (g)(1)(D), 42 U.S.C. Sec. 1395i3 (g)(1)(D). WSR 21-11-108, § 388-103-0100, filed 5/19/21, effective 7/1/21.

Wash. Admin. Code § 388-103-0110 What laws and rules will control the administrative hearings held regarding initial substantiated findings?

(1) Chapters 34.05 and 74.34 RCW, chapters 388-02 and 10-08 WAC, and this chapter govern an administrative hearing regarding an initial substantiated finding.

(2) In the event of a conflict between this chapter and chapter 388-02 or 10-08 WAC, this chapter will prevail; and in the event of a conflict between chapter 388-02 and 10-08 WAC, chapter 388-02 WAC will prevail.

History

Statutory Authority: RCW 74.34.068, 74.34.165
42 U.S.C. Sec. 1396r (g)(1)(D), 42 U.S.C. Sec. 1395i3 (g)(1)(D). WSR 21-11-108, § 388-103-0110, filed 5/19/21, effective 7/1/21.

Wash. Admin. Code § 388-103-0120 What additional rules apply to administrative hearings regarding initial substantiated findings of abuse, neglect, or misappropriation of resident property, where the alleged perpetrator is an individual used by a nursing facility or skilled nursing facility to provide services to residents of that facility?

(1) This section applies to the administrative hearing when an initial substantiated finding of abuse, neglect, or misappropriation of resident property is made against an individual used by a nursing facility or skilled nursing facility to provide services to residents of that facility.

(2) The hearing and the hearing record must be completed within one hundred and twenty days from the day the office of administrative hearings received the request for a hearing under WAC 388-103-0100.

(a) If the administrative law judge (ALJ) finds that extenuating circumstances exist that will make it impossible to render a decision within one hundred and twenty days, then the ALJ may extend the limit by a maximum of sixty days.

(b) The individual must be available for the hearing and other preliminary matters.

(c) If the individual is a nursing assistant, and if the hearing and hearing record cannot be completed within the time limit because of the unavailability of the nursing assistant, then, after the time limit has expired, the nursing assistant's name will be placed on the vulnerable adult abuse registry pending the outcome of the hearing.

(3) The hearing must be held at a reasonable place and time convenient for the individual.

(4) A final substantiated finding of neglect, where neglect is defined under WAC 388-103-0002, may not be made if the individual demonstrates the neglect was caused by factors beyond the control of the individual.

History

Statutory Authority: RCW 74.34.068, 74.34.165
42 U.S.C. Sec. 1396r (g)(1)(D), 42 U.S.C. Sec. 1395i3 (g)(1)(D). WSR 21-11-108, § 388-103-0120, filed 5/19/21, effective 7/1/21.

Wash. Admin. Code § 388-103-0130 How is confidential information protected in the administrative hearing process?

(1) All information described under RCW 74.34.095(1) is confidential, and not subject to disclosure in the administrative hearing process, except as described under RCW 74.34.095(3) and this section.

(2) If the administrative law judge (ALJ) determines that disclosure is essential to the administration of justice and will not endanger the life or safety of the alleged victim or the person who made the report, then the ALJ may order disclosure of the information otherwise protected under RCW 74.34.095

(3) Such disclosure may only be made under a protective order agreed to by the parties and entered by the ALJ. The ALJ may place restrictions on such disclosure as the ALJ deems proper.

History

Statutory Authority: RCW 74.34.068, 74.34.165
42 U.S.C. Sec. 1396r (g)(1)(D), 42 U.S.C. Sec. 1395i3 (g)(1)(D). WSR 21-11-108, § 388-103-0130, filed 5/19/21, effective 7/1/21.

Wash. Admin. Code § 388-103-0140 How does the administrative law judge make a decision regarding the initial substantiated finding?

(1) If the administrative law judge (ALJ) finds that the preponderance of the evidence supports the initial substantiated finding, the ALJ shall uphold the initial substantiated finding in an initial order.

(2) If the ALJ finds that the initial substantiated finding is not supported by a preponderance of the evidence, the ALJ shall remand the matter to the department to modify the finding consistent with the initial order.

History

Statutory Authority: RCW 74.34.068, 74.34.165
42 U.S.C. Sec. 1396r (g)(1)(D), 42 U.S.C. Sec. 1395i3 (g)(1)(D). WSR 21-11-108, § 388-103-0140, filed 5/19/21, effective 7/1/21.

Wash. Admin. Code § 388-103-0150 What if the alleged perpetrator or the department disagrees with the administrative law judge's initial order?

(1) If the alleged perpetrator or the department disagrees with the administrative law judge's (ALJ's) initial order, either party may request review of the initial order with the department's board of appeals as described under chapter 388-02 WAC.

(2) If either party requests review of the ALJ's initial order, the initial order will not be effected.

History

Statutory Authority: RCW 74.34.068, 74.34.165
42 U.S.C. Sec. 1396r (g)(1)(D), 42 U.S.C. Sec. 1395i3 (g)(1)(D). WSR 21-11-108, § 388-103-0150, filed 5/19/21, effective 7/1/21.

Wash. Admin. Code § 388-103-0160 When does the initial substantiated finding become a final substantiated finding?

(1) An initial substantiated finding becomes a final substantiated finding when:

(a) The department gives the alleged perpetrator notice of the initial substantiated finding as described under WAC 388-103-0050, and the alleged perpetrator does not request an administrative hearing under WAC 388-103-0100;

(b) The administrative law judge (ALJ) dismisses the alleged perpetrator's request for hearing;

(c) The ALJ issues an initial order upholding the initial substantiated finding and the order becomes a final order under WAC 388-02-0525; or

(d) The department's board of appeals enters a final order upholding the initial substantiated finding.

History

Statutory Authority: RCW 74.34.068, 74.34.165
42 U.S.C. Sec. 1396r (g)(1)(D), 42 U.S.C. Sec. 1395i3 (g)(1)(D). WSR 21-11-108, § 388-103-0160, filed 5/19/21, effective 7/1/21.

Wash. Admin. Code § 388-103-0170 What happens when an initial substantiated finding becomes a final substantiated finding?

When an initial substantiated finding becomes a final substantiated finding, identifying information about the perpetrator of the abandonment, abuse, financial exploitation, misappropriation of resident property, or neglect is placed on the vulnerable adult abuse registry that is maintained by the department.

History

Statutory Authority: RCW 74.34.068, 74.34.165
42 U.S.C. Sec. 1396r (g)(1)(D), 42 U.S.C. Sec. 1395i3 (g)(1)(D). WSR 21-11-108, § 388-103-0170, filed 5/19/21, effective 7/1/21.

Wash. Admin. Code § 388-103-0180 Is a final substantiated finding permanent?

(1) A final substantiated finding is permanent, except as described under subsection (2) of this section.

(2) A final substantiated finding may be reversed, and the person's identifying information removed from the vulnerable adult abuse registry, if:

(a) The department determines the final substantiated finding was made in error;

(b) The final substantiated finding is reversed or otherwise overturned upon judicial review; or

History

Statutory Authority: RCW 74.34.068, 74.34.165
42 U.S.C. Sec. 1396r (g)(1)(D), 42 U.S.C. Sec. 1395i3 (g)(1)(D). WSR 21-11-108, § 388-103-0180, filed 5/19/21, effective 7/1/21.

Wash. Admin. Code § 388-103-0190 Will adult protective services notify anyone other than the alleged perpetrator of the final substantiated finding?

(1) Adult protective services (APS) may provide notice of the final substantiated finding to those persons and entities described under WAC 388-103-0080.

(2) Where the perpetrator of a final substantiated finding is an individual used by a nursing home to provide services to residents of such nursing home, APS will notify the following on or before the tenth working day of the final substantiated finding:

(a) The perpetrator;

(b) The current administrator of the nursing home in which the incident occurred;

(c) The administrator of the nursing home in which the perpetrator is currently employed, if known by APS and if different than the nursing home in which the incident occurred; and

(d) The Washington state department of health.

History

Statutory Authority: RCW 74.34.068, 74.34.165
42 U.S.C. Sec. 1396r (g)(1)(D), 42 U.S.C. Sec. 1395i3 (g)(1)(D). WSR 21-11-108, § 388-103-0190, filed 5/19/21, effective 7/1/21.

Wash. Admin. Code § 388-103-0200 Does the department disclose information contained in the vulnerable adult abuse registry about final substantiated findings of abandonment, abuse, financial exploitation, misappropriation of resident property, and neglect?

Upon request of any person, the department shall disclose the identity of a person on the vulnerable adult abuse registry with a final substantiated finding of abandonment, abuse, financial exploitation, misappropriation of resident property, or neglect.

History

Statutory Authority: RCW 74.34.068, 74.34.165
42 U.S.C. Sec. 1396r (g)(1)(D), 42 U.S.C. Sec. 1395i3 (g)(1)(D). WSR 21-11-108, § 388-103-0200, filed 5/19/21, effective 7/1/21.

Wash. Admin. Code § 388-103-0210 May a nursing assistant petition the department to have their name removed from the vulnerable adult abuse registry?

(1) This section implements 42 U.S.C. Sec. 1396r (g)(1)(D) and Sec. 1395i-3 (g)(1)(D) regarding a singular occurrence of neglect in a nursing facility or skilled nursing facility.

(2) A nursing assistant may petition the department to have their name removed from the vulnerable adult abuse registry, subject to the requirements of this section.

(3) Preliminary requirements for the department to accept a petition:

(a) At least one year must have elapsed between the date of the final substantiated finding and the date the department receives the petition;

(b) The final substantiated finding was a singular occurrence of neglect;

(d) The petition must be in writing and contain the following information:

(i) About the petitioner:

(A) Name;

(B) Date of birth;

(D) Mailing address; and

(E) Phone number;

(ii) The final substantiated finding;

(iii) All documents regarding any disciplinary action, or any other negative action, taken against the petitioner under chapter 18.88A RCW;

(iv) A background check through the Washington state patrol that was completed no earlier than 30 days prior to the date the department accepts the petition;

(v) An affidavit stating why the petitioner believes the department should grant the petition. The statement must include whether the petitioner has abused or neglected a vulnerable adult since the final substantiated finding was entered;

(vi) A list of three references for the department to contact regarding the petitioner's employment and personal history, where two references must be professional references; and

(vii) Any other relevant information the petitioner wants the department to consider.

(4) Standard for removal.

(a) The department will accept a petition if the requirements of subsection (3) of this section are met.

(b) Once the petition is accepted, the petitioner must attend an in-person interview with the department. "In-person" means either physical presence with department personnel, or visual presence through electronic means.

(c) Once the petition is accepted and the interview is completed, the department will determine whether the petitioner's employment and personal history reflects a pattern of abusive behavior or neglect:

(i) If the department determines the petitioner's employment and personal history does not reflect a pattern of abusive behavior or neglect, the department approves the petition, and removes the petitioner's name from the vulnerable adult abuse registry.

(ii) If the department determines the petitioner's employment and personal history does reflect a pattern of abusive behavior or neglect, the department denies the petition.

(iii) If the department is unable to determine whether the petitioner's employment and personal history reflects a pattern of abusive behavior or neglect, the department denies the petition.

(5) Other information.

(a) The department will act with reasonable promptness upon receiving a petition that contains the information required under subsection (3) of this section, and make its decision within 60 days of accepting a petition.

(b) If the department requires additional information to make its determination, a letter will be sent to the petitioner requesting the additional information. The petitioner has 10 business days to provide the information. If the department does not receive the requested information, it may be unable to determine whether petitioner's employment and personal history reflects a pattern of abusive behavior or neglect, and deny the petition.

(c) Decisions and other correspondence regarding the petition will be mailed to the petitioner. At the petitioner's request, correspondence may also be sent via email.

(d) A petitioner does not have a right to an administrative hearing regarding any department action taken on a petition.

History

Statutory Authority: RCW 74.34.068, 74.34.165, 42 U.S.C. Sec. 1396r (g)(1)(D), and 42 U.S.C. Sec. 1395i-3 (g)(1)(D). WSR 22-13-144, § 388-103-0210, filed 6/21/22, effective 7/22/22
WSR 21-11-108, § 388-103-0210, filed 5/19/21, effective 7/1/21.

Chapter 388-105 Medicaid rates for contracted home and community residential care services.

Wash. Admin. Code § 388-105-0035 Requirements for a capital add-on rate for licensed boarding homes contracted to provide assisted living (AL) services.

(1) To the extent funds are appropriated to pay a capital add-on rate to AL contractors, beginning July 1, 2006 and every July 1 thereafter, the department will pay a capital add-on rate to AL contractors that have a medicaid occupancy percentage that equals or exceeds sixty percent as determined in accordance with subsection (2) and (3) of this section. The department will pay the capital add-on rate to those AL contractors meeting the sixty percent medicaid occupancy percentage for a full fiscal year i.e., July 1 through June 30.

(2) The department will determine an AL contractor's medicaid occupancy percentage by dividing its medicaid resident days from the last six months of the calendar year preceding the applicable July 1 rate effective date by the product of the weighted average for all its licensed boarding home beds irrespective of use times the calendar days (one hundred eighty-four) for the same six-month period.

(3) For the purposes of this section, medicaid resident days include those clients enrolled in medicaid managed long-term care programs, including but not limited to the program for all inclusive care (PACE) and medicaid/medicare integration project (MMIP).

History

Statutory Authority: Chapter 74.39A RCW, RCW 18.20.290, 2006 c 372, 260, and 64. WSR 06-19-017, § 388-105-0035, filed 9/8/06, effective 10/9/06. Statutory Authority: Chapter 74.39A RCW. WSR 06-07-012, § 388-105-0035, filed 3/3/06, effective 4/3/06. Statutory Authority: 2002 c 371. WSR 02-22-058, § 388-105-0035, filed 10/31/02, effective 12/1/02.

Wash. Admin. Code § 388-105-0045 Bed or unit hold—Medicaid residents at an ESF, AFH, ARC, EARC, or AL who need short-term care at a nursing home or hospital.

(1) An enhanced services facility (ESF) that contracts to provide services under chapter 70.97 RCW and an adult family home (AFH) or assisted living facilities contracted to provide adult residential care (ARC), enhanced adult residential care (EARC), or assisted living services (AL) under chapter 74.39A RCW, must hold a medicaid eligible resident's bed or unit if:

(a) The medicaid resident needs short-term care in a nursing home or hospital;

(b) The medicaid resident is likely to return to the ESF, AFH, ARC, EARC, or AL; and

(2) The ESF, AFH, ARC, EARC, or AL must hold a medicaid resident's bed or unit for up to twenty days when the department pays the ESF, AFH, ARC, EARC, or AL under subsections (3), (4), or (5) of this section.

(3) The department will pay an ESF seventy percent of the resident's medicaid daily rate set at the time he or she left the ESF for the first through twentieth day of the resident's hospital or nursing home stay.

(4) The department will pay an ARC, EARC, or AL seventy percent of the resident's medicaid daily rate set at the time he or she left the ARC, EARC, or AL for the first through seventh day of the resident's hospital or nursing home stay and eleven dollars a day for the eighth through twentieth day.

(5) The department will pay an AFH seventy percent of the resident's medicaid daily rate set at the time he or she left the AFH for the first through seventh day of the resident's hospital or nursing home stay and fifteen dollars per day for the eighth through twentieth day.

(6) A medicaid resident's short-term stay in a nursing home or hospital must be longer than twenty-four hours for subsection (3) or (4) of this section to apply.

(7) If a medicaid resident stays at a hospital or nursing home for more than twenty-four hours, the ESF, AFH, ARC, EARC, or AL must notify the department by email, fax, or telephone within twenty-four hours after the initial twenty-four hour period. If the end of the initial twenty-four hour period falls on a weekend or state holiday, the ESF, AFH, ARC, EARC, or AL must notify the department within twenty-four hours after the weekend or holiday.

(8) If a medicaid resident returns to the ESF, AFH, ARC, EARC, or AL from the hospital or nursing home and stays there for less than twenty-four hours before returning to the hospital or nursing home, the existing bed hold period continues to run. If the medicaid resident stays at the ESF, AFH, ARC, EARC, or AL for more than twenty-four hours before returning to the hospital or nursing home, a new bed hold period begins.

(9) The department's social service worker or case manager may determine that the medicaid resident's hospital or nursing home stay is not short term and he or she is unlikely to return to the ESF, AFH, ARC, EARC, or AL. If the social service worker or case manager makes such a determination, the department may cease payment the day it notifies the contractor of its decision.

(10) An ESF, AFH, ARC, EARC, or AL may seek third-party payment for a bed or unit hold that lasts for twenty-one days or longer or if the department determines that the medicaid resident's hospital or nursing home stay is not short-term and he or she is unlikely to return. The third-party payment must not exceed the resident's medicaid daily rate paid to the ESF, AFH, ARC, EARC, or AL.

(11) If third-party payment is not available for a bed or unit hold that lasts for twenty-one days or longer, the medicaid resident may return to the first available and appropriate bed or unit at the ESF, AFH, ARC, EARC, or AL if he or she continues to meet the admission criteria under chapter 388-106 WAC.

(12) When the medicaid resident's stay in the hospital or nursing home exceeds twenty days or the department's social service worker or case manager determines that the medicaid resident's stay in the nursing home or hospital is not short-term and he or she is unlikely to return to the ESF, AFH, ARC, EARC, or AL, only subsection (10) and (11) of this section apply to a private contract between the contractor and a third party regarding the medicaid resident's unit or bed.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 16-19-055, § 388-105-0045, filed 9/16/16, effective 10/17/16. Statutory Authority: RCW 74.39A.030(3), 18.20.290, and 2009 c 564 § 206(4). WSR 09-20-011, § 388-105-0045, filed 9/25/09, effective 10/26/09. Statutory Authority: RCW 74.39A.030 (3)(a). WSR 09-11-053, § 388-105-0045, filed 5/13/09, effective 6/13/09. Statutory Authority: Chapter 74.39A RCW, RCW 18.20.290, 2006 c 372, 260, and 64. WSR 06-19-017, § 388-105-0045, filed 9/8/06, effective 10/9/06. Statutory Authority: Chapter 74.39A RCW. WSR 06-07-013, § 388-105-0045, filed 3/3/06, effective 4/3/06. Statutory Authority: RCW 74.39A.030, 2003 c 231. WSR 04-09-092, § 388-105-0045, filed 4/20/04, effective 5/21/04.

Wash. Admin. Code § 388-105-0050 Supplementation—General requirements.

(1) Supplementation of the medicaid daily payment rate is an additional payment requested from a medicaid recipient or a third-party payer by an adult family home (AFH) contractor or a licensed boarding home contractor with a contract to provide adult residential care (ARC), enhanced adult residential care (EARC), or assisted living (AL) services.

(2) The AFH, ARC, EARC, or AL contractor may not request supplemental payment of a medicaid recipient's daily rate for services or items that are covered in the daily rate, and the contractor is required to provide:

(a) Under licensing chapters 388-76 or [388-] 78A WAC and chapter 388-110 WAC; and/or

(b) In accordance with his or her contract with the department.

(3) Before a contractor may request supplemental payments, the contractor must have a supplemental payment policy that has been given to all applicants for admittance and current residents. In the policy, the contractor must inform the applicant for admittance or current resident that:

(a) The department medicaid payment plus any client participation assigned by the department is payment in full for the services, items, activities, room and board required by the resident's negotiated service plan per chapter 388-78A WAC or the negotiated care plan per chapter 388-76 WAC and its contract with the department; and

(b) Additional payments requested by the contractor are for services, items, activities, room and board not covered by the medicaid per diem rate.

(4) For services, items and activities, the supplementation policy must comply with RCW 70.129.030(4).

(5) For units or bedrooms for which the contractor may request supplemental payments, the contractor must include in the supplemental payment policy the:

(a) Units and/or bedrooms for which the contractor may request supplementation;

(b) Action the contractor will take when a private pay resident converts to medicaid and the resident or a third party is unwilling or unable to pay a supplemental payment in order for the resident to remain in his or her unit or bedroom. When the only units or bedrooms available are those for which the contractor charges a supplemental payment, the contractor's policy may require the medicaid resident to move from the facility. However, the contractor must give the medicaid resident thirty days notice before requiring the medicaid resident to move.

(6) For the medicaid resident for whom the contractor receives supplemental payments, the contractor must indicate in the resident's record the:

(a) Unit or bedroom for which the contractor is receiving a supplemental payment;

(b) Services, items, or activities for which the contractor is receiving supplemental payments;

(d) Amount of the supplemental payments; and

(e) Private pay charge for the unit or bedroom for which the contractor is receiving a supplemental payment.

(7) When the contractor receives supplemental payment for a unit or bedroom, the contractor must notify the medicaid resident's case manager of the supplemental payment.

History

388-] 78A WAC and chapter 388-110 WAC
and/or(b) In accordance with his or her contract with the department.(3) Before a contractor may request supplemental payments, the contractor must have a supplemental payment policy that has been given to all applicants for admittance and current residents. In the policy, the contractor must inform the applicant for admittance or current resident that:(a) The department medicaid payment plus any client participation assigned by the department is payment in full for the services, items, activities, room and board required by the resident's negotiated service plan per chapter 388-78A WAC or the negotiated care plan per chapter 388-76 WAC and its contract with the department
and(b) Additional payments requested by the contractor are for services, items, activities, room and board not covered by the medicaid per diem rate.(4) For services, items and activities, the supplementation policy must comply with RCW 70.129.030(4).(5) For units or bedrooms for which the contractor may request supplemental payments, the contractor must include in the supplemental payment policy the:(a) Units and/or bedrooms for which the contractor may request supplementation
(b) Action the contractor will take when a private pay resident converts to medicaid and the resident or a third party is unwilling or unable to pay a supplemental payment in order for the resident to remain in his or her unit or bedroom. When the only units or bedrooms available are those for which the contractor charges a supplemental payment, the contractor's policy may require the medicaid resident to move from the facility. However, the contractor must give the medicaid resident thirty days notice before requiring the medicaid resident to move.(6) For the medicaid resident for whom the contractor receives supplemental payments, the contractor must indicate in the resident's record the:(a) Unit or bedroom for which the contractor is receiving a supplemental payment
(b) Services, items, or activities for which the contractor is receiving supplemental payments
(c) Who is making the supplemental payments
(d) Amount of the supplemental payments
and(e) Private pay charge for the unit or bedroom for which the contractor is receiving a supplemental payment.(7) When the contractor receives supplemental payment for a unit or bedroom, the contractor must notify the medicaid resident's case manager of the supplemental payment.[Statutory Authority: RCW 74.39A.901. WSR 07-04-042, § 388-105-0050, filed 1/30/07, effective 3/2/07.

Wash. Admin. Code § 388-105-0055 Supplementation—Unit or bedroom.

When the AFH, ARC, EARC, or AL contractor only has one type of unit or all private bedrooms, the contractor may not request supplementation from the medicaid applicant/resident or a third party, unless the unit or private bedroom has an amenity that some or all of the other units or private bedrooms lack e.g., a bathroom in private bedroom, a view unit, etc.

History

Statutory Authority: RCW 74.39A.901. WSR 07-04-042, § 388-105-0055, filed 1/30/07, effective 3/2/07.

Chapter 388-106 Long-term care services.

Wash. Admin. Code § 388-106-0005 What is the purpose and scope of this chapter?

This chapter applies to applicants and recipients of long-term care services.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0005, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0010 What definitions apply to this chapter?

"Ability to make self understood" means how you made yourself understood to those closest to you in the last seven days before the assessment; expressed or communicated requests, needs, opinions, urgent problems, and social conversations, whether in speech, writing, sign language, symbols, or a combination of these including use of an alternative communication method:

(1) Understood: You expressed ideas clearly;

(2) Usually understood: You had difficulty finding the right words or finishing thoughts, resulting in delayed responses, or you required some prompting to make self understood;

(3) Sometimes understood: You had limited ability, but were able to express concrete requests regarding at least basic needs (such as food, drink, sleep, toilet);

(4) Rarely/never understood: At best, understanding was limited to caregiver's interpretation of client specific sounds or body language (such as indicated presence of pain or need to toilet);

(5) Child under three: Proficiency is not expected of a child under three and a child under three would require assistance with communication with or without a functional disability. Refer to the developmental milestones table in WAC 388-106-0130.

"Active range of motion" means exercises performed by the client to maintain their joint function to the joint's optimal range. Exercises may be performed with the assistance of cueing or reminders by caregivers. A formal, active range of motion program needs to be first established by a qualified registered nurse or therapist. Range of motion may be self-directed based upon an occupational or physical therapist assessment and continued without occupational or physical therapist supervision.

"Activities of daily living (ADL)" means the following:

(1) Bathing: How you took a full-body bath/shower, sponge bath, and transferred in/out of tub/shower.

(2) Bed mobility: How you moved to and from a lying position, turned side to side, and positioned your body while in bed, in a recliner, or other type of furniture you slept in.

(3) Dressing: How you put on, fastened, and took off all items of clothing, including donning/removing prosthesis, splints, either braces or orthotics, or both.

(4) Eating: How you ate and drank, regardless of skill. Eating includes any method of receiving nutrition, such as, by mouth, tube, or through a vein. Eating does not include any set up help you received, such as bringing food to you or cutting it up in smaller pieces.

(5) Locomotion in room and immediate living environment: How you moved between locations in your room and immediate living environment. If you are in a wheelchair, locomotion includes how self-sufficient you were once in your wheelchair.

(6) Locomotion outside room: How you moved to and returned from your immediate living environment, outdoors, and more distant areas. If you are living in a contracted assisted living, enhanced services facility, adult residential care, enhanced adult residential care, enhanced adult residential care-specialized dementia care facility, or nursing facility (NF), this includes areas set aside for dining, activities, etc. If you are living in your own home or in an adult family home, locomotion outside immediate living environment including outdoors, includes how you moved to and returned from a patio or porch, backyard, to the mailbox, to see the next-door neighbor, or when accessing your community.

(7) Walk in room, hallway, and rest of immediate living environment: How you walked between locations in your room and immediate living environment.

(8) Medication management: Describes the amount of assistance, if any, required to receive prescription medications, over the counter medications, or herbal supplements.

(9) Toilet use: How you eliminated or toileted, used a commode, bedpan, or urinal, transferred on/off toilet, cleansed, changed pads, managed ostomy or catheter, and adjusted clothes. Toilet use does not include emptying a bedpan, commode, ostomy, or catheter bag. This type of set up assistance is considered under the definition of support provided.

(10) Transfer: How you moved between surfaces, such as, to/from bed, chair, wheelchair, standing position. Transfer does not include how you moved to/from the bath, toilet, or got in/out of a vehicle.

(11) Personal hygiene: How you maintained personal hygiene tasks, such as combing hair, brushing teeth, shaving, applying makeup, washing/drying face, hands (including nail care), and perineum, including menses care. Personal hygiene does not include hygiene tasks completed in baths and showers.

"Age appropriate" proficiency in the identified task is not expected of a child that age and a child that age would require assistance with the task with or without a functional disability. Refer to the developmental milestones table in WAC 388-106-0130 for the specific ages.

"Aged person" means a person 65 years of age or older.

"Agency provider" means a licensed home care agency or a licensed home health agency having a contract to provide long-term care personal care services to you in your own home.

"Alternative benefit plan" means the scope of services described in WAC 182-501-0060 available to persons eligible to receive health care coverage under the Washington apple health modified adjusted gross income (MAGI)-based adult coverage described in WAC 182-505-0250.

"Application" means a written request for medical assistance or long-term care services submitted to the department by the applicant, the applicant's authorized representative, or, if the applicant is incompetent or incapacitated, someone acting responsibly for the applicant. The applicant must submit the request on a form prescribed by the department.

"Assessment details" means a printed record of information that the department entered into the CARE assessment describing the assistance you may need.

"Assessment or reassessment" means an inventory and evaluation of strengths and limitations based on an in-person interview in your own home or another location that is convenient to you, using the department's comprehensive assessment reporting evaluation (CARE) tool.

"Assistance available" means the amount of assistance that will be available for a task if status is coded:

Partially met due to availability of other informal support. The department determines the amount of the assistance available using one of four categories:

(1) Less than one-fourth of the time;

(2) One-fourth to one-half of the time;

(3) Over one-half of the time to three-fourths of the time; or

(4) Over three-fourths but not all of the time.

"Assistance with body care" means you received or need assistance with:

(1) Application of ointment or lotions;

(2) Trimming of toenails;

(3) Dry bandage changes; or

(4) Passive range of motion treatment.

"Authorization" means an official approval of a departmental action, for example, a determination of client eligibility for service or payment for a client's long-term care services.

"Blind person" means a person determined blind as described under WAC 182-500-0015 by the division of disability determination services of the health care authority.

"Body care" means how you perform with passive range of motion, applications of dressings and ointments or lotions to the body, and pedicure to trim toenails and apply lotion to feet. In adult family homes, enhanced services facilities, contracted assisted living, enhanced adult residential care, and enhanced adult residential care-specialized dementia care facilities, dressing changes using clean technique and topical ointments must be performed by a licensed nurse or through nurse delegation in accordance with chapter 246-840 WAC. Body care excludes:

(1) Foot care if you are diabetic or have poor circulation; or

(2) Changing bandages or dressings when sterile procedures are required.

"Bowel program" means a regular, ongoing program, other than oral medications, that must include interventions such as rectal stimulation using the finger, over the counter suppositories, or enemas to facilitate evacuation of your bowels. Regimens only promoting bowel regularity, including oral medications or supplements, nutrition, hydration, or positioning are not considered in this definition.

"Categorically needy" means the status of a person who is eligible for medical care under Title XIX of the Social Security Act. See WAC 182-512-0010 and chapter 182-513 WAC.

"Child" means an individual less than 18 years of age.

"Client" means an applicant for service or a person currently receiving services from the department.

"Current behavior" means a behavior occurred within seven days of the CARE assessment date, including the day of the assessment. Behaviors that the department designates as current must include information about:

(1) Whether the behavior is easily altered or not easily altered; and

(2) The frequency of the behavior.

"Decisions" means your ability (verbally or nonverbally) to make, and actual performance in making, everyday decisions about tasks of daily living in the last seven days before the assessment. The department codes your ability to make decisions as one of the following:

(1) Independent: Decisions about your daily routine were consistent and organized; reflecting your lifestyle, choices, culture, and values;

(2) Difficulty in new situations: You had an organized daily routine, were able to make decisions in familiar situations, but experienced some difficulty in decision making when faced with new tasks or situations;

(3) Poor decisions; unaware of consequences: Your decisions were poor and you required reminders, cues, and supervision in planning, organizing, and correcting daily routines. You attempted to make decisions, although poorly;

(4) No or few decisions: Decision making was severely impaired; you never/rarely made decisions;

(5) Child under 12: Proficiency in decision making is not expected of a child under 12 and a child under 12 would require assistance with decision making with or without a functional disability. Refer to the developmental milestones table in WAC 388-106-0130.

"Department" means the state department of social and health services, home and community living administration or its designee.

"Designee" means area agency on aging or federally recognized Indian tribe.

"Developmental milestones table" is a chart showing the age range for which proficiency in the identified task is not expected of a child and assistance with the task would be required whether or not the child has a functional disability.

"Disability" is described under WAC 182-500-0025.

"Disabling condition" means you have a medical condition which prevents you from self-performance of personal care tasks without assistance.

"Estate recovery" means the department's process of recouping the cost of medicaid and long-term care benefit payments from the estate of the deceased client. See chapter 182-527 WAC.

"Health action plan" means an individual plan, which identifies health-related problems, interventions, and goals.

"Home health agency" means a licensed:

(1) Agency or organization certified under medicare to provide comprehensive health care on a part-time or intermittent basis to a patient in the patient's place of residence and reimbursed through the use of the client's medical identification card; or

(2) Home health agency, certified or not certified under medicare, contracted and authorized to provide:

(a) Private duty nursing; or

(b) Skilled nursing services under an approved medicaid waiver program.

"Income" means income as defined under WAC 182-509-0001.

"Individual provider" under RCW 74.39A.240 means a person, including a personal aide, who, under an individual provider contract with the department, or as an employee of a consumer directed employer, provides personal care or respite care services to persons who are functionally disabled or otherwise eligible under programs authorized and funded by the medicaid state plan, medicaid waiver programs, or similar state-funded in-home care programs.

"Informal support" means:

(1) Assistance that will be provided with the client's agreement as expressed in the assessment process without home and community-based services funding, except as allowed in subsection (3) of this definition. The person providing the informal support must be age 18 or older. Sources of informal support include but are not limited to: Family members, friends, housemates/roommates, neighbors, school, childcare, after school activities, church, and community programs.

(2) The department will not consider an individual provider to be a source of informal support.

(3) Adult day health and adult day care is coded in the assessment as a source of informal support, regardless of funding source.

(4) Informal support does not include age appropriate functioning.

"Institution" means medical facilities, nursing facilities, and institutions for the intellectually disabled. It does not include correctional institutions. See medical institutions in WAC 182-500-0050.

"Instrumental activities of daily living (IADL)" means routine activities performed around the home or in the community in 30 days prior to the assessment and includes the following:

(1) Meal preparation: How meals were prepared (such as, planning meals, cooking, assembling ingredients, setting out food, utensils, and cleaning up after meals). NOTE: The department will not authorize this IADL to only plan meals or clean up after meals. You must need assistance with other tasks of meal preparation.

(2) Ordinary housework: How ordinary work around the house was performed (such as, doing dishes, dusting, making bed, cleaning the bathroom, tidying up, laundry).

(3) Essential shopping: How shopping was completed to meet your health and nutritional needs (such as, selecting items). Shopping is limited to brief, occasional trips in the local area to shop for food, medical necessities, and household items required specifically for your health, maintenance, or well-being. This includes shopping with or for you.

(4) Wood supply: How wood or pellets were supplied (such as, splitting, stacking, or carrying wood or pellets) when you use wood, pellets, or a combination of both, as the only source of fuel for heating or cooking.

(5) Travel to medical services: How you traveled by vehicle to a physician's office or clinic in the local area to obtain medical diagnosis or treatment. This travel includes driving a vehicle yourself or traveling as a passenger in a car, bus, or taxi.

"Long-term care services" means the services administered directly or through contract by the department and identified in WAC 388-106-0015.

"MAGI" means modified adjusted gross income. It is a methodology used to determine eligibility for Washington apple health (medicaid), and is defined in WAC 182-500-0070.

"Medicaid" is defined under WAC 182-500-0070.

"Medically necessary" is defined under WAC 182-500-0070.

"Medically needy (MN)" or "medically needy program (MNP)" means the state and federally funded health care program available to specific groups of people who would be eligible as categorically needy (CN), except their monthly income is above the CN standard. Some long-term care clients with income or resources above the CN standard may also qualify for MN.

"New Freedom consumer directed services (NFCDS)" means a mix of services and supports to meet needs identified in your assessment and identified in a New Freedom spending plan, within the limits of the individual budget, that provide you with flexibility to plan, select, and direct the purchase of goods and services to meet identified needs. Participants have a meaningful leadership role in:

(1) The design, delivery, and evaluation of services and supports;

(2) Exercising control of decisions and resources, and making their own decisions about health and well-being;

(3) Determining how to meet their own needs;

(4) Determining how and by whom these needs should be met; and

(5) Monitoring the quality of services received.

"New Freedom consumer directed services (NFCDS) participant" means a participant who is an applicant for or currently receiving services under the NFCDS waiver.

"New Freedom spending plan (NFSP)" means the plan developed by you, as a New Freedom participant, within the limits of an individual budget, that details your choices to purchase specific NFCDS and provides required federal medicaid documentation.

"Own home" means your present or intended place of residence:

(1) In a building that you rent and the rental is not contingent upon the purchase of personal care services as defined in this section;

(2) In a building that you own;

(3) In a relative's established residence; or

(4) In the home of another where rent is not charged and residence is not contingent upon the purchase of personal care services as defined in this section.

"Passive range of motion" means a maintenance movement exercise of each joint only to the extent the joint can move. Passive range of motion is performed by a caregiver because the client is unable to move the joint without assistance. A formal passive range of motion program needs to be first established by a qualified registered nurse or therapist. Passive range of motion may be self-directed based upon an occupational or physical therapist assessment and continue without occupational or physical therapist supervision.

"Past behavior" means the behavior did not occur in the last seven days, but did occur more than seven days from the assessment date. For behaviors indicated as past behaviors, the department documents the month and year the behavior last occurred and whether the behavior is addressed with current interventions or whether no interventions are in place.

"Personal aide" is defined in RCW 74.39.007.

"Personal care services" means physical or verbal assistance with activities of daily living (ADL) and instrumental activities of daily living (IADL) due to your functional limitations. Assistance is evaluated with the use of assistive devices.

"Physician" is defined under WAC 182-500-0085.

"Plan of care" means assessment details and service summary generated by CARE.

"Provider or provider of service" means an institution, agency, or person:

(1) Having a signed department contract to provide long-term care client services; and

(2) Qualified and eligible to receive department payment.

"Reasonable cost" means a cost for a service or item that is consistent with the market standards for comparable services or items.

"Representative" means a person who you have chosen, or has been appointed by a court, whose primary duty is to act on your behalf to direct your service budget to meet your identified health, safety, and welfare needs.

"Residential facility" means a licensed adult family home under department contract; a licensed enhanced services facility under department contract; or licensed assisted living facility under department contract to provide assisted living, adult residential care, or enhanced adult residential care.

"Self-performance for ADLs" means a code based on what you actually did for yourself and how much help you received with ADLs, with the exception of bathing, in the last seven days before your assessment, not what you might be capable of doing. For codes of supervision, limited assistance, and extensive assistance, self-performance for ADLs is based on your level of performance that occurred three or more times in the seven-day period. Scoring of self-performance for ADL codes of supervision, limited assistance, and extensive assistance, does not include physical assistance that occurred less than three times in the seven-day look back period, or set-up help for any self-performance ADL code.

(1) Based on information provided during your assessment, the CARE tool assigns a self-performance code to each ADL. When you received the same type of help (such as oversight, nonweight bearing, or weight bearing help) with an ADL at least three times, CARE assigns the self-performance code associated with the most dependent type of help you received at least three times. Your self-performance level code is:

(a) Independent, if you received:

(i) No help, including oversight, encouragement, or cueing, or;

(ii) Help including oversight, encouragement, or cueing only once or twice in the seven-day period;

(b) Supervision, if you received oversight (monitoring or standby), encouragement, or cueing three or more times;

(c) Limited assistance, if you were highly involved in the ADL and received assistance that involved physical, nonweight bearing contact between you and your caregiver, or guided maneuvering of limbs three or more times;

(d) Extensive assistance, if you performed part of the ADL, but on three or more occasions, you needed weight bearing help or you did not participate in a subtask of the ADL, but did participate in other subtasks of the ADL;

(e) Total dependence, if you did not participate at all in the completion of the ADL. Every time the ADL was completed during the entire seven-day period, you received complete assistance of all subtasks completed during the entire seven-day period by others; or

(f) Did not occur, if you or others did not perform the ADL over the last seven days before your assessment. This means the activity did not happen. For example, for "walk in room" to have a code of "did not occur" it means in the last seven days before your assessment, you did not walk even one time. The ADL may not have occurred because:

(i) You were not able (such as, you were not able to walk because you are paralyzed);

(ii) No provider was available to assist; or

(iii) You declined help with the task.

(2) When your self-performance code is not independent, extensive assistance, total dependence, or did not occur, and you received help with the ADL at least three times, but not three times of the same type of help, the CARE tool determines a self-performance code by:

(a) Selecting the three times where you received the most help; and

(b) Assigning a self-performance code based on the least dependent type of help of those three times.

(3) CARE assigns a self-performance code of:

(a) Supervision, if oversight, encouragement, or cueing was the least dependent type of help you received of the three times; or

(b) Limited assistance, if nonweight bearing help or guided maneuvering of your limbs was the least dependent type of help you received out of the three times.

(c) For example, if you received oversight help twice, nonweight bearing help twice, and weight bearing help twice, CARE:

(i) Selects two times of weight bearing help and one time of nonweight bearing help because these were the three times where you received the most help; and

(ii) Assigns a self-performance code of limited assistance because nonweight bearing help was the least dependent type of help you received out of the three times where you received the most help.

"Self-administration of medication" means your ability to manage your prescribed and over the counter medications. Your level of ability is coded for the highest level of need and scored as:

(1) Independent, if you remember to take medications as prescribed and manage your medications without assistance.

(2) Assistance required, if you need assistance from a nonlicensed provider to facilitate your self-administration of a prescribed, over the counter, or herbal medication, as defined in chapter 246-980 WAC. Assistance required includes reminding or coaching you, handing you the medication container, opening the container, using an enabler to assist you in getting the medication into your mouth, alteration of a medication for self-administration, and placing the medication in your hand. This does not include assistance with intravenous or injectable medications. You must be aware that you are taking medications.

(3) Self-directed medication assistance/administration, if you are an adult with a functional disability who is capable of and who chooses to self-direct your medication assistance/administration as prescribed by your medical professional.

(4) Must be administered, if you must have prescription or over the counter medications placed in your mouth or applied or instilled to your skin or mucus membrane. Administration must either be performed by a licensed professional or delegated by a registered nurse to a qualified caregiver (per chapter 246-840 WAC). Administration may also be performed by a family member or unpaid caregiver in in-home settings or in residential settings if facility licensing regulations allow. Intravenous or injectable medications may never be delegated except for insulin injections.

"Self-performance for bathing" means what you actually did in the last seven days before your assessment, not what you might be capable of doing or how well you performed the ADL of bathing. Self-performance for bathing is based on your level of performance that occurred on at least one or more occasions in the seven-day period. Scoring of self-performance for bathing does not include physical assistance that did not occur in the seven-day look back period, or set-up help. Your self-performance level is scored as:

(1) Independent, if you received no help or oversight to complete the ADL of bathing.

(2) Supervision, if in order to bathe you received oversight (monitoring or standby), encouragement, or cueing.

(3) Physical help transfer only, if in order to bathe you had help to transfer only.

(4) Physical help, if in order to bathe you had hands on assistance with bathing, but you did not receive full caregiver performance of the ADL of bathing.

(5) Total dependence, if in order to bathe you received full caregiver performance of the ADL of bathing every time. Total dependence means complete physical nonparticipation by you in all aspects of bathing; or the ADL:

(6) Did not occur, if you or others did not perform the ADL of bathing over the last seven days before your assessment. The ADL of bathing may not have occurred because:

(a) You were not able (for example, you may be paralyzed);

(b) No provider was available to assist; or

"Self-performance for IADLs" means what you actually did in the last 30 days before the assessment, not what you might be capable of doing or how well you performed the IADL. Scoring is based on the level of performance that occurred at least one time in the 30-day period. Your self-performance is scored as:

(1) Independent, if you received no help, set-up help, or supervision;

(2) Assistance, if you received any type of help with the activity, including setup, cueing, or monitoring, or the activity was fully performed by others in the last 30 days;

(3) Total assistance, if you are a child and needed the IADL fully performed by others and you are functioning outside of typical developmental milestones; or

(4) IADL did not occur, if you or others did not perform the IADL in the last 30 days before the assessment.

"Service summary" is CARE information which includes: Contacts (such as, emergency contacts), services the client is eligible for, number of hours or residential rates, personal care tasks, the list of formal and informal providers and what tasks they will provide, a preferred schedule if identified by the client, identified referrals, and dates and agreement to the outlined services.

"SSI-related" is defined under WAC 182-512-0050.

"Status" means the level of assistance:

(1) That will be provided by informal supports; or

(2) That will be provided to a child primarily due to their age.

(3) The department determines the status of each ADL or IADL and codes the status as follows:

(a) Met, which means the ADL or IADL will be fully provided by an informal support;

(b) Unmet, which means an informal support will not be available to provide assistance with the identified ADL or IADL;

(c) Partially met, which means an informal support will be available to provide some assistance, but not all, with the identified ADL or IADL;

(d) Age appropriate or child under (age), means proficiency in the identified task is not expected of a child that age and a child that age would require assistance with the task with or without a functional disability. The department presumes children have a responsible adult(s) in their life to provide assistance with personal care tasks. Refer to the developmental milestones table in WAC 388-106-0130; or

(e) Client declines, which means you will not want assistance with the task.

"Supplemental security income (SSI)" means the federal program as described under WAC 182-500-0100.

"Support provided" means the highest level of support provided (to you) by others in the last seven days before the assessment, even if that level of support occurred only once. The department determines support provided as follows:

(1) No set-up or physical help provided by others;

(2) Set-up help only provided, which is the type of help characterized by providing you with articles, devices, or preparation necessary for greater independence in performance of the ADL. (For example, set-up help includes but is not limited to giving or holding out an item or cutting up prepared food);

(3) One-person physical assist provided;

(4) Two- or more person physical assist provided; or

(5) ADL did not occur during entire seven-day period.

"Task" means a component of an activity of daily living. Several tasks may be associated to a single activity of daily living.

"Turning and repositioning program" is a consistent and organized method in which your caregiver must position and realign your body to prevent or treat skin breakdown. This program is needed because you are physically unable to reposition yourself while sitting or lying down.

"You/your" means the client.

History

Statutory Authority: RCW 49.46.800 and 74.09.520. WSR 25-24-074, s 388-106-0010, filed 12/1/25, effective 1/1/26. Statutory Authority: 2022 c 255, RCW 74.09.520, 74.39A.009, 74.39A.090, 74.39A.095, and 74.39A.515. WSR 25-07-060, s 388-106-0010, filed 3/13/25, effective 4/13/25. Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 23-16-085, § 388-106-0010, filed 7/28/23, effective 8/28/23
WSR 21-04-037, § 388-106-0010, filed 1/26/21, effective 3/1/21. Statutory Authority: RCW 74.08.090. WSR 18-16-004, § 388-106-0010, filed 7/19/18, effective 8/19/18. Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 15-20-054, § 388-106-0010, filed 9/30/15, effective 10/31/15
WSR 14-13-060, § 388-106-0010, filed 6/12/14, effective 7/13/14
WSR 14-04-097, § 388-106-0010, filed 2/4/14, effective 3/7/14
WSR 11-22-043, § 388-106-0010, filed 10/27/11, effective 11/27/11
WSR 10-08-074, § 388-106-0010, filed 4/6/10, effective 5/7/10. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.030. WSR 06-16-035, § 388-106-0010, filed 7/25/06, effective 8/25/06. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.010 and 74.39A.020. WSR 06-05-022, § 388-106-0010, filed 2/6/06, effective 3/9/06. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0010, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0015 What long-term care services does the department provide?

The department provides long-term care services through programs that are designed to help you remain in the community. These programs offer an alternative to nursing home care (which is described in WAC 388-106-0350 through 388-106-0360). You may receive services from any of the following:

(1) Medicaid personal care (MPC) is a medicaid state plan program authorized under RCW 74.09.520. Clients eligible for this program may receive personal care in their own home, adult family home, or in adult residential care as defined in WAC 388-110-020.

(2) Community options program entry system (COPES) is a medicaid waiver program authorized under RCW 74.39A.030. Clients eligible for this program may receive personal care in their own home or in a residential facility.

(3) Community first choice (CFC) is a medicaid state plan program authorized under RCW 74.39A.400. Clients eligible for this program may receive services in their own home, in an adult family home, in adult residential care, enhanced adult residential care, or assisted living as defined in WAC 388-110-020.

(4) Chore is a state-only funded program authorized under RCW 74.39A.110. Grandfathered clients may receive assistance with personal care in their own home.

(5) Volunteer chore is a state-funded program that provides volunteer assistance with household tasks to eligible clients.

(6) Program of all-inclusive care for the elderly (PACE) is a medicaid/medicare managed care program authorized under 42 C.F.R. 460.2. Clients eligible for this program may receive personal care and medical services in their own home, in residential facilities, and in adult day health centers.

(7) Adult day health is a supervised daytime program providing skilled nursing and rehabilitative therapy services in addition to core services outlined in WAC 388-106-0800.

(8) Adult day care is a supervised daytime program providing core services, as defined under WAC 388-106-0800.

(9) Medical care services is a state-funded program authorized under RCW 74.09.035. Clients eligible for this program may receive personal care services in an adult family home or an adult residential care facility.

(10) Residential care discharge allowance is a service that helps eligible clients to establish or resume living in their own home.

(11) Private duty nursing is a medicaid service that provides an alternative to institutionalization in a hospital or nursing facility setting. Clients eligible for this program may receive at least four continuous hours of skilled nursing care on a day to day basis in their own home.

(12) Senior Citizens Services Act (SCSA) is a program authorized under chapter 74.38 RCW. Clients eligible for this program may receive community-based services as defined in RCW 74.38.040.

(13) Respite program is a program authorized under RCW 74.41.040 and WAC 388-106-1200. This program provides relief care for unpaid family or other caregivers of adults with a functional disability.

(14) Programs for persons with developmental disabilities are discussed in chapter 388-823 through 388-850 WAC.

(15) Nursing facility.

(16) New Freedom consumer directed services (NFCDS) is a medicaid waiver program authorized under RCW 74.39A.030.

(17) Residential support is a medicaid waiver program authorized under RCW 74.39A.030. Clients eligible for this program may receive personal care in a licensed and contracted enhanced services facility or in a licensed adult family home with a contract to provide specialized behavior services.

History

Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.400 and 42 C.F.R. § 441.500-590. WSR 16-04-020, § 388-106-0015, filed 1/22/16, effective 2/22/16. Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 15-01-085, § 388-106-0015, filed 12/16/14, effective 1/16/15
WSR 14-15-092, § 388-106-0015, filed 7/18/14, effective 8/18/14
WSR 12-16-026, § 388-106-0015, filed 7/25/12, effective 8/25/12
WSR 08-12-023, § 388-106-0015, filed 5/29/08, effective 7/1/08. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.030. WSR 06-16-035, § 388-106-0015, filed 7/25/06, effective 8/25/06. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.010 and 74.39A.020. WSR 06-05-022, § 388-106-0015, filed 2/6/06, effective 3/9/06. Statutory Authority: RCW 74.08.090, 42 C.F.R. 441.302(a), Social Security Act, Section 1915(c) waiver rules, 42 C.F.R. 438. WSR 05-19-045, § 388-106-0015, filed 9/15/05, effective 10/16/05. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0015, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0020 Under the MPC, CFC, COPES, and chore programs, what services are not covered?

The following types of services are not covered under MPC, CFC, COPES, and chore:

(1) Child care.

(2) Individual providers must not provide:

(a) Sterile procedures unless the provider is a family member or the client self directs the procedure;

(b) Administration of medications or other tasks requiring a licensed health professional unless these tasks are provided through nurse delegation, self-directed care, or the provider is a family member.

(3) Agency providers must not provide:

(a) Sterile procedures;

(b) Self-directed care;

(c) Administration of medications or other tasks requiring a licensed health care professional unless these tasks are provided through nurse delegation.

(4) Services provided over the telephone.

(5) Services to any person who has not been authorized by the department to receive them.

(6) Development of social, behavioral, recreational, communication, or other types of community living skills.

(7) Nursing care.

(8) Pet care.

(9) Assistance with managing finances.

(10) Respite.

(11) Yard care.

History

Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.400 and 42 C.F.R. § 441.500-590. WSR 16-04-020, § 388-106-0020, filed 1/22/16, effective 2/22/16. Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 12-16-026, § 388-106-0020, filed 7/25/12, effective 8/25/12
WSR 08-05-026, § 388-106-0020, filed 2/12/08, effective 3/14/08
WSR 05-11-082, § 388-106-0020, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0025 How do I apply for long-term care services?

To apply for long-term care services, you must request an assessment from the department and submit a medicaid application.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0025, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0030 Where can I receive services?

You may receive services:

(1) In your own home.

(2) In a residential facility, which includes licensed:

(a) Adult family homes, as defined in RCW 70.128.010; and

(b) Assisted living facilities. Types of licensed and contracted assisted living facilities include:

(i) Assisted living facilities, as defined in WAC 388-110-020;

(ii) Enhanced adult residential care facilities, as defined in WAC 388-110-020;

(iii) Enhanced adult residential care facilities-specialized dementia care, as defined in WAC 388-110-020; and

(iv) Adult residential care facilities, as defined in WAC 388-110-020.

(3) In an enhanced services facility, as defined in RCW 70.97.010(12) and chapter 388-107 WAC.

(4) In a nursing home, as defined in WAC 388-97-005.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 15-01-085, § 388-106-0030, filed 12/16/14, effective 1/16/15
WSR 14-15-092, § 388-106-0030, filed 7/18/14, effective 8/18/14
WSR 05-11-082, § 388-106-0030, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0033 When may I receive services in a facility contracted to provide specialized dementia care services?

(1) You may be eligible to receive services in a licensed assisted living facility that has DSHS "enhanced adult residential care-specialized dementia care ("EARC-SDC")," which is defined in WAC 388-110-220. You may be eligible to receive EARC-SDC services in a licensed assisted living facility under the following circumstances:

(a) You are enrolled in CFC, as defined in WAC 388-106-0015;

(b) The department has received written or verbal confirmation from a health care practitioner that you have an irreversible dementia (such as Alzheimer's disease, multi-infarct or vascular dementia, Lewy body dementia, Pick's disease, alcohol-related dementia);

(c) You are receiving services in an assisted living facility that has a current EARC-SDC contract, and you are living in the part of the facility that is covered by the contract;

(d) The department has authorized you to receive EARC-SDC services in the assisted living facility; and

(e) You are assessed by the comprehensive assessment reporting evaluation tool ("CARE") as having a cognitive performance scale score of 3 or more; and any one or more of the following:

(i) An unmet need for assistance with the activity of daily living (ADL) of eating as defined in WAC 388-106-0010;

(ii) Inappropriate toileting menses activities;

(iii) Rummages/takes belongings of others;

(iv) Disrupts household at night when others are sleeping and requires intervention(s);

(v) Wanders/exit seeking;

(vi) Wanders/not exit seeking;

(vii) Left home and gotten lost;

(viii) Inappropriate spitting;

(ix) Inappropriate nakedness;

(x) Eats nonedible substances/objects (Pica)(persistent for at least a month);

(xi) Sexual acting out;

(xii) Delusions;

(xiii) Hallucinations;

(xiv) Assaultive (not during personal care);

(xv) Breaks, throws items;

(xvi) Combative during personal care;

(xvii) Easily irritable/agitated requiring intervention;

(xviii) Obsessive regarding own health or body functions;

(xix) Repetitive movement/pacing;

(xx) Unrealistic fears or suspicions;

(xxi) Nonhealth related repetitive anxious complaints/questions;

(xxii) Resistive to care with words/gestures (does not include informed choice);

(xxiii) Verbally abusive;

(xxiv) Yelling/screaming;

(xxv) Inappropriate verbal noises; or

(xxvi) Accuses others of stealing.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 20-23-124, § 388-106-0033, filed 11/18/20, effective 12/19/20. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.400 and 42 C.F.R. § 441.500-590. WSR 16-04-020, § 388-106-0033, filed 1/22/16, effective 2/22/16. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 14-15-071, § 388-106-0033, filed 7/15/14, effective 8/15/14
WSR 14-02-094, § 388-106-0033, filed 12/31/13, effective 2/1/14.

Wash. Admin. Code § 388-106-0035 May I receive personal care services through any of the long-term care programs when I am out of the state of Washington?

(1) You may receive personal care assistance through any long-term care programs in WAC 388-106-0015 subsections (1) through (5) when temporarily traveling out of state for less than thirty days, as long as your:

(a) Individual provider is contracted with the state of Washington or an employee of the consumer directed employer;

(b) Travel plans are coordinated with your case manager prior to departure;

(d) Services are strictly for your personal care and do not include your provider's travel time, expenses.

(2) You may not receive personal care services outside of the United States.

History

Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-106-0035, filed 8/30/21, effective 10/1/21. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.010 and 74.39A.020. WSR 06-05-022, § 388-106-0035, filed 2/6/06, effective 3/9/06. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0035, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0040 Who can provide long-term care services?

The following types of providers can provide long-term care services:

(1) Individual providers (IPs), who provide services to clients in their own home.

(2) Home care agencies that provide services to clients in their own home. Home care agencies must be licensed under chapter 70.127 RCW and chapter 246-335 WAC and contracted with the department.

(3) Residential providers, which include licensed adult family homes, enhanced services facilities, and assisted living facilities, that contract with the department to provide assisted living, adult residential care, and enhanced adult residential care services (which may also include specialized dementia care).

(4) Providers who have contracted with the department to perform other services.

(5) In the case of new freedom consumer directed services (NFCDS), additional providers meeting NFCDS HCBS waiver requirements contracting with a department approved provider of fiscal management services.

History

Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-106-0040, filed 8/30/21, effective 10/1/21. Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 15-01-085, § 388-106-0040, filed 12/16/14, effective 1/16/15
WSR 14-15-092, § 388-106-0040, filed 7/18/14, effective 8/18/14
WSR 13-18-039 and 13-17-125, § 388-106-0040, filed 8/29/13 and 8/21/13, effective 10/1/13. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.030. WSR 06-16-035, § 388-106-0040, filed 7/25/06, effective 8/25/06. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0040, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0045 When will the department authorize my long-term care services?

The department will authorize long-term care services when you:

(1) Are assessed using CARE;

(2) Are found financially and functionally eligible for services including, if applicable, the determination of the amount of participation toward the cost of your care and/or the amount of room and board that you must pay;

(3) Have given consent for services and approved your plan of care; and

(4) Have chosen a provider(s), qualified for payment.

History

Statutory Authority: RCW 74.08.090. WSR 18-22-068, § 388-106-0045, filed 11/1/18, effective 12/2/18. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.400 and 42 C.F.R. § 441.500-590. WSR 16-04-020, § 388-106-0045, filed 1/22/16, effective 2/22/16. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0045, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0047 When can the department terminate or deny long-term care services to me?

(1) The department will deny or terminate long-term care services if you are not eligible for long-term care services pursuant to WAC 388-106-0210, 388-106-0277, 388-106-0310, or 388-106-0610.

(2) The department may deny or terminate long-term care services to you if, after exhaustion of standard case management activities and the approaches delineated in the department's challenging cases protocol, which must include an attempt to reasonably accommodate your disability or disabilities, any of the following conditions exist:

(a) After a department representative reviews with you your rights and responsibilities as a client of the department, per WAC 388-106-1300 and 388-106-1303, you refuse to accept those long-term care services identified in your plan of care that are vital to your health, welfare or safety;

(b) You choose to receive services in your own home and you or others in your home demonstrate behaviors that are substantially likely to cause serious harm to you or your care provider;

(c) You choose to receive services in your own home and hazardous conditions in or immediately around your home jeopardize the health, safety, or welfare of you or your provider. Hazardous conditions include but are not limited to the following:

(i) Threatening, uncontrolled animals (e.g., dogs);

(ii) The manufacture, sale, or use of illegal drugs;

(iii) The presence of hazardous materials (e.g., exposed sewage, evidence of a methamphetamine lab).

(3) The department may terminate long-term care services if you do not sign and return your service summary document within sixty days of your assessment completion date.

History

Statutory Authority: RCW 74.08.090. WSR 18-22-068, § 388-106-0047, filed 11/1/18, effective 12/2/18. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.400 and 42 C.F.R. § 441.500-590. WSR 16-04-020, § 388-106-0047, filed 1/22/16, effective 2/22/16. Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 15-03-038, § 388-106-0047, filed 1/12/15, effective 2/12/15. Statutory Authority: RCW 74.08.090, 74.09.520, 42 C.F.R. 441.302(a)
Social Security Act section 1915c waiver rules, 42 C.F.R. 440.180. WSR 06-16-070, § 388-106-0047, filed 7/28/06, effective 8/28/06.

Wash. Admin. Code § 388-106-0050 What is an assessment?

(1) An assessment is an in-person interview in your home, current residence, or another location that is convenient to you that is conducted by the department, to inventory and evaluate your ability to care for yourself. The department will assess you at least every twelve months, or more often when there are significant changes necessitating revisions to your CARE plan, or at your request. If your assessment did not take place in the residence where you receive services, the department must visit that residence to evaluate your living situation and environment, for you to continue to receive services.

(2) Between assessments, the department may modify your current assessment without an in-person interview in your home or place of residence. The reasons that the department may modify your current assessment without conducting an in-person interview in your home or place of residence include but are not limited to the following:

(a) Errors made by department staff in coding the information from your in-person interview;

(b) New information requested by department staff at the time of your assessment and received after completion of the in-person interview (e.g. medical diagnosis);

(d) Clarification of the coding selected.

(3) When the department modifies your current assessment, it will notify you using a Planned Action Notice of the modification regardless of whether the modification results in a change to your benefits. You will also receive a new service summary and assessment details, if requested.

(4) An assessment interview does not need to be in-person under the following circumstances:

(a) You agree to the interview being conducted remotely, and have adequate support to participate in the assessment if you need it; or

(b) An in-person interview is not required by the applicable federal regulation or the requirement is waived by the centers for medicare and medicaid services.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 21-08-006, § 388-106-0050, filed 3/24/21, effective 4/24/21. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.400 and 42 C.F.R. § 441.500-590. WSR 16-04-020, § 388-106-0050, filed 1/22/16, effective 2/22/16. Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 13-18-039 and 13-17-125, § 388-106-0050, filed 8/29/13 and 8/21/13, effective 10/1/13. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.010 and 74.39A.020. WSR 06-05-022, § 388-106-0050, filed 2/6/06, effective 3/9/06. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0050, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0055 What is the purpose of an assessment?

The purpose of an assessment is to:

(1) Determine eligibility for long-term care programs;

(2) Identify your strengths, limitations, goals, and preferences;

(3) Evaluate your living situation and environment;

(4) Evaluate your physical health, functional, and cognitive abilities;

(5) Determine availability of informal supports and other nondepartment paid resources;

(6) Determine need for intervention;

(7) Determine need for case management activities;

(8) Determine your classification group that will set your payment rate for residential care or number of hours of in-home care;

(9) Determine need for referrals; and

(10) Develop a plan of care, as defined in WAC 388-106-0010.

(11) In the case of New Freedom consumer directed services, the purpose of an assessment is to determine functional eligibility and for the participant to develop the New Freedom spending plan, as defined in WAC 388-106-0010.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 21-04-037, § 388-106-0055, filed 1/26/21, effective 3/1/21. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.400 and 42 C.F.R. § 441.500-590. WSR 16-04-020, § 388-106-0055, filed 1/22/16, effective 2/22/16. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.030. WSR 06-16-035, § 388-106-0055, filed 7/25/06, effective 8/25/06. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0055, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0060 Who must perform the assessment?

The assessment must be performed by the department, an area agency on aging, or a federally recognized Indian tribe contracted with the department, as described in chapters 388-106 and 388-828 WAC.

History

Statutory Authority: 2022 c 255, RCW 74.09.520, 74.39A.009, 74.39A.090, 74.39A.095, and 74.39A.515. WSR 25-07-060, s 388-106-0060, filed 3/13/25, effective 4/13/25. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 07-24-026, § 388-106-0060, filed 11/28/07, effective 1/1/08
WSR 05-11-082, § 388-106-0060, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0065 What is the process for conducting an assessment?

The department:

(1) Will assess you using a department-prescribed assessment tool, titled the comprehensive assessment reporting evaluation (CARE).

(2) May request the assessment be conducted in private. However, you have the right to request that third parties be present.

(3) Has the right to end the assessment if behaviors by any party are impeding the assessment process. If an assessment is terminated, the department will reschedule.

History

Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.010 and 74.39A.020. WSR 06-05-022, § 388-106-0065, filed 2/6/06, effective 3/9/06. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0065, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0070 Will I be assessed in CARE?

You will be assessed in CARE if you are applying for or receiving DDA services, CFC, COPES, MPC, chore, respite, adult day health, medical care services, PACE, private duty nursing, residential support, and new freedom.

If you are under the age of eighteen and within thirty calendar days of your next birthday, CARE determines your assessment age to be that of your next birthday.

History

Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.400 and 42 C.F.R. § 441.500-590. WSR 16-04-020, § 388-106-0070, filed 1/22/16, effective 2/22/16. Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 14-15-092, § 388-106-0070, filed 7/18/14, effective 8/18/14
WSR 12-16-026, § 388-106-0070, filed 7/25/12, effective 8/25/12
WSR 08-12-023, § 388-106-0070, filed 5/29/08, effective 7/1/08
WSR 07-24-026, § 388-106-0070, filed 11/28/07, effective 1/1/08
WSR 07-10-024, § 388-106-0070, filed 4/23/07, effective 6/1/07
WSR 05-11-082, § 388-106-0070, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0075 How is my need for personal care services assessed in CARE?

The department gathers information from you, your caregivers, family members, and other sources to assess your abilities and how you perform personal care tasks. The department will also consider developmental milestones for children as defined in WAC 388-106-0130 when individually assessing your abilities and need for assistance. The department will assess your ability to perform:

(1) Activities of daily living (ADL) using self-performance, support provided, status, and assistance available, as defined in WAC 388-106-0010. Also, the department determines your need for "assistance with body care" and "assistance with medication management," as defined in WAC 388-106-0010; and

(2) Instrumental activities of daily living (IADL) using self-performance, status, and assistance available, as defined in WAC 388-106-0010.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 20-23-124, § 388-106-0075, filed 11/18/20, effective 12/19/20
WSR 12-14-064, § 388-106-0075, filed 6/29/12, effective 7/30/12
WSR 05-11-082, § 388-106-0075, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0080 How is the amount of long-term care services I can receive in my own home or in a residential facility determined?

The amount of long-term care services you can receive in your own home or in a residential facility is determined through a classification system. Seventeen classifications apply to clients served in residential and in-home settings. The department has assigned each classification a residential facility daily rate or a base number of hours you can receive in your own home.

History

Statutory Authority: 2008 c 329. WSR 08-19-102, § 388-106-0080, filed 9/17/08, effective 10/18/08. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0080, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0085 What criteria does the CARE tool use to place me in one of the classification groups?

The department uses CARE to assess your characteristics. Based on this assessment, the CARE tool uses the following criteria to place you in one of the classification groups:

(1) Cognitive performance.

(2) Clinical complexity.

(3) Mood/behaviors symptoms.

(4) Activities of daily living (ADLs).

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0085, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0090 How does the CARE tool measure cognitive performance?

(1) The CARE tool uses the cognitive performance scale (CPS) to evaluate your cognitive impairment. The CPS results in a score that ranges from zero (intact) to six (very severe impairment). Your CPS score is based on information given at your assessment and documented in the CARE tool:

(a) Whether you are comatose.

(b) Your ability to make decisions, as defined in WAC 388-106-0010 "Decisions."

(d) Whether you have short-term memory problem (e.g. can you remember recent events?) as determined by the following:

(i) Information given at your assessment and documented in the CARE tool showed there is evidence that you have short-term memory loss; or

(ii) You could not recall at least one of the three words you were asked to recall during the mini mental status exam completed during your assessment using the CARE tool; and

(e) Whether you score as total dependence for self-performance in eating, as defined in WAC 388-106-0010 "Self-performance of ADLs."

(2) You will receive a CPS score of:

(a) Zero when you do not have problems with decision-making ability, making yourself understood, or recent memory.

(b) One when you meet one of the following:

(i) Decisions are scored as difficulty in new situations or poor decisions/unaware of consequences as defined in WAC 388-106-0010;

(ii) Your ability to make yourself understood is scored as usually, sometimes, or rarely/never understood as defined in WAC 388-106-0010; or

(iii) You have a short-term memory problem.

(i) Decisions are scored as difficulty in new situations or poor decisions/unaware of consequences as defined in WAC 388-106-0010;

(ii) Your ability to make yourself understood is scored as usually, sometimes, or rarely/never understood; and/or

(iii) You have a short-term memory problem or delayed recall.

(d) Three when you meet at least two of the criteria listed in subsection (2)(b) of this section and one of the following applies:

(i) Decisions are scored as poor decisions/unaware of consequences as defined in WAC 388-106-0010; or

(ii) Your ability to make yourself understood is scored as sometimes or rarely/never understood as defined in WAC 388-106-0010.

(e) Four when both of the following criteria applies:

(i) Decisions are scored as poor decisions/unaware of consequences as defined in WAC 388-106-0010; and

(ii) Your ability to make yourself understood is scored as sometimes or rarely/never understood as defined in WAC 388-106-0010.

(f) Five Decisions are scored as no/few decisions as defined in WAC 388-106-0010.

(g) Six when one of the following applies:

(i) Decisions are scored as no/few decisions and you require total dependence in eating as defined in WAC 388-106-0010; or

(ii) You are comatose.

History

Statutory Authority: RCW 49.46.800 and 74.09.520. WSR 25-24-074, s 388-106-0090, filed 12/1/25, effective 1/1/26. Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 20-23-124, § 388-106-0090, filed 11/18/20, effective 12/19/20
WSR 05-11-082, § 388-106-0090, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0095 How does the CARE tool measure clinical complexity?

The CARE tool places you in the clinically complex classification group only when you have one or more of the following criteria and corresponding ADL scores:

| Condition | AND an ADL score of | | --- | --- | | ALS (Lou Gehrig's Disease) | ˃14 | | Aphasia (expressive, receptive, or both) | ˃=2 | | Cerebral Palsy | ˃14 | | Diabetes Mellitus (insulin dependent) | ˃14 | | Diabetes Mellitus (noninsulin dependent) | ˃14 | | Emphysema & shortness of breath (at rest or exertion) or dizziness/vertigo | ˃10 | | COPD & shortness of breath (at rest or exertion) or dizziness/vertigo | ˃10 | | Explicit terminal prognosis | ˃14 | | Hemiplegia | ˃14 | | Multiple Sclerosis | ˃14 | | Parkinson Disease | ˃14 | | Pathological bone fracture | ˃14 | | Quadriplegia | ˃14 | | Rheumatoid Arthritis | ˃14 | | You have one or more of the following skin problems: ■ Current pressure injuries, with areas of persistent skin redness; ■ Current pressure injuries with partial loss of skin layers; ■ Current pressure injuries, with a full thickness lost; ■ Skin desensitized to pain/pressure; ■ Open lesions (not cuts, rashes); or ■ Stasis ulcers. and You received one of the following types of skin care or treatment: ■ Pressure injury care; ■ Pressure relieving device; ■ Turning/repositioning program as defined in WAC 388-106-0010; ■ Application of dressing; or ■ Wound/skin care treatment. | ˃=2 | | You have a burn(s) and you received one of the following: ■ Application of dressing; or ■ Wound/skin care | ˃=2 | | You have one or more of the following problems: ■ You are frequently incontinent daily with some control present (bladder); ■ You are incontinent all or most of the time multiple times per day having no control (bladder); ■ You are frequently incontinent two to three times per week (bowel); or ■ You are incontinent all or most of the time (bowel). and One of the following applies: ■ The status of your individual management of bowel bladder supplies is "Uses, needs assistance, has incontinence"; ■ The status of your individual management of bowel bladder supplies is "Does not use, has leakage onto skin"; or ■ You use "Any scheduled toileting plan." | ˃10 | | You have a current swallowing problem, and you are not independent in eating. | ˃10 | | You have edema. | ˃14 | | You have pain daily. | ˃14 | | You need and received a bowel program as defined in WAC 388-106-0010. | ˃10 | | You need dialysis. | ˃10 | | You require IV nutritional support or tube feedings; and Your total calories received per IV or tube was at least 25%; and Your fluid intake is greater than 2 cups. | ˃=2 | | You need hospice care. | ˃14 | | You need injections. | ˃14 | | You need intravenous medications. | ˃10 | | You need management of IV lines. | ˃10 | | You need ostomy care. | ˃=2 | | You need oxygen therapy. | ˃10 | | You need radiation. | ˃10 | | You need and received passive range of motion. | ˃10 | | You need and received walking training. | ˃10 | | You need suction treatment. | ˃=2 | | You need tracheostomy care. | ˃10 | | You need a ventilator/respirator | ˃10 | | You are <18 and you have pain related to your disability and you complain of pain or show evidence of pain daily. (If you are under eighteen and do not have pain related to your disability, you may be placed in the clinically complex classification based on other factors above.) | ˃14 | | Key: < means less than. ˃ means greater than. ˃= means greater than or equal to. | |

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 20-23-124, § 388-106-0095, filed 11/18/20, effective 12/19/20
WSR 07-10-024, § 388-106-0095, filed 4/23/07, effective 6/1/07
WSR 05-11-082, § 388-106-0095, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0100 How does the CARE tool measure mood and behaviors?

(1) When you do not meet the criteria for the clinically complex classification group, or the criteria for exceptional care, or for in-home only have a cognitive performance scale score of five or six, then the mood and behavior criteria listed in subsections (3) and (4) below determines your classification group. If you are eligible for more than one "B" group classification based on the two methodologies, CARE will place you in the highest group for which you qualify.

(2) For each behavior that was assessed and documented in the CARE tool, the department will determine a status as "current behavior" or "past behavior" as defined in WAC 388-106-0010.

(3) CARE places you in the mood and behavior classification group only if you have one or more of the behavior/moods that also meets the listed status, frequency, and alterability as identified in the following chart:

| Behavior/Mood | and Status, Frequency & Alterability | | --- | --- | | Assaultive (not during personal care) | Current behavior | | Combative during personal care | Current behavior | | Combative during personal care | Past behavior, addressed with current interventions | | Many incidences of uncontrollable crying tearfulness | Current behavior, frequency 4 or more days per week | | Delusions | Past behavior, addressed with current interventions | | Depression score of 14 or greater | N/A | | Inappropriate nakedness | Current behavior and not easily altered | | Easily irritable/agitated requiring intervention(s) | Current behavior and not easily altered | | Eats nonedible substances/objects (Pica)(persistent for at least a month) | Current behavior | | Eats nonedible substances/objects (Pica)(persistent for at least a month) | Past behavior, addressed with current interventions | | Hallucinations | Current behavior | | Hiding items | Past behavior, addressed with current interventions | | Hoarding | Past behavior, addressed with current interventions | | Mental health therapy/program | Needs | | Nonhealth related repetitive anxious complaints/questions | Current behavior, daily | | Nonhealth related repetitive complaints/questions | Past behavior, addressed with current interventions | | Repetitive movement/pacing, hand wringing, fidgeting | Current behavior, daily | | Resistive to care with words/gestures (does not include informed choice) | Current behavior | | Resistive to care with words/gestures (does not include informed choice) | Past behavior, addressed with current interventions | | Sexual acting out | Current behavior | | Sexual acting out | Past behavior, addressed with current interventions | | Inappropriate spitting | Current behavior and not easily altered | | Inappropriate spitting | Past behavior, addressed with current interventions | | Breaks/throws items | Current behavior | | Unsafe smoking | Current behavior and not easily altered | | Disturbs household at night when others are sleeping and requires intervention | Current behavior | | Wanders exit seeking | Current behavior | | Wanders exit seeking | Past behavior, addressed with current interventions | | Wanders not exit seeking | Current behavior | | Wanders not exit seeking | Past behavior, addressed with current interventions | | Yelling/screaming | Current behavior, frequency 4 or more days per week |

(4) CARE places you in the mood and behavior classification group if you have a behavior point score greater than 1, your CPS score (as defined in WAC 388-106-0090) is greater than 2, and your ADL score (as defined in WAC 388-106-0105) is greater than 1.

| Status | Intervention | Frequency | Weight | | --- | --- | --- | --- | | Past | No intervention | N/A | 0 | | Past | With intervention | N/A | 0.25 | | Current | N/A | 1-3 days per wk | 0.5 | | Current | N/A | 4-6 days per wk | 0.75 | | Current | N/A | Daily | 1 |

Each current behavior (as shown in the table below) has a value from .5 to 6 depending on the severity and alterability. Each status combination (shown in the table above) has a weight from 0 to 1. Behavior points are determined by multiplying the value of each current behavior (from the list below) by the weight of the status combination (above). Behavior points for past behaviors will be determined by multiplying the easily altered value of the behavior from the table below by the appropriate weight from the table above (0 or .25).

The list of behaviors below is divided into categories. Each category has a point limit of how many points can be counted toward the total behavior point score as detailed below. The total behavior point score is determined by totaling the weight-adjusted values for each category below.

| Behavior | Value | | | --- | --- | --- | | | Easily Altered/Past | Not Easily Altered | | 1. Many incidences of uncontrollable crying, tearfulness | .5 | 1 | | 2. Easily irritable/agitated | .5 | 1 | | 3. Obsessive regarding own health or body functions | .5 | 1 | | 4. Repetitive physical movement/pacing, hand wringing, fidgeting | .5 | 1 | | 5. Hiding items | .5 | 1 | | 6. Hoarding | .5 | 1 | | 7. Inappropriate verbal noise | .5 | 1 | | 8. Wanders, not exit seeking | .5 | 1 | | Maximum total points after adjusting for status for behaviors 1-8 = 2 | | | | 9. Repetitive anxious complaints/questions | 1 | 2 | | 10. Rummages/takes belongings of others | 1 | 2 | | 11. Verbally abusive | 1 | 2 | | 12. Yelling or screaming | 1 | 2 | | 13. Inappropriate spitting | 1 | 2 | | 14. Unrealistic fears and suspicions | 1 | 2 | | 15. Accuses others of stealing | 1 | 2 | | Maximum total points after adjusting for status for behaviors 9-15 = 3 | | | | 16. Resistive to care with words/gestures | 2 | 3 | | 17. Disturbs household at night when others are sleeping, requires intervention | 2 | 3 | | 18. Unsafe cooking | 2 | 3 | | 19. Inappropriate toileting/menses activity | 2 | 3 | | 20. Unsafe smoking | 2 | 3 | | 21. Left home and gotten lost | 2 | 3 | | 22. Inappropriate nakedness | 2 | 3 | | Maximum total points after adjusting for status for behaviors 16-22 = 4 | | | | 23. Intentional self-injury | 4 | 5 | | 24. Wanders/Exit seeking | 4 | 5 | | 25. Sexual acting out | 4 | 5 | | 26. Intimidating/threatening (no physical contact) | 4 | 5 | | 27. Assaultive (not during personal care) | 4 | 5 | | 28. Breaks, throws items | 4 | 5 | | Maximum total points after adjusting for status for behaviors 23-28 = 10 | | | | 29. Deliberate fire setting behaviors | 5 | 6 | | 30. Combative during care | 5 | 6 | | 31. Eats nonedible substances/objects (Pica)(persistent for at least a month) | 5 | 6 | | 32. Deliberate sexual violence | 5 | 6 | | Maximum total points after adjusting for status for behaviors 29-32 = 12 | | |

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 20-23-124, § 388-106-0100, filed 11/18/20, effective 12/19/20. Statutory Authority: RCW 74.08.090, 74.09.520, and 2007 c 522. WSR 08-10-022, § 388-106-0100, filed 4/25/08, effective 5/26/08. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0100, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0105 How does the CARE tool measure activities of daily living (ADLs)?

(1) CARE determines an ADL score ranging from zero to twenty-eight for each of the following ADLs.

(a) Personal hygiene;

(b) Bed mobility;

(d) Eating;

(e) Toilet use;

(f) Dressing;

(g) Locomotion in room;

(h) Locomotion outside room; and

(i) Walk in room.

(2) The department through the CARE tool determines the ADL score by using the definitions in WAC 388-106-0010 under "Self-performance for ADLs." The CARE tool assigns the following points to the level of self performance for each of the ADLs listed in subsection (1) of this section. For the locomotion in room, locomotion outside of room and walk in room, the department uses the highest score of the three in determining the total ADL score.

| ADL Scoring Chart | | | --- | --- | | If Self Performance is: | Score Equals | | Independent | 0 | | Supervision | 1 | | Limited assistance | 2 | | Extensive assistance | 3 | | Total dependence | 4 | | Did not occur/no provider | 4 | | Did not occur/client not able | 4 | | Did not occur/client declined | 0 |

(3) Although assessed by CARE, the department does not score bathing and medication management to determine classification groups.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0105, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0110 How does the CARE tool evaluate me for the exceptional care classification of the E Group?

CARE places you in the exceptional care E Group classifications when the following criteria are met in either diagram 1 or 2:

| Diagram 1 | | --- | | You have an ADL score of greater than or equal to 22. | | and | | You need a turning/repositioning program. | | and | | You need at least one of the following: ■ External catheter; ■ Intermittent catheter; ■ Indwelling catheter care; ■ Bowel program; ■ Ostomy care; or ■ Total in self performance for toilet use. | | and | | You need one of the following services provided by an individual provider, agency provider, a private duty nurse, or through self-directed care when in the in home setting, or provided by AFH/assisted living facility staff, facility RN/LPN, facility staff or private duty nursing when living in a residential setting: ■ Active range of motion (AROM); or ■ Passive range of motion (PROM). |

| Diagram 2 | | --- | | You have an ADL score of greater than or equal to 22. | | and | | You need a turning/repositioning program. | | and | | You need one of the following services provided by an individual provider, agency provider, a private duty nurse, or through self-directed care when in the in home setting, or provided by AFH or assisted living facility staff, facility RN/LPN, facility staff or private duty nursing when living in a residential setting: ■ Active range of motion (AROM); or ■ Passive range of motion (PROM). | | and | | All of the following apply: ■ You require IV nutrition support or tube feeding; ■ Your total calories received per IV or tube was greater than 50%; and ■ Your fluid intake by IV or tube is greater than 2 cups per day. | | and | | You need assistance with one of the following, provided by an individual provider, agency provider, a private duty nurse, or through self-directed care when in the in home setting or provided by AFH or assisted living facility staff, facility RN/LPN, facility staff, a private duty nurse or nurse delegation when living in a residential setting: ■ Dialysis; or ■ Ventilator/respirator. |

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 14-15-092, § 388-106-0110, filed 7/18/14, effective 8/18/14. Statutory Authority: 2008 c 329. WSR 08-19-102, § 388-106-0110, filed 9/17/08, effective 10/18/08. Statutory Authority: RCW 74.08.090, 74.09.520, and 2007 c 522. WSR 08-10-022, § 388-106-0110, filed 4/25/08, effective 5/26/08. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0110, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0115 How does CARE use criteria to place me in a classification group for residential facilities?

The CARE tool uses the criteria of cognitive performance as determined under WAC 388-106-0090, clinical complexity as determined under WAC 388-106-0095, mood/behaviors as determined under WAC 388-106-0100, ADLs as determined under WAC 388-106-0105 and exceptional care under WAC 388-106-0110 to place you into one of the following seventeen residential classification groups:

CARE classification is determined first by meeting criteria to be placed into a group, then you are further classified based on ADL score or behavior point score into a classification subgroup following a classification path of highest possible group to lowest qualifying group.

(1) If you meet the criteria for exceptional care, then CARE will place you in Group E. CARE then further classifies you into:

(a) Group E High if you have an ADL score of 26-28; or

(b) Group E Medium if you have an ADL score of 22-25.

(2) If you meet the criteria for clinical complexity and have a cognitive performance score of 4-6 then you are classified in Group D regardless of your mood and behavior qualification or behavior points. CARE then further classifies you into:

(a) Group D High if you have an ADL score of 25-28; or

(b) Group D Medium-High if you have an ADL score of 18-24; or

(d) Group D Low if you have an ADL score of 2-12.

(3) If you meet the criteria for clinical complexity and have a CPS score of less than 4, then you are classified in Group C regardless of your mood and behavior qualification or behavior points. CARE then further classifies you into:

(a) Group C High if you have an ADL score of 25-28; or

(b) Group C Medium-High if you have an ADL score of 18-24; or

(d) Group C Low if you have an ADL score of 2-8.

(4) If you meet the criteria for mood and behavior qualification and do not meet the classification for C, D, or E groups, then you are classified into Group B. CARE further classifies you into:

(a) Group B High if you have an ADL score of 15-28; or

(b) Group B Medium if you have an ADL score of 5-14; or

(5) If you meet the criteria for behavior points and have a CPS score of greater than 2 and your ADL score is greater than 1, and do not meet the classification for C, D, or E groups, then you are classified in Group B. CARE further classifies you into:

(a) Group B High if you have a behavior point score 12 or greater; or

(b) Group B Medium-High if you have a behavior point score greater than 6; or

(d) Group B Low if you have a behavior point score greater than 1.

(6) If you are not clinically complex and you do not qualify under either mood and behavior criteria, then you are classified in Group A. CARE further classifies you into:

(a) Group A High if you have an ADL score of 10-28; or

(b) Group A Medium if you have an ADL score of 5-9; or

History

Statutory Authority: 2008 c 329. WSR 08-19-102, § 388-106-0115, filed 9/17/08, effective 10/18/08. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0115, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0120 What is the payment rate that the department will pay the provider if I receive personal care services in a residential facility?

The department publishes rates and/or adopts rules to establish how much the department pays toward the cost of your care in a residential facility.

(1) For CFC, COPES, MPC, medical care services, RCL, and new freedom programs, the department assigns payment rates to the CARE classification group. Under these programs, payment for care in a residential facility corresponds to the payment rate assigned to the classification group in which the CARE tool has placed you.

(2) The enhanced services facility rate is determined by legislative action and appropriation.

(3) The rate for adult family homes with a specialized behavior support contract is based on the CARE classification group and an add-on amount, which is negotiated through the collective bargaining process.

History

Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.400 and 42 C.F.R. § 441.500-590. WSR 16-04-020, § 388-106-0120, filed 1/22/16, effective 2/22/16. Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 15-01-085, § 388-106-0120, filed 12/16/14, effective 1/16/15
WSR 14-15-092, § 388-106-0120, filed 7/18/14, effective 8/18/14
WSR 05-11-082, § 388-106-0120, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0125 How does CARE use criteria to place me in a classification group for in-home care?

CARE uses the criteria of cognitive performance score as determined under WAC 388-106-0090, clinical complexity as determined under WAC 388-106-0095, mood/behavior and behavior point score as determined under WAC 388-106-0100, ADLs as determined under WAC 388-106-0105, and exceptional care as determined under WAC 388-106-0110 to place you into one of the following seventeen in-home groups. CARE classification is determined first by meeting criteria to be placed into a group, then you are further classified based on ADL score or behavior point score into a classification sub-group following a classification path of highest possible base hours to lowest qualifying base hours. Each classification group is assigned a number of base hours as described below based upon the level of funding provided by the legislature for personal care services, and based upon the relative level of functional disability of persons in each classification group as compared to persons in other classification groups.

(1) If you meet the criteria for exceptional care, then CARE will place you in Group E. CARE then further classifies you into:

(a) Group E High with 393 base hours if you have an ADL score of 26-28; or

(b) Group E Medium with 327 base hours if you have an ADL score of 22-25.

(2) If you meet the criteria for clinical complexity and have cognitive performance score of 4-6 or you have cognitive performance score of 5-6, then you are classified in Group D regardless of your mood and behavior qualification or behavior points. CARE then further classifies you into:

(a) Group D High with 260 base hours if you have an ADL score of 25-28; or

(b) Group D Medium-High with 215 base hours if you have an ADL score of 18-24; or

(d) Group D Low with 120 base hours if you have an ADL score of 2-12.

(a) Group C High with 176 base hours if you have an ADL score of 25-28; or

(b) Group C Medium-High with 158 base hours if you have an ADL score of 18-24; or

(d) Group C Low with 73 base hours if you have an ADL score of 2-8.

(4) If you meet the criteria for mood and behavior qualification and do not meet the classification for C, D, or E groups, then you are classified into Group B. CARE further classifies you into:

(a) Group B High with 129 base hours if you have an ADL score of 15-28; or

(b) Group B Medium with 69 base hours if you have an ADL score of 5-14; or

(a) Group B High with 129 base hours if you have a behavior point score 12 or greater; or

(b) Group B Medium-High with 84 base hours if you have a behavior point score greater than 6; or

(d) Group B Low with 39 base hours if you have a behavior point score greater than 1.

(6) If you are not clinically complex and your CPS score is less than 5 and you do not qualify under either mood and behavior criteria, then you are classified in Group A. CARE further classifies you into:

(a) Group A High with 59 base hours if you have an ADL score of 10-28; or

(b) Group A Medium with 47 base hours if you have an ADL score of 5-9; or

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 12-13-068, § 388-106-0125, filed 6/18/12, effective 7/19/12. Statutory Authority: RCW 74.08.090, 74.09.520, 2009 c 564 § 206(5). WSR 10-11-050, § 388-106-0125, filed 5/12/10, effective 6/12/10. Statutory Authority: RCW 74.08.090, 74.09.520, and 2007 c 522. WSR 08-10-022, § 388-106-0125, filed 4/25/08, effective 5/26/08. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0125, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0130 How does the department determine the number of hours I may receive for in-home care?

(1) The department assigns a base number of hours to each classification group as described in WAC 388-106-0125.

(2) The department will adjust base hours to account for informal supports and age appropriate functioning (as those terms are defined in WAC 388-106-0010), and other paid services that meet some of an individual's need for personal care services:

(a) The CARE tool determines the adjustment for informal supports and age appropriate functioning. A numeric value is assigned to the status and assistance available coding for ADLs and IADLs based on the table below. The base hours assigned to each classification group are adjusted by the numeric value in subsection (b) of this section.

| Meds | Status | Assistance Available | Numeric Value | | --- | --- | --- | --- | | Medication management The rules to the right apply for all self-performance codes except independent which is not counted as a qualifying ADL | Unmet | N/A | 1 | | Met | N/A | 0 | | | Decline | N/A | 0 | | | Age appropriate functioning | N/A | 0 | | | Partially met | <1/4 time | .9 | | | 1/4 to 1/2 time | .7 | | | | 1/2 to 3/4 time | .5 | | | | ˃3/4 time | .3 | | |

| Unscheduled ADLs | Status | Assistance Available | Value | | --- | --- | --- | --- | | Bed mobility, transfer, walk in room, eating, toilet use The rules to the right apply for all self-performance codes except: Did not occur/client not able and Did not occur/no provider = 1; Did not occur/client declined and independent are not counted as qualifying ADLs | Unmet | N/A | 1 | | Met | N/A | 0 | | | Decline | N/A | 0 | | | Age appropriate functioning | N/A | 0 | | | Partially met | <1/4 time | .9 | | | 1/4 to 1/2 time | .7 | | | | 1/2 to 3/4 time | .5 | | | | ˃3/4 time | .3 | | |

| Scheduled ADLs | Status | Assistance Available | Value | | --- | --- | --- | --- | | Dressing, personal hygiene, bathing The rules to the right apply for all self-performance codes except: Did not occur/client not able and Did not occur/no provider = 1; Did not occur/client declined and independent which are not counted as qualifying ADLs | Unmet | N/A | 1 | | Met | N/A | 0 | | | Decline | N/A | 0 | | | Age appropriate functioning | N/A | 0 | | | Partially met | <1/4 time | .75 | | | 1/4 to 1/2 time | .55 | | | | 1/2 to 3/4 time | .35 | | | | ˃3/4 time | .15 | | |

| IADLs | Status | Assistance Available | Value | | --- | --- | --- | --- | | Meal preparation, ordinary housework, essential shopping The rules to the right apply for all self-performance codes except independent is not counted as a qualifying IADL | Unmet | N/A | 1 | | Met | N/A | 0 | | | Decline | N/A | 0 | | | Child under (age) (see subsection (7)) | N/A | 0 | | | Partially met | <1/4 time | .3 | | | 1/4 to 1/2 time | .2 | | | | 1/2 to 3/4 time | .1 | | | | ˃3/4 time | .05 | | |

| IADLs | Status | Assistance Available | Value | | --- | --- | --- | --- | | Travel to medical The rules to the right apply for all self-performance codes except independent which is not counted as a qualifying IADL | Unmet | N/A | 1 | | Met | N/A | 0 | | | Decline | N/A | 0 | | | Child under (age) (see subsection (7)) | N/A | 0 | | | Partially met | <1/4 time | .9 | | | 1/4 to 1/2 time | .7 | | | | 1/2 to 3/4 time | .5 | | | | ˃3/4 time | .3 | | |

Key: ˃ means greater than; < means less than

(b) To determine the amount adjusted for informal support or age appropriate functioning, the numeric values are totaled and divided by the number of qualifying ADLs and IADLs needs. The result is value A. Value A is then subtracted from one. This is value B. Value B is divided by three. This is value C. Value A and Value C are summed. This is value D. Value D is multiplied by the "base hours" assigned to your classification group and the result is the number of adjusted in-home hours. Values are rounded to the nearest hundredths (for example, .862 is rounded to .86).

(3) Effective July 1, 2012, after adjustments are made to your base hours, as described in subsection (2) of this section, the department may add on hours based on off-site laundry, living more than 45 minutes from essential services, and wood supply, as follows:

| Condition | Status | Assistance Available | Add On Hours | | --- | --- | --- | --- | | Offsite laundry facilities, which means the client does not have facilities in own home and the caregiver is not available to perform any other personal or household tasks while laundry is done. The status used for the rules to the right is for housekeeping. | Unmet | N/A | 8 | | Met | N/A | 0 | | | Declines | N/A | 0 | | | Child under (age) (see subsection (7)) | N/A | 0 | | | Partially met: | <1/4 time | 8 | | | between 1/4 to 1/2 time | 6 | | | | between 1/2 to 3/4 time | 4 | | | | ˃3/4 time | 2 | | | | Client is ˃45 minutes from essential services (which means the client lives more than 45 minutes one-way from a full-service market). The status used for the rules to the right is essential shopping. | Unmet | N/A | 5 | | Met | N/A | 0 | | | Declines | N/A | 0 | | | Child under (age) (see subsection (7)) | N/A | 0 | | | Partially met | <1/4 time | 5 | | | between 1/4 to 1/2 time | 4 | | | | between 1/2 to 3/4 time | 3 | | | | ˃3/4 time | 2 | | | | Wood supply used as sole source of heat. | Unmet | N/A | 8 | | Met | N/A | 0 | | | Declines | N/A | 0 | | | Child under (age) (see subsection (7)) | N/A | 0 | | | Partially met | <1/4 time | 8 | | | between 1/4 to 1/2 time | 6 | | | | between 1/2 to 3/4 time | 4 | | | | ˃3/4 time | 2 | | |

(4) In the case of New Freedom consumer directed services (NFCDS), the department determines the monthly budget available as described in WAC 388-106-1445.

(5) The result of adjustments under subsections (2) and (3) of this section is the maximum number of hours that can be used to develop your plan of care. The department must take into account cost effectiveness, client health and safety, and program limits in determining how hours can be used to address your identified needs. In the case of New Freedom consumer directed services (NFCDS), a New Freedom spending plan (NFSP) is developed in place of a plan of care.

(6) If you are eligible, your hours may be used to authorize the following services:

(a) Personal care services from a home care agency provider, an individual provider, or both.

(b) Home delivered meals (a half hour from the available hours for each meal authorized) per WAC 388-106-0805.

(c) A private duty nurse (PDN) if you are eligible per WAC 388-106-1010 or 182-551-3000 (one hour from the available hours for each hour of PDN authorized).

(d) The purchase of New Freedom consumer directed services (NFCDS).

(7) If you are a child applying for personal care services:

(a) The department presumes that children have legally responsible parents or other responsible adults who provide informal support for the child's ADLs, IADLs, and other needs. The department will not provide services or supports that are within the range of activities that a legally responsible parent or other responsible adult would ordinarily perform on behalf of a child of the same age who does not have a disability or chronic illness.

(b) The department will complete a CARE assessment and use the developmental milestones tables in this section when assessing your ability to perform personal care tasks.

(c) Your status will be coded as age appropriate for ADLs when your self-performance is at a level expected for persons in your assessed age range, as indicated by the developmental milestones table in subpart (e) of this section, unless the circumstances in subpart (d) of this section apply.

(d) The department will code status as other than age appropriate for an ADL, despite your self-performance falling within the developmental age range for the ADL on the developmental milestones table in subpart (e) of this section, if the department determines during your assessment that your level of functioning is related to your disability and not primarily due to your age and the frequencyor the duration of assistance required for a personal care task is not typical for a person of your age.

(e)

| Developmental Milestones for Activities of Daily Living (ADLs) | | | | --- | --- | --- | | ADL | Self-Performance | Developmental Age Range | | Medication management | Independent Self-directed Assistance required | Child under 18 years of age | | | Must Be administered | Child under 12 years of age | | Locomotion in room | Independent Supervision Limited Extensive | Child under 4 years of age | | | Total | Child under 13 months of age | | Locomotion outside room | Independent Supervision | Child under 6 years of age | | Limited Extensive | Child under 4 years of age | | | | Total | Child under 25 months of age | | Walk in room | Independent Supervision Limited Extensive | Child under 4 years of age | | | Total | Child under 19 months of age | | Bed mobility | Independent Supervision Limited | Child under 37 months of age | | | Extensive | Child under 25 months of age | | | Total | Child under 19 months of age | | Transfers | Independent Supervision Limited Extensive | Child under 3 years of age | | | Total | Child under 19 months of age | | Toilet use | Independent Supervision Limited Extensive | Child under 7 years of age | | | Total | Child under 37 months of age | | Eating | Independent Supervision Limited Extensive | Child under 3 years of age | | | Total | Child under 13 months of age | | Bathing | Independent Supervision | Child under 12 years of age | | | Physical help/Transfer only | Child under 5 years of age | | | Physical help/part of bathing | Child under 6 years of age | | | Total | Child under 37 months of age | | Dressing | Independent Supervision | Child under 12 years of age | | | Limited | Child under 8 years of age | | | Extensive | Child under 7 years of age | | | Total | Child under 25 months of age | | Personal hygiene | Independent Supervision | Child under 12 years of age | | | Limited Extensive | Child under 7 years of age | | | Total | Child under 37 months of age |

(f) For IADLs, the department presumes that children typically have legally responsible parents or other responsible adults to assist with IADLs. Status will be coded as "child under (age)" the age indicated by the developmental milestones table for IADLs in subpart (h) of this section unless the circumstances in subpart (g) of this section apply. (For example, a 16-year-old child coded as supervision in self-performance for wood supply would be coded "child under 18.")

(g) If the department determines during your assessment that the frequencyor the duration of assistance required is not typical for a person of your age due to your disability or your level of functioning, the department will code status as other than described in subpart (h) of this section for an IADL.

(h)

| Developmental Milestones for Instrumental Activities of Daily Living | | | | --- | --- | --- | | IADL | Self- Performance | Developmental Age Range | | Wood supply | Independent Assistance Activity did not occur | Child under 18 | | Transportation | Independent Assistance Activity did not occur | Child under 18 | | | Total | Child under 16 | | Essential shopping, housework, meal preparation | Independent Assistance Activity did not occur | Child under 18 | | Total | Child under 12 | |

(i) The department presumes that children have legally responsible parents or other responsible adults who provide support for comprehension, decision-making, memory, and continence issues. These items will be coded as indicated by the additional developmental milestones table in subpart (k) of this section unless the circumstances in subpart (j) of this section apply.

(j) If the department determines during your assessment that due to your disability, the support you are provided for comprehension, decision making, memory, and continence issues is substantially greater than is typical for a person of your age, the department will code status as other than described in subpart (k) of this section.

(k)

| Additional Developmental Milestones coding within CARE | | | | | --- | --- | --- | --- | | Name of CARE panel | Question in CARE Panel | Developmental Milestone coding selection | Developmental Age Range | | Behavioral Health: Cognitive Performance- Comprehension | "By others, client is" / "By client, others are" | Child under 3 | Child under 3 | | Behavioral Health: MMSE | "Can MMSE be administered?" | = No | Child under 18 | | Behavioral Health: Memory | "Is there evidence of short term memory loss?" | Child under 12 | Child under 12 | | | "Is there evidence of long term memory loss?" | Child under 12 | Child under 12 | | Behavioral Health: Depression | "Interview" | Unable to obtain | Child under 9 | | Behavioral Health: Cognitive Performance-Decision Making | "Rate how client makes decision" | Child under 12 | Child under 12 | | Bladder/Bowel: | "Bladder/Bowel Control" is which of the following: | | | | | Continent Usually Continent Occasionally Incontinent | Age appropriate | Child under 12 | | | Frequently Incontinent | Age appropriate | Child under 9 | | | Incontinent all or most of the time | Age appropriate | Child under 6 | | Bladder/Bowel: | "Appliance and programs" | Potty Training | Child under 4 |

(8) If you are a child applying for personal care services and your status for ADLs and IADLs is not coded per the developmental age range indicated on the milestones tables under subsection (7) of this section, the department will assess for any informal supports available to assist you with each ADL and IADL. The department will presume that children have legally responsible parents or other responsible adults who provide informal support to them.

(a) The department will code status for an ADL or IADL as met if your assessment shows that your need for assistance with a personal care task is fully met by informal supports.

(b) Informal supports for school-age children include supports actually available through a school district, regardless of whether you take advantage of those available supports.

(c) When you are living with your legally responsible parent(s), the department will presume that you have informal supports available to assist you with your ADLs and IADLs over three-fourths but not all the time. Legally responsible parents include natural parents, stepparents, and adoptive parents. Generally, a legally responsible parent will not be considered unavailable to meet your personal care needs simply due to other obligations such as work or additional children because such obligations do not decrease the parent's legal responsibility to care for you regardless of your disabilities. However, the department will consider factors that cannot reasonably be avoided, and which prevent a legally responsible parent from providing for your personal care needs when determining the amount of informal support available to you. You may rebut the department's presumption by providing specific information during your assessment to indicate why you do not have informal supports available at least three-fourths of time to assist you with a particular ADL or IADL.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 23-16-085, § 388-106-0130, filed 7/28/23, effective 8/28/23
WSR 21-04-037, § 388-106-0130, filed 1/26/21, effective 3/1/21
WSR 15-20-054, § 388-106-0130, filed 9/30/15, effective 10/31/15
WSR 14-04-097, § 388-106-0130, filed 2/4/14, effective 3/7/14. Statutory Authority: RCW 74.08.090, 74.09.520, and 2010 c 37. WSR 11-11-024, § 388-106-0130, filed 5/10/11, effective 6/10/11. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 08-23-011, § 388-106-0130, filed 11/6/08, effective 12/7/08
WSR 08-03-111, § 388-106-0130, filed 1/22/08, effective 2/22/08. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.030. WSR 06-16-035, § 388-106-0130, filed 7/25/06, effective 8/25/06. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.010 and 74.39A.020. WSR 06-05-022, § 388-106-0130, filed 2/6/06, effective 3/9/06. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0130, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0135 What is the maximum number of hours of personal care services that I can receive for in-home services?

(1) If you are age 21 or older, the maximum number of hours that you may receive is the base hours assigned to your classification group and adjusted per WAC 388-106-0130, unless additional hours are authorized through an exception to rule per WAC 388-440-0001. For chore program clients, the maximum personal care hours per month the department will authorize is one hundred sixteen (116).

(2) If you are under age twenty-one:

(a) The maximum number of hours that you may receive will be the base hours assigned to your classification group and adjusted per WAC 388-106-0130, unless additional hours are authorized under parts (2)(b) or (3) below.

(b) Additional hours may be authorized at the department's discretion through an exception to rule per WAC 388-440-0001. You may request additional hours of personal care services through an exception to rule by contacting your case manager and explaining why you do not believe the authorized hours provide adequate assistance with your personal care tasks. The case manager will document your request and forward the request for review per WAC 388-440-0001. You will be notified in writing of the decision.

(3) If you are under age twenty-one, the department will authorize additional hours of personal care services beyond those authorized under section (2) according to the limitation extension process described below. If the evidence shows that additional personal care assistance is necessary to correct, improve, or prevent further deterioration of your condition, the department will authorize additional hours in the amount required to fully complete your ADLs or IADLs.

(a) You may request a limitation extension in writing within 90 days after you have received the department's written decision under subsection (2)(b); or if 30 days have passed since you requested an exception to rule under subsection (2)(b) and you have not yet received a written decision from DSHS.

(b) You may submit any evidence to show that additional hours of personal care are necessary. The following evidence should be provided:

(i) An explanation of the hours necessary to complete your ADLs and IADLs;

(ii) Documentation of the supports available to you over the course of a week; and,

(iii) An explanation of why informal supports are unavailable to provide the additional assistance you are requesting. When you are living with your legally responsible parent, the considerations described in WAC 388-106-0130 (8)(d) apply to the determination of availability of informal supports.

(c) If requested by the department, you must also provide additional documentation of your situation. If requested documents are not reasonably available to you without cost and/or if you need assistance from the department to obtain the requested documents, you must provide written permission to the department to obtain the documents on your behalf. Documents that the department may ask for include the following:

(i) Your most recent individualized educational plan (IEP), if you are still in school.

(ii) Treatment plans for clinically recommended treatments relevant to your personal care services, such as active range of motion, passive range of motion, bowel program, etc.

(iii) Documents indicating residential time with your noncustodial parent or the availability of a noncustodial parent to provide assistance, such as parenting plans or child support orders. If those documents do not accurately reflect the supports currently available to you, you may also submit information or documents describing the support actually provided by your noncustodial parent.

(d) The department may also require a further review of your functional ability to perform specific ADLs and IADLs, to be conducted at the department's expense. The review must be completed under WAC 182-551-2110 by a qualified occupational therapist. If a qualified occupational therapist is not available to complete the review, the department will designate another qualified healthcare professional to complete the review.

(e) Upon receiving your request for a limitation extension and any additional supporting information you choose to submit under subsection (3)(b), the department will make a decision according to the timeline below.

(i) The department will make a decision under subsection (3) within 30 days unless additional information is required under subsections (3)(c) and/or (3)(d).

(ii) If additional information is required under subsections (3)(c) and/or (3)(d), the department will notify you of what additional information is required within 30 days of the date the department received your request and supporting information, if any. The department will then make a determination under subsection (3) within 15 days of either of the following, whichever comes first:

(A) The date that the department receives all of the requested information, including a report of any review of your functional ability conducted under subsection (3)(d); or,

(B) The date that you notify the department that you will not be providing any additional information.

(f) Additional hours will not be approved to substitute for the duties of legally responsible adults, replace child care or school, replace recommended equipment available through medicaid, or provide supervision other than task-specific supervision necessary for you to perform an ADL or IADL.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 14-10-077, § 388-106-0135, filed 5/6/14, effective 6/26/14
WSR 05-11-082, § 388-106-0135, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0136 What if I disagree with the result of the limitation extension decision regarding personal care?

(1) In addition to your right to contest the result of your CARE assessment under WAC 388-106-1305, if you are under the age of twenty-one you have the right to an administrative hearing to contest the number of personal care hours authorized pursuant to WAC 388-106-0135(3).

(2) The department will notify you in writing of your right to an administrative hearing under subsection (1) and will provide you with information about how to request a hearing.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 14-10-077, § 388-106-0136, filed 5/6/14, effective 6/26/14.

Wash. Admin. Code § 388-106-0140 What may change the maximum number of hours that I can receive for in-home personal care services?

The maximum number of in-home personal care hours you can receive may change:

(1) When you have a change in any of the criteria listed in WAC 388-106-0125 and/or 388-106-0130; or

(2) Because you meet the criteria in WAC 388-440-0001, an exception to rule is approved by the department for in-home personal care hours in excess of the amount determined to be available to you by the CARE tool.

History

Statutory Authority: RCW 74.08.090, 74.09.520, chapters 74.39 and 74.39A RCW. WSR 07-01-046, § 388-106-0140, filed 12/14/06, effective 1/14/07. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0140, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0145 What may change the maximum payment rate that will be paid for residential personal care services provided to me?

The maximum payment rate that will be paid for residential personal care services provided to you may change:

(1) When you have a change in any of the criteria listed in WAC 388-106-0115 and/or 388-106-0120; or

(2) Because you meet the criteria in WAC 388-440-0001, an exception to rule is approved by the department for a payment rate for your residential personal care services in excess of the rate determined to be applicable to you by the CARE tool.

History

Statutory Authority: RCW 74.08.090, 74.09.520, chapters 74.39 and 74.39A RCW. WSR 07-01-046, § 388-106-0145, filed 12/14/06, effective 1/14/07.

Wash. Admin. Code § 388-106-0200 What services may I receive under medicaid personal care (MPC)?

You may be eligible to receive only the following services under medicaid personal care (MPC):

(1) Personal care services, as defined in WAC 388-106-0010, in your own home and, as applicable, assistance with personal care tasks while you are out of the home accessing community resources or working.

(2) Personal care services in one of the following residential care facilities:

(a) Adult family homes; or

(b) A licensed assisted living facility that has contracted with the department to provide adult residential care services.

(3) Nursing services, if you are not already receiving this type of service from another resource. A registered nurse may visit you and perform any of the following activities. The frequency and scope of the nursing services is based on your individual need as determined by your CARE assessment and any additional collateral contact information obtained by your case manager:

(a) Nursing assessment/reassessment;

(b) Instruction to you and your providers;

(d) Skilled treatment, only in the event of an emergency. A skilled treatment is care that would require authorization, prescription, and supervision by an authorized practitioner prior to its provision by a nurse, for example, medication administration or wound care such as debridement. In nonemergency situations, the nurse will refer the need for any skilled medical or nursing treatments to a health care provider, a home health agency or other appropriate resource;

(e) File review; and/or

(f) Evaluation of health-related care needs affecting service planning and delivery.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 14-15-092, § 388-106-0200, filed 7/18/14, effective 8/18/14. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.010 and 74.39A.020. WSR 06-05-022, § 388-106-0200, filed 2/6/06, effective 3/9/06. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0200, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0210 Am I eligible for medicaid personal care (MPC) funded services?

You are eligible for MPC-funded services when the department assesses your functional ability and determines that you meet all of the following criteria:

(1) You are certified as noninstitutional categorically needy, as defined in WAC 182-500-0020, or have been determined eligible for Washington apple health alternative benefit plan coverage, as described in WAC 182-505-0250. Categorically needy medical institutional programs described in chapter 182-513 and 182-515 WAC do not meet the criteria for MPC.

(2) You do not require the level of care furnished in a hospital or nursing facility, as defined in WAC 388-106-0355, an intermediate care facility for intellectual disability, as defined in WAC 388-825-3080 and WAC 388-828-4400, an institution providing psychiatric services for individuals under the age of twenty-one, or an institution for mental disease for individuals age sixty-five or over.

(3) You are functionally eligible which means one of the following applies:

(a) You have an unmet or partially met need for assistance with at least three of the following activities of daily living, as defined in WAC 388-106-0010:

| For each Activity of Daily Living, the minimum level of assistance required in: | | | | --- | --- | --- | | | Self-Performance, Status or Treatment Need is: | Support Provided is: | | Eating | N/A | Setup | | Toileting | Supervision | N/A | | Bathing | Supervision | N/A | | Dressing | Supervision | N/A | | Transfer | Supervision | Setup | | Bed Mobility | Supervision | Setup | | Walk in Room or Locomotion in Room or Locomotion Outside Immediate Living Environment | Supervision | Setup | | Medication Management | Assistance Required | N/A | | Personal Hygiene | Supervision | N/A | | Body care which includes: ■ Application of ointment or lotions; ■ Toenails trimmed; ■ Dry bandage changes; (■ = if you are over eighteen years of age or older) or Passive range of motion treatment (if you are four years of age or older). | Needs or Received/Needs Need: Coded as "Yes" | N/A |

| Your need for assistance in any of the activities listed in subsection (a) of this section did not occur because you were unable or no provider was available to assist you will be counted for the purpose of determining your functional eligibility. | | --- |

; or

(b) You have an unmet or partially met need for assistance or the activity did not occur (because you were unable or no provider was available) with at least one or more of the following:

| For each Activity of Daily Living, the minimum level of assistance required in | | | | --- | --- | --- | | | Self-Performance, Status or Treatment Need is: | Support Provided is: | | Eating | Supervision | One person physical assist | | Toileting | Extensive Assistance | One person physical assist | | Bathing | Physical Help/part of bathing | One person physical assist | | Dressing | Extensive Assistance | One person physical assist | | Transfer | Extensive Assistance | One person physical assist | | Bed Mobility and Turning and repositioning | Limited Assistance and Need | One person physical assist | | Walk in Room or Locomotion in Room or Locomotion Outside Immediate Living Environment | Extensive Assistance | One person physical assist | | Medication Management | Assistance Required Daily | N/A | | Personal Hygiene | Extensive Assistance | One person physical assist | | Body care which includes: ■ Application of ointment or lotions; ■ Toenails trimmed; ■ Dry bandage changes; (■ = if you are eighteen years of age or older) or Passive range of motion treatment (if you are four years of age or older). | Needs or Received/Needs Need: Coded as "Yes" | N/A |

| Your need for assistance in any of the activities listed in subsection (b) of this section did not occur because you were unable or no provider was available to assist you will be counted for the purpose determining your functional eligibility. | | --- |

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 15-11-049, § 388-106-0210, filed 5/15/15, effective 7/1/15
WSR 15-03-038, § 388-106-0210, filed 1/12/15, effective 2/12/15
WSR 12-14-064, § 388-106-0210, filed 6/29/12, effective 7/30/12
WSR 05-11-082, § 388-106-0210, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0215 When do MPC services start?

Your eligibility for MPC begins the date the department authorizes services.

History

Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.010 and 74.39A.020. WSR 06-05-022, § 388-106-0215, filed 2/6/06, effective 3/9/06.

Wash. Admin. Code § 388-106-0220 How do I remain eligible for MPC?

(1) In order to remain eligible for MPC, you must be in need of services in accordance with WAC 388-106-0210 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 financial circumstances.

(2) When eligibility statutes, regulations, and/or rules for MPC change, irrespective of whether your functional or financial circumstances have changed, if you do not meet the changed eligibility requirements, the department will terminate your MPC services.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0220, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0225 How do I pay for medicaid personal care?

You pay for medicaid personal care (MPC) as follows:

(1) If you live in your own home, you do not share in the cost of your personal care services.

(2) If you live in a residential facility, you:

(a) Keep a personal needs allowance as described in WAC 182-513-1105;

(b) Pay for room and board as described in WAC 182-513-1105; and

(3) The department pays the residential care facility from the first day of service through the:

(a) Last day of service when the medicaid resident dies in the facility; or

(b) Day of service before the day the medicaid resident is discharged.

History

Statutory Authority: RCW 74.08.090. WSR 18-01-049, § 388-106-0225, filed 12/12/17, effective 1/12/18. Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 15-11-049, § 388-106-0225, filed 5/15/15, effective 7/1/15
WSR 14-15-092, § 388-106-0225, filed 7/18/14, effective 8/18/14. Statutory Authority: RCW 74.04.050, 74.04.057, 74.08.090, 74.09.500, and 74.09.530 and Washington state 2007-09 operating budget (SHB 1128). WSR 08-22-052, § 388-106-0225, filed 11/3/08, effective 12/4/08. Statutory Authority: RCW 34.05.353 (2)(d), 74.08.090, and chapters 74.09, 74.04 RCW. WSR 08-11-047, § 388-106-0225, filed 5/15/08, effective 6/15/08. Statutory Authority: RCW 74.08.090, 74.09.520 and 2007-09 operating budget (SHB 1128). WSR 07-21-020, § 388-106-0225, filed 10/8/07, effective 11/8/07. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0225, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0230 Can I be employed and receive MPC?

You can be employed and receive MPC services if you remain medicaid eligible under the noninstitutional categorically needy program.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0230, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0235 Are there waiting lists for MPC?

There are no waiting lists for MPC. Instead of waiting lists, the department may revise rules to reduce caseload size, hours, rates, or payments in order to stay within the legislative appropriation.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0235, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0250 What is the roads to community living (RCL) demonstration project and who is eligible?

(1) Roads to community living (RCL) is a demonstration project, funded by a "money follows the person" grant originally authorized under section 6071 of the Deficit Reduction Act of 2005 (P.L. 109-171) and extended through the Patient Affordable Care Act (P.L. 111-148). It is designed to test services and supports which help customers move from institutional settings into the community if they wish to.

(2) To be eligible, the department must assess your needs in CARE per chapter 388-106 or 388-845 WAC and you must:

(a) Have a continuous stay of at least sixty days in a qualified institutional setting (hospital, nursing home, residential habilitation center);

(i) Any days you were solely receiving medicare-paid, short term rehabilitation services are excluded from the sixty days.

(ii) If you are discharging from a state psychiatric hospital and meet the length of stay criteria, you must be under age twenty-two, or age sixty-five and older.

(b) Have received at least one day of medicaid-paid inpatient services immediately prior to discharge from the institutional setting;

(d) On the day of discharge, you must be functionally and financially eligible for, but are not required to receive, medicaid waiver or state plan services.

History

Statutory Authority: RCW 74.08.090, 74.09.520
Affordable Care Act (ACA), Deficit Reduction Act of 2005 (P.L. 209-171), and Consolidate[d] Appropriations Act of 2021 (Section 204) and 2018 c 278. WSR 21-19-013, § 388-106-0250, filed 9/3/21, effective 10/4/21. Statutory Authority: RCW 74.08.090, 74.09.520, and Affordable Care Act (ACA). WSR 14-01-112, § 388-106-0250, filed 12/18/13, effective 1/18/14. Statutory Authority: RCW 74.08.090, 74.09.520, and Deficit Reduction Act of 2005 (P.L. 109-171). WSR 08-18-046, § 388-106-0250, filed 8/29/08, effective 9/29/08.

Wash. Admin. Code § 388-106-0255 What services may I receive under RCL?

Following eligibility and case management criteria outlined in chapters 388-106 or 388-845 WAC:

(1) The state plan or medicaid waiver services for which you would otherwise be eligible;

(2) You may receive additional RCL demonstration services; and

(3) When you are discharged to a qualified community setting, you are eligible for continuous medicaid coverage until your RCL services end.

History

Statutory Authority: RCW 74.08.090, 74.09.520, and Affordable Care Act (ACA). WSR 14-01-112, § 388-106-0255, filed 12/18/13, effective 1/18/14. Statutory Authority: RCW 74.08.090, 74.09.520, and Deficit Reduction Act of 2005 (P.L. 109-171). WSR 08-18-046, § 388-106-0255, filed 8/29/08, effective 9/29/08.

Wash. Admin. Code § 388-106-0256 When do RCL services start?

(1) RCL services to prepare for your discharge may begin while you are in the institution.

(2) After discharge, roads to community living (RCL) can be authorized for no longer than three hundred sixty-five days in a qualified community setting. Day one of the demonstration year is the day you move from the institutional setting into the qualified community setting. Day three hundred sixty-five is the last day you can receive demonstration services.

History

Statutory Authority: RCW 74.08.090, 74.09.520, and Affordable Care Act (ACA). WSR 14-01-112, § 388-106-0256, filed 12/18/13, effective 1/18/14.

Wash. Admin. Code § 388-106-0257 How do I remain eligible for RCL?

You remain eligible for RCL until any of the following occur:

(1) Reach the end of your demonstration year;

(2) Return to an institution for longer than 30 days (you can re-enroll later);

(3) Move out of state; or

(4) No longer want the service.

History

Statutory Authority: RCW 74.08.090, 74.09.520, and Affordable Care Act (ACA). WSR 14-01-112, § 388-106-0257, filed 12/18/13, effective 1/18/14.

Wash. Admin. Code § 388-106-0260 How do I pay for RCL services?

Depending on your income and resources, you may be required to participate toward the cost of the services you receive under RCL, including personal care and demonstration services, as outlined in chapters 388-515 or 388-106 WAC.

History

Statutory Authority: RCW 74.08.090, 74.09.520, and Affordable Care Act (ACA). WSR 14-01-112, § 388-106-0260, filed 12/18/13, effective 1/18/14. Statutory Authority: RCW 74.08.090, 74.09.520, and Deficit Reduction Act of 2005 (P.L. 109-171). WSR 08-18-046, § 388-106-0260, filed 8/29/08, effective 9/29/08.

Wash. Admin. Code § 388-106-0261 How does the department determine the number of hours or the payment rate for my personal care in RCL?

(1) The number of personal care hours you receive is determined by the CARE assessment as outlined in chapter 388-106 WAC.

(2) The payment rate structure for residential personal care received in a residential facility is outlined in chapter 388-106 WAC.

History

Statutory Authority: RCW 74.08.090, 74.09.520, and Affordable Care Act (ACA). WSR 14-01-112, § 388-106-0261, filed 12/18/13, effective 1/18/14.

Wash. Admin. Code § 388-106-0262 What may change the number of hours or payment rate for my personal care in RCL?

The maximum number of in-home personal care hours or payment rate you can receive may change:

(1) When you have a change in any of the criteria listed in WAC 388-106-0125, 388-106-0115, 388-106-0120 and/or 388-106-0130; or

(2) Because you meet the criteria in WAC 388-440-0001, an exception to rule is approved by the department.

History

Statutory Authority: RCW 74.08.090, 74.09.520, and Affordable Care Act (ACA). WSR 14-01-112, § 388-106-0262, filed 12/18/13, effective 1/18/14.

Wash. Admin. Code § 388-106-0265 Do I have the right to an administrative hearing while receiving RCL services?

Yes, you may request an administrative hearing based on the rules outlined in WAC 388-106-1305 to contest eligibility decisions made by the department. Once your three hundred sixty-five days of roads to community living (RCL) eligibility end, per WAC 388-106-0256, you may not request an administrative hearing to contest the conclusion of RCL services or to request an extension.

History

Statutory Authority: RCW 74.08.090, 74.09.520, and Affordable Care Act (ACA). WSR 14-01-112, § 388-106-0265, filed 12/18/13, effective 1/18/14. Statutory Authority: RCW 74.08.090, 74.09.520, and Deficit Reduction Act of 2005 (P.L. 109-171). WSR 08-18-046, § 388-106-0265, filed 8/29/08, effective 9/29/08.

Wash. Admin. Code § 388-106-0270 What services are available under community first choice (CFC)?

The services you may receive under the community first choice program include:

(1) Personal care services as defined in WAC 388-106-0010.

(2) Relief care, which is personal care services by a second individual or agency provider as a back-up to your primary paid personal care provider.

(3) Skills acquisition training, which is training that allows you to acquire, maintain, and enhance skills necessary to accomplish ADLs, IADLs, or health related tasks more independently. Health related tasks are specific tasks related to the needs of an individual that under state law licensed health professionals can delegate or assign to a qualified health care practitioner.

(4) Personal emergency response systems (PERS), which are basic electronic devices that enable you to secure help in an emergency when:

(a) You live alone in your own home;

(b) You are alone in your own home for significant parts of the day and have no provider for extended periods of time; or

(5) Assistive technology, including assistive equipment, which are adaptive and assistive items that increase your independence or substitute for human assistance specifically with ADLs, IADLs, or health related tasks, including but not limited to:

(a) PERS add-on services, such as fall detection, GPS, or medication reminder systems;

(b) Department approved devices that are not excluded by WAC 388-106-0274, including but not limited to:

(i) Adaptive utensils to assist with activities such as eating, dressing, and writing;

(ii) Communication applications/software or devices;

(iii) Visual alert systems;

(iv) Voice activated systems;

(v) Switches and eyegazes; and

(vi) Timers or electronic devices that monitor or sense movement and react in a prescribed manner such as turning on or off an appliance;

(d) Training of participants and caregivers on the maintenance or upkeep of equipment purchased under assistive technology.

(6) Nurse delegation services as defined in WAC 246-840-910 through 246-840-970.

(7) Nursing services when you are not already receiving nursing services from another source. A registered nurse may visit you and perform any of the following activities:

(a) Nursing assessment/reassessment;

(b) Instruction to you and your providers;

(d) Skilled treatment, which is care that requires authorization, prescription, and supervision by an authorized practitioner prior to its provision by a nurse, including but not limited to medication administration or wound care such as debridement; nursing services will only provide skilled treatment in the event of an emergency and in nonemergency situations, the nurse will refer the need for any skilled medical or nursing treatments to a health care provider, home health agency, or other appropriate resource;

(e) File review; and

(f) Evaluation of health-related care needs that affect service plan and delivery.

(8) Community transition services, which are nonrecurring, setup items or services to assist you with discharge from a nursing facility, institution for mental diseases, or intermediate care facility for individuals with intellectual disabilities, when these items or services are necessary for you to set up your own home, including but not limited to:

(a) Security deposits that are required to lease an apartment or home, including first month's rent;

(b) Essential household furnishings required to occupy and use a community domicile, including furniture, window coverings, food preparation items, and bath and linen supplies;

(d) Services necessary for your health and safety such as pest eradication and one-time cleaning prior to occupancy;

(e) Moving expenses; and

(f) Activities to assess need, arrange for, and procure necessary resources.

(9) Caregiver management training on how to select, manage, and dismiss personal care providers.

History

Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.400, and 42 C.F.R. 441.500-590. WSR 23-12-082, § 388-106-0270, filed 6/6/23, effective 7/7/23. Statutory Authority: RCW 74.08.090. WSR 17-03-127, § 388-106-0270, filed 1/18/17, effective 2/18/17. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.400 and 42 C.F.R. § 441.500-590. WSR 16-04-020, § 388-106-0270, filed 1/22/16, effective 2/22/16.

Wash. Admin. Code § 388-106-0271 Are there limits to the skills acquisition training I may receive?

Skills acquisition training:

(1) Shall not replace any training or therapy otherwise provided under medicaid, medicare, or any private insurance;

(2) Does not include therapy or nursing services that must be performed by a licensed therapist or nurse, but may be used to complement therapy or nursing goals coordinated through the care plan;

(3) For children, must be related to the child's disability and will not be provided for tasks that are determined to be age appropriate as described in WAC 388-106-0130(7); and

(4) In combination with assistive technology purchases, is limited to a yearly amount determined by the department per fiscal year.

History

Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.400 and 42 C.F.R. § 441.500-590. WSR 16-04-020, § 388-106-0271, filed 1/22/16, effective 2/22/16.

Wash. Admin. Code § 388-106-0272 Who are qualified providers for skills acquisition training?

(1) Long term care workers, who must only provide skills acquisition training on IADLs and the following ADL tasks: dressing, application of deodorant, washing hands and face, hair washing, hair combing and styling, application of make-up, menses care, shaving with an electric razor, tooth brushing or denture care, and bathing tasks excluding any transfers in or out of the bathing area; and

(2) Contracted home health agencies, which may provide skills acquisition training on ADLs, IADLs or health related tasks that are within the profession's scope of practice.

History

Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.400 and 42 C.F.R. § 441.500-590. WSR 16-04-020, § 388-106-0272, filed 1/22/16, effective 2/22/16.

Wash. Admin. Code § 388-106-0273 May I receive additional personal emergency response 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 capabilities if:

(a) You have a recent documented history of short-term memory loss; and a recent documented history of wandering with exit seeking behavior; or

(b) A recent documented history of getting lost in a familiar surrounding and being unaware of the need or unable to ask for assistance; and

(c) In addition, if you are under the age of 12, there must be information presented at your assessment that due to your disability the support you are provided for memory or decision making is greater than is typical for a person of your age.

(3) A medication reminder if:

(a) You are eligible for a standard PERS unit;

(b) You do not have a caregiver available to provide the service; and

History

Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.400 and 42 C.F.R. § 441.500-590. WSR 16-04-020, § 388-106-0273, filed 1/22/16, effective 2/22/16.

Wash. Admin. Code § 388-106-0274 Are there limits to the assistive technology I may receive?

(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 splitter, facial wipes, menstrual supplies, or a slow cooker;

(d) Educational software, game applications, or gift cards for educational/game applications;

(e) Medical supplies and medical equipment, items available as specialized equipment and supplies, or durable medical equipment;

(f) Specialized clothing or slip-on shoes that are for convenience and not adaptive in nature;

(g) Exercise equipment;

(h) Home/environmental modifications;

(i) Medically necessary items, including but not limited to compression socks/stockings, orthotics, hearing aids, and eyeglasses; and

(j) Any item that would otherwise be covered under any other payment source, including but not limited to medicare, medicaid, private insurance, or another resource.

(2) In combination with skills acquisition training, assistive technology purchases are limited to a yearly amount determined by the department per fiscal year.

(3) To help decide whether to authorize assistive technology the department may require a treating professional's written recommendation regarding the need for an assistive technology evaluation. The treating professional who makes this recommendation must:

(a) Have personal knowledge of and experience with the requested assistive technology that is in alignment with their profession; and

(b) Have evaluated you, reviewed your medical records, have knowledge of your level of functioning, and your ability to use the requested assistive technology or device.

(4) Your choice of assistive technology is limited to the most cost effective option that meets your health and welfare needs.

(5) Replacement of an assistive technology item or piece of equipment is limited to once every two years.

History

Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.400, and 42 C.F.R. 441.500-590. WSR 25-21-065, s 388-106-0274, filed 10/13/25, effective 11/13/25. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.400, and 42 C.F.R. 441.500-590. WSR 23-12-082, § 388-106-0274, filed 6/6/23, effective 7/7/23. Statutory Authority: RCW 74.08.090. WSR 17-03-127, § 388-106-0274, filed 1/18/17, effective 2/18/17. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.400 and 42 C.F.R. § 441.500-590. WSR 16-04-020, § 388-106-0274, filed 1/22/16, effective 2/22/16.

Wash. Admin. Code § 388-106-0275 Are there limits to the community transition services I may receive?

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 388-76-10685 for adult family homes;

(4) Do not include items that would otherwise be covered under other payment sources, including but not limited to, medicare, medicaid, and private insurance; and

(5) May not exceed twenty-five hundred dollars per discharge for items and services.

History

Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.400
and 42 C.F.R. § 441.500-590. WSR 21-20-036, § 388-106-0275, filed 9/27/21, effective 10/28/21
WSR 16-04-020, § 388-106-0275, filed 1/22/16, effective 2/22/16.

Wash. Admin. Code § 388-106-0276 Where can I receive CFC services?

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 home accessing the community or working.

History

Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.400 and 42 C.F.R. § 441.500-590. WSR 16-04-020, § 388-106-0276, filed 1/22/16, effective 2/22/16.

Wash. Admin. Code § 388-106-0277 Am I eligible for CFC services?

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 for individuals under age twenty-one, or an institution for mental diseases for individuals age sixty-five or over (or will likely need the level of care within thirty days unless CFC services are provided); and

(2) You are eligible for a categorically needy (CN) or the alternative benefit plan (ABP) Washington apple health program. Financial eligibility rules for CFC are described in WAC 182-513-1210 through WAC 182-513-1220; or

(3) If you are not financially eligible for a non-institutional CN or ABP program, but are financially eligible for a home and community based waiver, you are eligible for CFC as long as you continue to receive at least one monthly waiver service.

History

Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.400 and 42 C.F.R. § 441.500-590. WSR 16-04-020, § 388-106-0277, filed 1/22/16, effective 2/22/16.

Wash. Admin. Code § 388-106-0280 When do CFC services begin?

Your services begin on the date the department authorizes services.

History

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.

Wash. Admin. Code § 388-106-0283 How do I remain eligible for CFC services?

(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 significant changes in your functional or financial circumstances; or

(2) If you receive services through DDA, you must remain financially eligible and eligible for ICF/ID or nursing facility level of care as described in WAC 388-828-4400, 388-828-3080 and 388-106-0355.

(3) When your eligibility is dependent on your eligibility for a home and community based waiver, you must receive at least one waiver service every month. If you do not receive a waiver service for more than thirty calendar days, you will no longer be eligible for CFC and the department will terminate your CFC services.

(4) If eligibility laws, regulations, or rules for CFC change, and if you do not meet the changed eligibility requirements, the department will terminate your CFC services, even if your functional or financial circumstances have not changed.

History

Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.400 and 42 C.F.R. § 441.500-590. WSR 16-04-020, § 388-106-0283, filed 1/22/16, effective 2/22/16.

Wash. Admin. Code § 388-106-0285 What do I pay for if I receive CFC services?

(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 must pay for your room and board. You are allowed to keep some of your income for personal needs allowance (PNA). Depending on your financial eligibility group and income, you may also be responsible to pay an additional amount towards the cost of your care.

(2) If you are receiving services through CFC and a home and community based waiver, you may be required to pay toward the cost of your care as outlined in WAC 182-515-1509. If you are receiving services in:

(a) Your own home, you are allowed to keep some of your income for a maintenance allowance.

(b) If you are living in a residential facility, you must pay for your room and board and may have to pay an additional amount towards the cost of services. You are allowed to keep some of your income for PNA.

History

Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.400 and 42 C.F.R. § 441.500-590. WSR 16-04-020, § 388-106-0285, filed 1/22/16, effective 2/22/16.

Wash. Admin. Code § 388-106-0290 What does the department pay towards the cost of care when you are receiving CFC services and live in a residential facility?

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 service through the:

(1) The day before your discharge date; or

(2) The last day of service if you die while living at the facility.

History

Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.400 and 42 C.F.R. § 441.500-590. WSR 16-04-020, § 388-106-0290, filed 1/22/16, effective 2/22/16.

Wash. Admin. Code § 388-106-0295 May I be employed and receive CFC services?

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.

History

Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.400 and 42 C.F.R. § 441.500-590. WSR 16-04-020, § 388-106-0295, filed 1/22/16, effective 2/22/16.

Wash. Admin. Code § 388-106-0300 What services may I receive under community options program entry system (COPES) when I live in my own home?

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 to ensure your health, welfare, and safety;

(b) Enable you to function with greater independence in the home;

(d) Meet applicable state or local codes; and

(e) Are not adaptations or improvements, which are of general utility or add to the total square footage;

(3) Home delivered meals which provide one nutritionally balanced meal per day if:

(a) You are homebound and live in your own home;

(b) You are unable to prepare the meal;

(d) Receiving this meal is more cost-effective than having a paid caregiver;

(4) Community choice guiding are services to help you establish or stabilize your living arrangement in your own home if:

(a) You have frequent institutional contacts;

(b) You have frequent turn-over of caregivers; or

(5) Skilled nursing, if the service is:

(a) Provided by a registered nurse or licensed practical nurse under the supervision of a registered nurse; and

(b) Beyond the amount, duration, or scope of medicaid-reimbursed home health services as provided under WAC 182-551-2100;

(6) Specialized medical equipment and supplies under WAC 182-543-1000, if the items:

(a) Are necessary for:

(i) Life support;

(ii) To increase your ability to perform activities of daily living; or

(iii) To perceive, control, or communicate with the environment in which you live; or

(b) Are directly remedially beneficial to you; and

(7) Training needs identified in the CARE assessment which meet a therapeutic goal such as:

(a) Adjusting to a serious impairment;

(b) Managing personal care needs; or

(8) Transportation services, when the service:

(a) Provides access to community services and resources to meet a therapeutic goal;

(b) Is not diverting in nature; and

(9) Nursing services from a registered nurse based on your individual need as determined by your CARE assessment, when you are not already receiving this type of service from another resource, which may include any of the following activities:

(a) Nursing assessment/reassessment;

(b) Instruction to you and your providers;

(d) Skilled treatment, in the event of an emergency, which requires authorization, prescription, and supervision by an authorized practitioner prior to its provision by a nurse, for example, medication administration or wound care such as debridement;

(e) File review; or

(f) Evaluation of health-related care needs affecting service plan and delivery;

(10) Adult day health services as described in WAC 388-71-0706 when you are:

(a) Assessed as having an unmet need for skilled nursing under WAC 388-71-0712 or skilled rehabilitative therapy under WAC 388-71-0714 and:

(i) There is a reasonable expectation that these services will improve, restore, or maintain your health status, or in the case of a progressive disabling condition, will either restore or slow the decline of your health and functional status or ease related pain or suffering;

(ii) You are at risk for deteriorating health, deteriorating functional ability, or institutionalization; and

(iii) You have a chronic or acute health condition that you are not able to safely manage due to a cognitive, physical, or other functional impairment;

(b) Assessed as having needs for personal care or other core services, whether or not those needs are otherwise met; however

(i) Can independently perform or obtain the services provided at an adult day health center; or

(ii) Have referred care needs that:

(A) Exceed the scope of authorized services that the adult day health center is able to provide;

(B) Do not need to be provided or supervised by a licensed nurse or therapist;

(D) In the case of skilled care needs, are being met by paid or unpaid caregivers;

(E) Live in a nursing home or other institutional facility; or

(F) Are not capable of participating safely in a group care setting;

(11) Wellness education, as identified in your person centered service plan to address an assessed need or condition; and

(12) Community support: Goods and services are nonrecurring set-up items and services to assist with expenses if you choose to move from a residential setting to an in-home setting and may include:

(a) Security deposits that are required to lease an apartment or home;

(b) Activities to assess need, arrange for, and obtain needed resources, including essential household furnishings;

(c) Set-up fees or deposits for utility or services access, including telephone, electricity, heating, water, and garbage;

(d) Services necessary for your health and safety such as pest eradication, and one-time cleaning prior to occupancy;

(e) Moving expenses; and

(f) Necessary home accessibility adaptations.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 19-15-029, § 388-106-0300, filed 7/10/19, effective 8/10/19
WSR 15-11-049, § 388-106-0300, filed 5/15/15, effective 7/1/15
WSR 15-03-038, § 388-106-0300, filed 1/12/15, effective 2/12/15. Statutory Authority: RCW 74.08.090, 74.09.520, and 2012 2nd sp.s. c 7. WSR 12-15-087, § 388-106-0300, filed 7/18/12, effective 8/18/12. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 07-24-026, § 388-106-0300, filed 11/28/07, effective 1/1/08. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.010 and 74.39A.020. WSR 06-05-022, § 388-106-0300, filed 2/6/06, effective 3/9/06. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0300, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0305 What services may I receive under COPES if I live in a residential facility?

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 be eligible to receive only the following services under COPES:

(1) Specialized medical equipment and supplies under WAC 182-543-1000, when the items:

(a) Are necessary for:

(i) Life support;

(ii) To increase your ability to perform activities of daily living; or

(iii) To perceive, control, or communicate with the environment in which you live; or

(b) Are directly remedially beneficial to you;

(d) Do not replace the services required by the department's contract with a residential facility;

(2) Training needs identified in the CARE assessment that are in addition to and do not replace the services required by the department's contract with the residential facility and that meet a therapeutic goal such as:

(a) Adjusting to a serious impairment;

(b) Managing personal care needs; or

(3) Transportation services, when the service:

(a) Provides access to community services and resources to meet a therapeutic goal;

(b) Is not diverting in nature;

(d) Does not replace the services required by DSHS contract in residential facilities;

(4) Skilled nursing, when the service is:

(a) Provided by a registered nurse or licensed practical nurse under the supervision of a registered nurse;

(b) Beyond the amount, duration or scope of medicaid-reimbursed home health services as provided under WAC 182-551-2100; and

(c) In addition to and does not replace the services required by the department's contract with the residential facility (e.g. intermittent nursing services as described in WAC 388-78A-2310);

(5) Nursing services from a registered nurse based on your individual need as determined by your CARE assessment, when you are not already receiving this type of service from another resource, which may include any of the following activities:

(a) Nursing assessment/reassessment;

(b) Instruction to you and your providers;

(d) Skilled treatment in the event of an emergency, which requires authorization, prescription, and supervision by an authorized practitioner prior to its provision by a nurse, for example, medication administration or wound care such as debridement;

(e) File review; or

(f) Evaluation of health-related care needs affecting service plan and delivery.

(6) Adult day health services as described in WAC 388-71-0706 when you are:

(a) Assessed as having an unmet need for skilled nursing under WAC 388-71-0712 or skilled rehabilitative therapy under WAC 388-71-0714, and:

(i) There is a reasonable expectation that these services will improve, restore or maintain your health status, or in the case of a progressive disabling condition, will either restore or slow the decline of your health and functional status or ease related pain or suffering;

(ii) You are at risk for deteriorating health, deteriorating functional ability, or institutionalization; and

(iii) You have a chronic or acute health condition that you are not able to safely manage due to a cognitive, physical, or other functional impairment;

(b) Assessed as having needs for personal care or other core services, whether or not those needs are otherwise met; however

(i) Can independently perform or obtain the services provided at an adult day health center;

(ii) Have referred care needs that:

(A) Exceed the scope of authorized services that the adult day health center is able to provide;

(B) Do not need to be provided or supervised by a licensed nurse or therapist;

(D) In the case of skilled care needs, are being met by paid or unpaid caregivers;

(E) Live in a nursing home or other institutional facility; or

(F) Are not capable of participating safely in a group care setting;

(7) Wellness education, as identified in your person centered service plan to address an assessed need or condition;

(8) Community choice guiding are services to help you establish or stabilize your living arrangement in your own home or a residential setting if:

(a) You have frequent institutional contacts;

(b) You have frequent turn-over of caregivers; or

(9) Community support: Goods and services are nonrecurring set-up items and services to assist with expenses if you choose to move from a residential setting to an in-home setting and may include:

(a) Security deposits that are required to lease an apartment or home;

(b) Activities to assess need, arrange for, and obtain needed resources, including essential household furnishings;

(c) Set-up fees or deposits for utility or services access, including telephone, electricity, heating, water, and garbage;

(d) Services necessary for your health and safety such as pest eradication, and one-time cleaning prior to occupancy;

(e) Moving expenses; and

(f) Necessary home accessibility adaptations.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 19-15-029, § 388-106-0305, filed 7/10/19, effective 8/10/19
WSR 15-11-049, § 388-106-0305, filed 5/15/15, effective 7/1/15
WSR 14-15-092, § 388-106-0305, filed 7/18/14, effective 8/18/14. Statutory Authority: RCW 74.08.090, 74.09.520, and 2012 2nd sp.s. c 7. WSR 12-15-087, § 388-106-0305, filed 7/18/12, effective 8/18/12. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.010 and 74.39A.020. WSR 06-05-022, § 388-106-0305, filed 2/6/06, effective 3/9/06. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0305, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0310 Am I eligible for COPES-funded services?

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.

(2) You meet financial eligibility requirements. This means the department will assess your finances and determine if your income and resources fall within the limits set in WAC 182-515-1505, community options program entry system (COPES).

(3) Your CARE assessment shows you need and are eligible for:

(a) The level of care provided in a nursing facility (or will likely need the level of care within thirty days unless COPES services are provided) which is defined in WAC 388-106-0355(1); and

(b) A COPES waiver service.

(5) You continue to receive at least one monthly waiver service.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 15-11-049, § 388-106-0310, filed 5/15/15, effective 7/1/15
WSR 12-16-026, § 388-106-0310, filed 7/25/12, effective 8/25/12. Statutory Authority: RCW 34.05.353 (2)(d), 74.08.090, and chapters 74.09, 74.04 RCW. WSR 08-11-047, § 388-106-0310, filed 5/15/08, effective 6/15/08. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0310, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0315 When do COPES services start?

Your eligibility for COPES begins the date the department authorizes services.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0315, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0320 How do I remain eligible for COPES?

(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 financial circumstances.

(2) When eligibility statutes, regulations, and/or rules for COPES change, irrespective of whether your functional or financial circumstances have changed, if you do not meet the changed eligibility requirements, the department will terminate your COPES services.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0320, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0325 How do I pay for COPES services?

(1) Your own home, you are allowed to keep some of your income for a maintenance allowance.

(2) In a residential facility, you must use your income to pay for your room and board and services. You are allowed to keep some of your income for personal needs allowance (PNA). The department determines the amount of PNA that you may keep. The department pays the facility for the difference between what you pay and the department-set rate for the facility. The department pays the residential care facility from the first day of service through the:

(a) Last day of service when the medicaid resident dies in the facility; or

(b) Day of service before the day the medicaid resident is discharged.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 15-03-038, § 388-106-0325, filed 1/12/15, effective 2/12/15
WSR 05-11-082, § 388-106-0325, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0330 Can I be employed and receive COPES?

You can be employed and receive COPES, per WAC 182-515-1505.

History

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.

Wash. Admin. Code § 388-106-0335 Are there waiting lists for COPES?

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 application for services;

(2) Then clients living in the community with a higher level of need, as determined by the CARE assessment, will be ranked higher on the waitlist over clients with a lower level of need; and

(3) When two or more clients in the community have equal need levels, the client with the earlier application for services will have priority over later applications for services.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0335, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0336 What services may I receive under the residential support waiver?

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;

(d) Medication management; and

(e) Coordination and collaboration with a contracted behavior support provider;

(2) Adult family homes with a specialized behavior support contract that will provide:

(a) Personal care;

(b) 24-hour on-site support and response staff;

(d) Medication management;

(e) Coordination and collaboration with a contracted behavior support provider; and

(f) Specialized behavior support that provides you with six to eight hours a day of individualized staff time;

(3) Assisted living facilities with a community stability support contract that will provide:

(a) Personal care;

(b) 24-hour on-site support and response staff;

(d) Medication management; and

(e) On-site staffing ratios and professional staffing as described in the contract;

(4) Enhanced services facilities that will provide:

(a) Personal care;

(b) 24-hour on-site support and response staff;

(d) Medication management; and

(e) On-site staffing ratios and professional staffing as described in WAC 388-107-0230 through 388-107-0270;

(5) Specialized durable and nondurable medical equipment and supplies under WAC 182-543-1000 when:

(a) Medically necessary under WAC 182-500-0005;

(b) Necessary:

(i) For life support;

(ii) To increase your ability to perform activities of daily living; or

(iii) To perceive, control, or communicate with the environment in which you live;

(d) They are additional and do not replace any medical equipment or supplies otherwise provided under either medicaid, medicare, or both; and

(e) In addition to and do not replace the services required by the department's contract with a residential facility;

(6) Client support training to address your needs identified in your CARE assessment or other professional evaluation that are additional and do not replace the services required by the department's contract with the residential facility and meet a therapeutic goal, such as:

(a) Adjusting to a serious impairment;

(b) Managing personal care needs; or

(7) Nurse delegation under RCW 18.79.260 when:

(a) You receive personal care from a registered or certified nursing assistant who has completed nurse delegation core training;

(b) The delegating nurse considers your medical condition stable and predictable;

(d) The services are additional and do not replace the services required by the department's contract with the residential facility;

(8) Skilled nursing when:

(a) Provided by a registered nurse or licensed practical nurse under a registered nurse's supervision;

(b) Beyond the amount, duration, or scope of medicaid-reimbursed home health services as provided under WAC 182-551-2100; and

(9) Nursing services not already received from another resource, based on your individual need as determined by your CARE assessment and any additional collateral contact information obtained by your case manager, including any one or more of the following activities performed by a registered nurse:

(a) Nursing assessment/reassessment;

(b) Instruction to you, your providers, and your caregivers;

(d) Skilled treatment, only in the event of an emergency as in nonemergency situations, the nurse will refer the need for any skilled medical or nursing treatments to a health care provider or other appropriate resource;

(e) File review; or

(f) Evaluation of health-related care needs affecting service plan and delivery;

(10) Adult day health services as described in WAC 388-71-0706 when:

(a) Your CARE assessment shows an unmet need for personal care or other core services, whether or not those needs are otherwise met; and

(b) Your CARE assessment shows an unmet need for skilled nursing under WAC 388-71-0712 or skilled rehabilitative therapy under 388-71-0714 and:

(i) There is a reasonable expectation that the services will improve, restore, or maintain your health status, or in the case of a progressive disabling condition, will either restore or slow the decline of your health and functional status or ease related pain and suffering;

(ii) You are at risk for deteriorating health, deteriorating functional ability, or institutionalization; or

(iii) You have a chronic acute health condition that you are not able to safely manage due to a cognitive, physical, or other functional impairment.

(11) For care plans resulting from an eligibility assessment on or after July 1, 2025, to be eligible to receive the following waiver services you must first be found to not be eligible to receive services through the community behavioral health supports 1915(i) state plan option under chapter 182-561 WAC:

(a) Services provided under a specialized behavior support contract in an adult family home as described in subsection (2) of this section; or

(b) On-site staffing ratios as described in subsections (3)(e) and (4)(e) of this section.

History

Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.030, and 74.39A.400. WSR 25-15-100, s 388-106-0336, filed 7/16/25, effective 8/16/25. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.030, 74.39A.400, 42 C.F.R. § 441.300-310, and 42 C.F.R. § 441.500-590. WSR 24-09-037, § 388-106-0336, filed 4/11/24, effective 5/12/24. Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 16-19-055, § 388-106-0336, filed 9/16/16, effective 10/17/16
WSR 15-01-085, § 388-106-0336, filed 12/16/14, effective 1/16/15
WSR 14-15-092, § 388-106-0336, filed 7/18/14, effective 8/18/14.

Wash. Admin. Code § 388-106-0337 When are you not eligible for adult day health services?

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 not need to be provided or supervised by a licensed nurse or therapist;

(d) In the case of skilled care needs, are being met by paid or unpaid providers;

(e) Live in a nursing home or other institutional facility; or

(f) Are not capable of participating safely in a group care setting.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 16-19-055, § 388-106-0337, filed 9/16/16, effective 10/17/16.

Wash. Admin. Code § 388-106-0338 Am I eligible for services funded by the residential support waiver?

(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 182-512-0050, or are age 65 or older;

(b) Your income and resources fall within the limits set in WAC 182-515-1505 and meet the income and resource criteria for home and community based waiver programs and hospice clients;

(c) Your CARE assessment shows you need the level of care provided in a nursing facility or that you will likely need this level of care within 30 days unless you receive residential support waiver services as defined in WAC 388-106-0355(1);

(d) You have been assessed as medically and psychiatrically stable and one or more of the following applies:

(i) You currently reside at a state mental hospital or the psychiatric unit of a hospital and the hospital has found you are ready for discharge to the community;

(ii) You have a history of frequent or protracted psychiatric hospitalizations; or

(iii) You have a history of an inability to remain medically or behaviorally stable for more than six months and you;

(A) Have exhibited serious challenging behaviors within the last year; or

(B) Have had problems managing your medication which has affected your ability to live in the community;

(e) Because of the protracted nature of your behavior and clinical complexity, you have no other placement options and have found no community placement with a qualified community provider;

(f) You have behavioral or clinical complexity that requires staffing supports available only in the qualified community settings provided through the residential support waiver; and

(g) You require caregiving staff with specific training in providing personal care, supervision, and behavioral supports to adults with challenging behaviors.

(2) You are not eligible to receive a service under the waiver that is similar in scope and nature and available to you through the Washington medicaid state plan, including, but not limited to, services and supports offered under the community behavioral health supports 1915(i) state plan option under chapter 182-561 WAC.

(3) Under this section, "challenging behaviors" means a persistent pattern of behaviors or uncontrolled symptoms of a cognitive or mental condition that inhibit the individual's functioning in public places, the facility, or integration within the community that have been present for long periods of time or have manifested as an acute onset.

(4) Subsection (2) of this section applies to eligibility assessments for care plans starting on or after July 1, 2025.

History

Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.030, and 74.39A.400. WSR 25-15-100, s 388-106-0338, filed 7/16/25, effective 8/16/25. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 16-19-055, § 388-106-0338, filed 9/16/16, effective 10/17/16
WSR 14-15-092, § 388-106-0338, filed 7/18/14, effective 8/18/14.

Wash. Admin. Code § 388-106-0340 When do services from the residential support waiver start?

Your eligibility for Residential Support begins the date the department authorizes services.

History

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.

Wash. Admin. Code § 388-106-0342 How do I remain eligible for residential support waiver services?

(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 defined in WAC 388-106-0355(1). The assessment in CARE must be completed at least annually or more often when there are significant changes in your functional or financial circumstances.

(2) When eligibility statutes, regulations and/or rules for the residential support waiver change, irrespective of whether your functional or financial circumstances have changed, if you do not meet the changed eligibility requirements, the department will terminate your Residential Support services.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 14-15-092, § 388-106-0342, filed 7/18/14, effective 8/18/14.

Wash. Admin. Code § 388-106-0344 How do I pay for residential support waiver services?

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 services under the residential support waiver you must use your income to pay for your room and board and services. You are allowed to keep some of your income for personal needs allowance (PNA). The department determines the amount of PNA that you may keep. The department pays the facility for the difference between what you pay and the department-set rate for the facility. The department pays the residential care facility from the first day of service through the:

(1) Last day of service when the medicaid resident dies in the facility; or

(2) Day of service before the day the medicaid resident is discharged.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 15-01-085, § 388-106-0344, filed 12/16/14, effective 1/16/15
WSR 14-15-092, § 388-106-0344, filed 7/18/14, effective 8/18/14.

Wash. Admin. Code § 388-106-0346 Can I be employed and receive residential support waiver services?

You can be employed and receive residential support services, per WAC 182-515-1505.

History

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.

Wash. Admin. Code § 388-106-0348 Are there waiting lists for the residential support waiver services?

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 eligibility;

(3) Geographical preferences; and

(4) Choice of provider, setting, and roommate.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 14-15-092, § 388-106-0348, filed 7/18/14, effective 8/18/14.

Wash. Admin. Code § 388-106-0350 What are nursing facility care services?

You may receive care in a nursing facility, as outlined in chapter 388-97 WAC.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0350, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0355 Am I eligible for nursing facility care services?

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 registered nurse or a licensed practical nurse on a daily basis;

(b) You have an unmet or partially met need with at least three of the following activities of daily living, as defined in WAC 388-106-0010:

| For each Activity of Daily Living, the minimum level of assistance required in | | | | --- | --- | --- | | | Self Performance is: | Support Provided is: | | Eating | N/A | Setup | | Toileting | Supervision | N/A | | Bathing | Supervision | N/A | | Transfer | Supervision | Setup | | Bed Mobility | Supervision | Setup | | Walk in Room or Locomotion in Room or Locomotion Outside Immediate Living Environment | Supervision | Setup | | Medication Management | Assistance Required | N/A | | Your need for assistance in any activities listed in subsection (b) of this section did not occur because you were unable or no provider was available to assist you will be counted for the purpose in determining your functional eligibility. | | |

(c) You have an unmet or partially met need with at least two of the following activities of daily living, as defined in WAC 388-106-0010:

| For each Activity of Daily Living, the minimum level of assistance required in | | | | --- | --- | --- | | | Self Performance is: | Support Provided is: | | Eating | Supervision | One person physical assist | | Toileting | Extensive Assistance | One person physical assist | | Bathing | Limited Assistance | One person physical assist | | Transfer | Extensive Assistance | One person physical assist | | Bed Mobility and Turning and repositioning | Limited Assistance and Need | One person physical assist | | Walk in Room or Locomotion in Room or Locomotion Outside Immediate Living Environment | Extensive Assistance | One person physical assist | | Medication Management | Assistance Required Daily | N/A | | Your need for assistance in any of the activities listed in subsection (c) of this section did not occur because you were unable or no provider was available to assist you will be counted for the purpose of determining your functional eligibility. | | |

or:

(d) You have a cognitive impairment and require supervision due to one or more of the following: Disorientation, memory impairment, impaired decision making, or wandering and have an unmet or partially met need with at least one or more of the following:

| For each Activity of Daily Living, the minimum level of assistance required in | | | | --- | --- | --- | | | Self Performance is: | Support Provided is: | | Eating | Supervision | One person physical assist | | Toileting | Extensive Assistance | One person physical assist | | Bathing | Limited Assistance | One person physical assist | | Transfer | Extensive Assistance | One person physical assist | | Bed Mobility and Turning and repositioning | Limited Assistance and Need | One person physical assist | | Walk in Room or Locomotion in Room or Locomotion Outside Immediate Living Environment | Extensive Assistance | One person physical assist | | Medication Management | Assistance Required Daily | N/A | | Your need for assistance in any of the activities listed in subsection (d) of this section did not occur because you were unable or no provider was available to assist you will be counted for the purpose of determining your functional eligibility. | | |

(2) Determines that you meet the financial eligibility requirements set through WAC 182-513-1315.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 15-03-038, § 388-106-0355, filed 1/12/15, effective 2/12/15
WSR 05-11-082, § 388-106-0355, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0360 How do I pay for nursing facility care services?

(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 your family/representative for any care provided before the date of request for assessment.

(2) If you are eligible for medicaid-funding nursing facility care, the department pays for your services beginning on the date:

(a) Of the request for a department assessment; or

(b) Nursing facility care actually begins, whichever is later.

(3) If you become financially eligible for medicaid after you have been admitted, the department pays for your nursing facility care beginning on the date of:

(a) Request for assessment or financial application, whichever is earlier;

(b) Nursing facility placement; or

(4) Exception: Payment back to the request date is limited to three months prior to the month that the financial application is received.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0360, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0600 What services may I receive under chore?

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.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0600, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0610 Am I eligible for chore-funded services?

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 older.

(4) Have an unmet or partially met need with at least one of the following activities of daily living, as defined in WAC 388-106-0010.

| For each Activity of Daily Living, the minimum level of assistance required in | | | | --- | --- | --- | | | Self Performance is: | Support Provided is: | | Eating | N/A | Setup | | Toileting | Supervision | N/A | | Bathing | Supervision | N/A | | Dressing | Supervision | N/A | | Transfer | Supervision | Setup | | Bed Mobility | Supervision | Setup | | Walk in Room or Locomotion in Room or Locomotion Outside Immediate Living Environment | Supervision | Setup | | Medication Management | Assistance Required | N/A | | Personal Hygiene | Supervision | N/A | | Body care which includes: Application of ointment or lotions; Toenails trimmed; Dry bandage changes; or Passive range of motion treatment. | Need | N/A | | Your need for assistance in any of the activities listed in this section did not occur because you were unable or no provider was available to assist you will be counted for the purpose of determining your functional eligibility. | | |

(5) Have net household income (as described in WAC 388-450-0005 and 388-450-0040) not exceeding:

(a) The sum of the cost of your chore services; and

(b) One-hundred percent of the federal poverty level (FPL) adjusted for family size.

(6) Have resources, as described in chapter 388-470 WAC, which do not exceed ten thousand dollars for a one-person family or fifteen thousand dollars for a two-person family. (Note: One thousand dollars for each additional family member may be added to these limits.); and

(7) Not transfer assets on or after November 1, 1995 for less than fair market value, as described in WAC 182-513-1365.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 15-03-038, § 388-106-0610, filed 1/12/15, effective 2/12/15
WSR 05-11-082, § 388-106-0610, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0615 When do chore services start?

Your eligibility for chore services begins the date the department authorizes services.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0615, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0620 How do I remain eligible for chore?

(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 financial circumstances.

(2) When eligibility statutes, regulations, and/or rules for chore change, irrespective of whether your functional or financial circumstances have changed, if you do not meet the changed eligibility requirements, the department will terminate your chore services.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0620, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0625 How do I pay for chore?

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) Spousal income allocated and actually paid as participation in the cost of the spouse's community options program entry system (COPES) services;

(3) Amounts paid for medical expenses not subject to third party payment;

(4) Health insurance premiums, coinsurance or deductible charges; and

(5) If applicable, those work expense deductions listed in WAC 388-106-0630(2).

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 15-03-038, § 388-106-0625, filed 1/12/15, effective 2/12/15
WSR 05-11-082, § 388-106-0625, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0630 Can I be employed and receive chore?

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 department will exempt fifty percent of your earned income after work expense deductions. Work expense deductions are:

(a) Personal work expenses in the form of self-employment taxes (FICA); and income taxes when paid;

(b) Payroll deductions required by law or as a condition of employment in the amounts actually withheld;

(c) The necessary cost of transportation to and from the place of employment by the most economical means, except rental cars;

(d) Expenses necessary for continued employment such as tools, materials, union dues, transportation to service customers not furnished by the employer; and

(e) Uniforms needed on the job and not suitable for wear away from the job.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0630, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0650 What is the volunteer services program?

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 allocating volunteer services, the needs of persons who have traditionally been served through long-term care services and supports, including older adults, individuals with disabilities or their unpaid caregivers, will be given priority.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 15-07-074, § 388-106-0650, filed 3/17/15, effective 4/17/15
WSR 05-11-082, § 388-106-0650, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0655 Am I eligible to receive assistance through volunteer services?

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) Unable to perform certain independent living tasks due to a functional, mental or cognitive disability;

(4) Financially unable to purchase services privately; or

(5) Not receiving medicaid paid long-term care services under the medicaid state plan or medicaid waiver program unless the volunteer service is not available through the state plan waiver program; or

(6) An unpaid caregiver who provides ongoing care for an older adult or person with a disability, including minors, who meets any of the criteria in WAC 388-106-0655 (2) through (5) above.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 15-07-074, § 388-106-0655, filed 3/17/15, effective 4/17/15
WSR 15-03-038, § 388-106-0655, filed 1/12/15, effective 2/12/15
WSR 05-11-082, § 388-106-0655, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0660 What types of services may be offered through volunteer services?

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) Limited personal care;

(11) Socialization activities to improve quality of life;

(12) Electronic device/computer use;

(13) Clerical and budgeting tasks;

(14) Transportation

(15) Emergency preparation;

(16) Companionship or supervision;

(17) Access to benefits;

(18) Access to employment opportunities; and

(19) Health and nutrition enhancement.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 15-07-074, § 388-106-0660, filed 3/17/15, effective 4/17/15.

Wash. Admin. Code § 388-106-0665 How are volunteers qualified to provide volunteer services?

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 per RCW 43.20A.0710 (1)(c) prior to working alone with them.

(2) The volunteer services contractor(s) will provide orientation and ongoing training as needed to volunteers.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 21-11-072, § 388-106-0665, filed 5/17/21, effective 6/17/21
WSR 15-07-074, § 388-106-0665, filed 3/17/15, effective 4/17/15.

Wash. Admin. Code § 388-106-0670 When may volunteer services not be available or offered?

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 volunteer stops providing services at their discretion; or

(5) Providing the service would cause a health or safety risk to the volunteer or staff.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 15-07-074, § 388-106-0670, filed 3/17/15, effective 4/17/15.

Wash. Admin. Code § 388-106-0675 What if I disagree with a decision made by the contracted volunteer services provider(s) related to volunteer services?

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 chapter 388-02 WAC.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 15-07-074, § 388-106-0675, filed 3/17/15, effective 4/17/15.

Wash. Admin. Code § 388-106-0700 What services may I receive under PACE?

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 care plan includes, but is not limited to any of the following long-term care services:

(a) Care coordination;

(b) Home and community-based services:

(i) Personal (in-home) care;

(ii) Residential care.

(2) The care plan may also include, but is not limited to, the following medical services:

(a) Primary medical care;

(b) Vision care;

(d) Restorative therapies, including speech, occupational, and physical therapy;

(e) Oxygen therapy;

(f) Audiology (including hearing aids);

(g) Transportation;

(h) Podiatry;

(i) Durable medical equipment (e.g., wheelchair);

(j) Dental care;

(k) Pharmaceutical products;

(l) Immunizations and vaccinations;

(m) Emergency room visits and inpatient hospital stays.

(3) The care plan may also include any other services determined necessary by the interdisciplinary team to improve and maintain your overall health status.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0700, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0705 Am I eligible for PACE services?

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 182-512-0050, SSI-related eligibility requirements; or

(b) Sixty-five or older.

(2) Need nursing facility level of care as defined in WAC 388-106-0355;

(3) Live within the designated service area of the PACE provider;

(4) Meet financial eligibility requirements. This means the department will assess your finances, determine if your income and resources fall within the limits, and determine the amount you may be required to contribute, if any, toward the cost of your care as described in WAC 182-515-1505;

(5) Not be enrolled in any other medicare or medicaid prepayment plan or optional benefit; and

(6) Agree to receive services exclusively through the PACE provider and the PACE provider's network of contracted providers.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 15-03-038, § 388-106-0705, filed 1/12/15, effective 2/12/15. Statutory Authority: RCW 34.05.353 (2)(d), 74.08.090, and chapters 74.09, 74.04 RCW. WSR 08-11-047, § 388-106-0705, filed 5/15/08, effective 6/15/08. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.010 and 74.39A.020. WSR 06-05-022, § 388-106-0705, filed 2/6/06, effective 3/9/06. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0705, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0710 How do I pay for PACE services?

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.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0710, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0715 How do I end my enrollment in the PACE program?

(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 organization receives the participant's notice of voluntary disenrollment.

(2) Your enrollment may also end involuntarily if you:

(a) Move out of the designated service area or are out of the service area for more than thirty consecutive days, unless the PACE provider agrees to a longer absence due to extenuating circumstances;

(b) Engage in disruptive or threatening behavior such that the behavior jeopardizes your health or safety, or the safety of others;

(d) Fail to pay or make arrangements to pay your part of the costs after the thirty-day grace period;

(e) Become financially ineligible for medicaid services, unless you choose to pay privately;

(f) Are enrolled with a provider that loses its license or contract, or both; or

(g) No longer meet the nursing facility level of care requirement as defined in WAC 388-106-0205.

(3) For any of the above reasons, the PACE provider must give you written notice, including your appeal rights, explaining that they are terminating benefits. A PACE participant's involuntary disenrollment is effective on the first day of the next month that begins thirty days after the day the PACE organization sends notice of the disenrollment to the participant.

(4) Before the PACE provider can involuntarily end your enrollment in the PACE program, the department must review and approve it.

History

Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.010, and 74.39A.020. WSR 20-13-027, § 388-106-0715, filed 6/9/20, effective 7/10/20
WSR 06-05-022, § 388-106-0715, filed 2/6/06, effective 3/9/06. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0715, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0800 What adult day care services may I receive?

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;

(d) Repositioning;

(e) Medication management that does not require a licensed nurse;

(f) Transfer;

(g) Toileting;

(h) Personal hygiene at a level that ensures your safety and comfort while in attendance at the program; and

(i) Bathing at a level that ensures your safety and comfort while in attendance at the program.

(2) Social services on a consultation basis, which may include:

(a) Referrals to other providers for services not within the scope of medicaid reimbursed adult day care services;

(b) Caregiver support and education; or

(3) Routine health monitoring with consultation from a registered nurse that a consulting nurse acting within the scope of practice can provide with or without a physician's order. Examples include:

(a) Obtaining baseline and routine monitoring information on your health status, such as vital signs, weight, and dietary needs;

(b) General health education such as providing information about nutrition, illnesses, and preventative care;

(d) Annual and as needed updating of your medical record; or

(e) Assistance as needed with coordination of health services provided outside of the adult day care program.

(4) General therapeutic activities that an unlicensed person can provide or that a licensed person can provide with or without a physician's order. These services are planned for and provided based on your abilities, interests, and goals. Examples include:

(a) Recreational activities;

(b) Diversionary activities;

(d) Cognitive stimulation; or

(e) Group range of motion or conditioning exercises.

(5) General health education that an unlicensed person can provide or that a licensed person can provide with or without a physician's order, including but not limited to topics such as:

(a) Nutrition;

(b) Stress management;

(d) Preventative care.

(6) A nutritional meal and snacks are provided every four hours, including a modified diet if needed and within the scope of the program, as provided under WAC 388-71-0768;

(7) Supervision and/or protection if needed for your safety;

(8) Assistance with arranging transportation to and from the program; and

(9) First aid and provisions for obtaining or providing care in an emergency. NOTE: If you require the intervention or services of a registered nurse or licensed rehabilitative therapist acting under the supervision of your physician, consider adult day health services.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0800, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0805 Am I eligible for adult day care?

(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;

(d) Supervision and/or protection if required for your safety.

(2) You are not eligible for adult day care if you receive COPES and you:

(a) Can independently perform or obtain the services provided at an adult day care center;

(b) Have unmet needs that can be met through the COPES program more cost effectively without authorizing day care services;

(i) Exceed the scope of authorized services that the adult day care center is able to provide;

(ii) Can be met in a less structured care setting; or

(iii) Are being met by paid or unpaid caregivers.

(d) Live in a nursing home, assisted living facility, adult family home, or other licensed institutional or residential facility; or

(e) Are not capable of participating safely in a group care setting.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 14-15-092, § 388-106-0805, filed 7/18/14, effective 8/18/14
WSR 05-11-082, § 388-106-0805, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0810 What adult day health services may I receive?

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;

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0810, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0815 Am I eligible for adult day health?

You are eligible for adult day health if you meet the conditions described in WAC 388-106-0300 or 388-106-0305.

History

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 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0815, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0900 What services may I receive under medical care services?

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.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 14-15-092, § 388-106-0900, filed 7/18/14, effective 8/18/14
WSR 05-11-082, § 388-106-0900, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0905 Am I eligible to receive medical care services (MCS) residential care services?

You are eligible to receive MCS-funded residential care services if:

(1) You meet financial eligibility requirements for medical care services (MCS), described in WAC 182-508-0005;

(2) You are not eligible for services under COPES, or MPC; and

(3) You are assessed in CARE and meet the functional criteria outlined in WAC 388-106-0210(3) or 388-106-0355(1).

History

Statutory Authority: RCW 74.08.090. WSR 18-22-066, § 388-106-0905, filed 11/1/18, effective 12/2/18. Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 15-03-038, § 388-106-0905, filed 1/12/15, effective 2/12/15
WSR 05-11-082, § 388-106-0905, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0950 What services may I receive under community transition or sustainability services?

Community transition or sustainability services are nonrecurring setup items or services necessary to assist you to establish, resume, or stabilize your home or community-based residential setting. Community transition or sustainability services may include, but are not limited to:

(1) Security deposits that are required to lease an apartment or home, including first month's rent.

(2) Activities to assess need, arrange for, and procure necessary household furnishings.

(3) Setup fees or deposits for utilities, including telephone, electricity, heating, water, and garbage.

(4) Services necessary for your health and safety such as pest eradication and nonrecurring extreme cleaning.

(5) Moving expenses.

History

Statutory Authority: RCW 74.08.090. WSR 18-12-100, § 388-106-0950, filed 6/5/18, effective 7/6/18. Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-0950, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0955 Am I eligible for community transition or sustainability services?

You may be eligible for community transition or sustainability services if you:

(1) Meet eligibility criteria to receive long-term services and supports from home and community services;

(2) Are transitioning to the community from a hospital, nursing facility, licensed assisted living facility, enhanced services facility, or adult family home, or are living in the community and need stabilization services to remain there; and

(3) Do not have other programs, services, or resources to assist you with these costs; and

(a) Have needs beyond what is covered under community transition services (under community first choice); or

(b) Are not eligible for community transition services (under community first choice).

History

Statutory Authority: RCW 74.08.090. WSR 18-12-100, § 388-106-0955, filed 6/5/18, effective 7/6/18. Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 15-03-038, § 388-106-0955, filed 1/12/15, effective 2/12/15
WSR 14-15-092, § 388-106-0955, filed 7/18/14, effective 8/18/14
WSR 05-11-082, § 388-106-0955, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-0960 Are there limits to the community transition or sustainability services I may receive?

Community transition or sustainability services:

(1) Do not include recreational or entertainment items, such as a television, cable, or a DVD player;

(2) Do not include room and board; and

(3) May not exceed eight hundred fifty dollars per transition or occurrence of instability that threatens the loss of your home in the community.

History

Statutory Authority: RCW 74.08.090. WSR 18-12-100, § 388-106-0960, filed 6/5/18, effective 7/6/18.

Wash. Admin. Code § 388-106-0965 Are there waiting lists for community transition or sustainability services?

There are no waiting lists for community transition or sustainability services. Instead of waiting lists, the department may revise rules to reduce the type of available services, the number of individuals served, or maximum rate, in order to stay within the legislative appropriation.

History

Statutory Authority: RCW 74.08.090. WSR 18-12-100, § 388-106-0965, filed 6/5/18, effective 7/6/18.

Wash. Admin. Code § 388-106-1000 What is the intent of WAC 388-106-1000 through 388-106-1055?

The intent of WAC 388-106-1000 through 388-106-1055 is to:

(1) Describe the eligibility requirements under which an adult age eighteen or older may receive private duty nursing (PDN) services through the department's aging and disability services administration (ADSA);

(2) Provide assistance to clients and enable families to support clients in their own homes; and

(3) Describe the requirements clients and their families, home health agencies, and privately contracted registered nurses (RNs) and licensed practical nurses (LPNs) must meet in order for services to be authorized for PDN.

History

Statutory Authority: RCW 74.08.090, 74.09.520 and 42 C.F.R. 440.80. WSR 05-24-091, § 388-106-1000, filed 12/6/05, effective 1/6/06.

Wash. Admin. Code § 388-106-1005 What services may I receive under private duty nursing (PDN)?

PDN is a program that provides skilled nursing care if you have complex medical needs that cannot be met through other services. PDN is an alternative to institutional care and is the program of last resort.

History

Statutory Authority: RCW 74.08.090, 74.09.520 and 42 C.F.R. 440.80. WSR 05-24-091, § 388-106-1005, filed 12/6/05, effective 1/6/06.

Wash. Admin. Code § 388-106-1010 Am I eligible for medicaid-funded private duty nursing services?

In order to be eligible for medicaid-funded private duty nursing (PDN):

(1) You must be eighteen years of age or older and financially eligible, which means you:

(a) Meet medicaid requirements under the categorically needy program or the medically needy program; and

(b) Use private insurance as first payer, as required by medicaid rules. Private insurance benefits, which cover hospitalization and in-home services, must be ruled out as the first payment source to PDN.

(2) You must be medically eligible, which means:

(a) The department has received the skilled nursing task log or ADSA-approved equivalent completed by a nurse licensed under chapter 18.79 RCW.

(b) You have been assessed by an ADSA community nurse consultant (CNC) or nursing care consultant (NCC) and determined medically eligible for PDN.

(3) The department must assess you using the CARE assessment tool, as provided in chapter 388-106 WAC to determine that you:

(a) Require care in a hospital or meet nursing facility level of care, as defined in WAC 388-106-0310; and

(b) Have unmet skilled nursing needs that cannot be met in a less costly program or less restrictive environment; and

(c) Are not able to have your care tasks provided through nurse delegation, WAC 246-840-910 through 246-840-970; COPES skilled nursing, WAC [388] [182]-515-1505; DDD waiver skilled nursing, WAC 388-845-0215 or self-directed care RCW 74.39.050; and

(d) Have a complex medical need that requires four or more hours every day of continuous skilled nursing care that can be safely provided outside a hospital or nursing facility; and

(e) Require skilled nursing care that is medically necessary, per WAC 182-500-0070; and

(f) Are able to supervise your care or have a guardian who is authorized and able to supervise your care; and

(g) Have a family member or other appropriate informal support who is responsible for assuming a portion of your care; and

(h) Are medically stable and appropriate for PDN services, as reflected by your primary care provider's:

(i) Orders for medical services; and

(ii) Documentation of approval for the service provider's PDN care plan.

(i) Do not have any other resources or means to obtain PDN services; and

(j) Are dependent upon technology every day with at least one of the following skilled care needs:

(i) Mechanical ventilation which takes over active breathing due to your inability to breathe on your own due to injury or illness. A tracheal tube is in place and is hooked up to a ventilator that pumps air into the lungs; or

(ii) Complex respiratory support, which means that you require two of the following treatment needs:

(A) Postural drainage and chest percussion;

(B) Application of respiratory vests;

(D) Intermittent positive pressure breathing;

(E) O2 saturation measurement with treatment decisions dependent on the results; or

(F) Tracheal suctioning.

(iii) Intravenous/parenteral administration of multiple medications, and care is occurring on a continuing or frequent basis; or

(iv) Intravenous administration of nutritional substances, and care is occurring on a continuing or frequent basis.

Wash. Admin. Code § 388-106-1020 How do I pay for my PDN services?

You are not required to pay participation for PDN services, but the cost of services is subject to estate recovery, under chapter 182-527 WAC. If you are also receiving other services (e.g. COPES), you may be responsible for paying participation as required under WAC 182-515-1505. Your financial worker will inform you about your participation requirements for those services.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 15-03-038, § 388-106-1020, filed 1/12/15, effective 2/12/15. Statutory Authority: RCW 74.08.090, 74.09.520 and 42 C.F.R. 440.80. WSR 05-24-091, § 388-106-1020, filed 12/6/05, effective 1/6/06.

Wash. Admin. Code § 388-106-1021 What days are considered holidays for private duty nursing providers?

The following dates are holidays solely for the purpose of contracted services rates for private duty nursing providers:

(1) The first day of January (New Year's Day);

(2) The third Monday of January (Martin Luther King, Jr.'s birthday);

(3) The third Monday of February (Presidents' Day);

(4) The last Monday of May (Memorial Day);

(5) The 19th day of June (Juneteenth);

(6) The fourth day of July (Independence Day);

(7) The first Monday in September (Labor Day);

(8) The 11th day of November (Veteran's Day);

(9) The fourth Thursday in November (Thanksgiving Day);

(10) The Friday immediately following the fourth Thursday in November (Native American Heritage Day); and

(11) The 25th day of December (Christmas Day).

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 25-02-051, s 388-106-1021, filed 12/20/24, effective 1/20/25.

Wash. Admin. Code § 388-106-1025 Who can provide my PDN services?

PDN services can be provided by:

(1) A home health agency licensed by the Washington state department of health chapter 246-335 WAC that has a contract with the medicaid agency to provide PDN services; or

(2) A Washington state licensed RN, or LPN under the direction of an RN who has a contract with the medicaid agency to provide PDN services and meets the requirements set forth in WAC 388-106-1040.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 11-05-079, § 388-106-1025, filed 2/15/11, effective 3/18/11. Statutory Authority: RCW 74.08.090, 74.09.520 and 42 C.F.R. 440.80. WSR 05-24-091, § 388-106-1025, filed 12/6/05, effective 1/6/06.

Wash. Admin. Code § 388-106-1030 Are there limitations or other requirements for PDN?

Limitations and other requirements to PDN services are as follows:

(1) You may be authorized to receive PDN services for between four to sixteen hours per day, except as noted in WAC 388-106-1045(4).

(2) PDN hours will be deducted from the personal care hours generated by CARE to account for services that meet your need for personal care services (i.e., one hour from the available hours for each hour of PDN authorized). WAC 388-106-0130 (9)(e).

(3) Trained family members must provide for any hours above your assessment determination, or you or your family must pay for these additional hours.

(4) In instances where your family is temporarily absent due to vacations, additional PDN hours must be:

(a) Paid for by you or your family; or

(b) Provided by other trained family members. If this is not possible, you may require placement in a long-term care facility during their absence.

(5) You may use respite care if you and your unpaid family caregiver meet the eligibility criteria defined in WAC 388-106-1210 (for LTC clients) or WAC 388-832-0145 (for DDD individual and family services clients) or WAC 388-845-1605 (for DDD waiver clients).

(6) There may be a one time approval for additional hours for a period not to exceed thirty days when:

(a) Your family is being trained in care and procedures;

(b) You have an acute episode that would otherwise require hospitalization;

(d) There is a family emergency.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 11-05-079, § 388-106-1030, filed 2/15/11, effective 3/18/11. Statutory Authority: RCW 74.08.090, 74.09.520 and 42 C.F.R. 440.80. WSR 05-24-091, § 388-106-1030, filed 12/6/05, effective 1/6/06.

Wash. Admin. Code § 388-106-1035 What requirements must a home health agency meet in order to provide and be paid for my PDN?

In order for a home health agency to provide and be paid for your PDN, the home health agency must:

(1) Be licensed by the Washington state department of health pursuant to chapter 246-335 WAC and have a contract with the medicaid agency to provide PDN services;

(2) Operate under primary care provider orders;

(3) Develop and follow a detailed service plan that is reviewed and signed at least every six months by the client's primary care provider and submitted to CNC or NCC for review;

(4) Initiate and complete the PDN skilled nursing task log or an approved equivalent for seven days and submit it to the CNC or NCC for review for an initial eligibility determination and for ongoing eligibility every six months thereafter;

(5) Meet all documentation required by DOH for in-home licensing, WAC 246-335-055, 246-335-080, and 246-335-110; and

(6) Submit timely and accurate invoices for payments.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 11-05-079, § 388-106-1035, filed 2/15/11, effective 3/18/11. Statutory Authority: RCW 74.08.090, 74.09.520 and 42 C.F.R. 440.80. WSR 05-24-091, § 388-106-1035, filed 12/6/05, effective 1/6/06.

Wash. Admin. Code § 388-106-1040 What requirements must an RN, or LPN under the supervision of an RN, meet in order to provide and get paid for my PDN services?

In order to be paid by the department, a private RN under the supervision of a primary care provider or an LPN under the supervision of an RN, must:

(1) Be licensed and in good standing, as provided in RCW 18.79.030 (1) (3);

(2) Have a contract with the medicaid agency to provide PDN services;

(3) Complete a background check which requires fingerprinting if the RN or LPN has lived in Washington state less than three years;

(4) Have no conviction for a disqualifying crime, as provided in RCW 43.43.830 and 43.43.842 and WAC 388-71-0500 through 388-71-05640 series;

(5) Have no finding of fact and conclusion of law (stipulated or otherwise), agreed order, or final order issued by a disciplining authority, a court of law, or entered into a state registry with a finding of abuse, neglect, abandonment or exploitation of a minor or vulnerable adult;

(6) Provide services according to the care plan under the supervision/direction of the primary care provider;

(7) Document all PDN services provided by the care plan as required by WAC 182-502-0020 and 246-840-700;

(8) Meet provider requirements under WAC 388-71-0510, 388-71-0515, 388-71-0540, 388-71-0551, and 388-71-0556;

(9) Complete time sheets on a monthly basis;

(10) Complete the PDN seven-day look back skilled nursing task log and submit it to the CNC or NCC for review for initial eligibility determination, and for ongoing eligibility every six months; and

(11) Submit timely and accurate invoices for payment.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 15-03-038, § 388-106-1040, filed 1/12/15, effective 2/12/15
WSR 11-05-079, § 388-106-1040, filed 2/15/11, effective 3/18/11. Statutory Authority: RCW 74.08.090, 74.09.520 and 42 C.F.R. 440.80. WSR 05-24-091, § 388-106-1040, filed 12/6/05, effective 1/6/06.

Wash. Admin. Code § 388-106-1045 When may I receive private duty nursing (PDN) services in a contracted PDN adult family home (AFH)?

You may receive private duty nursing (PDN) services in an adult family home (AFH) when:

(1) You are assessed;

(a) Using the comprehensive assessment reporting evaluation (CARE) assessment tool as provided in WAC 388-106-0500; and

(b) By an aging and long-term support administration (ALTSA) community nurse consultant (CNC) or developmental disabilities administration (DDA) nurse care consultant (NCC) who, using their professional judgment, determines that you require a minimum of eight hours of PDN services per day.

(2) You reside in an AFH that:

(a) Meets all AFH licensing requirements under chapter 388-76 WAC; and

(b) Has a PDN contract with ALTSA; and

(3) Your detailed service plan is reviewed and signed by your primary care provider at your initial assessment and at least every six months thereafter, and your detailed service plan is submitted to an ALTSA CNC or DDA NCC for review along with the following documents:

(a) Physical exam findings completed by your physician;

(b) Current Physician's orders;

(d) Current plan of care;

(e) The nursing progress notes for the seven days prior to assessment, if applicable; and

(f) The PDN skilled nursing task log for dates corresponding with the nursing progress notes, if applicable.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 18-08-084, § 388-106-1045, filed 4/4/18, effective 5/5/18
WSR 11-05-079, § 388-106-1045, filed 2/15/11, effective 3/18/11. Statutory Authority: RCW 74.08.090, 74.09.520 and 42 C.F.R. 440.80. WSR 05-24-091, § 388-106-1045, filed 12/6/05, effective 1/6/06.

Wash. Admin. Code § 388-106-1046 When may an adult family home (AFH) be paid an all-inclusive daily rate for private duty nursing (PDN) services?

An adult family home (AFH) may be paid for private duty nursing (PDN) services when:

(1) The AFH provider, as defined in WAC 388-76-10000, ensures that personal care and nursing services are available in the home 24 hours per day.

(2) The AFH provider is either:

(a) A registered nurse (RN) licensed in Washington state in good standing under RCW 18.79.030(1); or

(b) Operates an in-home services agency licensed through the Washington state department of health (DOH) to provide home health services under chapter 246-335 WAC; and

(i) Employs a resident manager or entity representative, who is a registered nurse licensed in Washington state in good standing under RCW 18.79.030(1); and

(ii) The PDN program manager has approved a plan submitted by the AFH provider to replace the resident manager or entity representative in the event the resident manager or entity representative is no longer employed by the AFH; and

(iii) Ensures that a sufficient number of capable, qualified, and trained staff are available to provide necessary care and services consistent with each client's negotiated service agreement at all times, including but not limited to routine conditions, emergencies, fires, and disaster situations; and

(iv) May use nurses employed by their own in-home services agency to provide PDN for clients in the AFH.

(3) The RN resident manager or RN entity representative employed by the AFH provider, as required under subsection (2):

(a) Manages the daily operations of the AFH and oversees the care provided to the client; and

(b) Must notify the local fire agency, gas, phone, and electric companies at the time of each PDN client's admission to the AFH.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 18-08-084, § 388-106-1046, filed 4/4/18, effective 5/5/18.

Wash. Admin. Code § 388-106-1047 What is included in the all-inclusive daily rate payment to the adult family home (AFH) providing private duty nursing (PDN) services?

Department of social and health services (DSHS) will pay the adult family home (AFH) an all-inclusive daily rate for a private duty nursing (PDN) client, which includes payment for PDN services, all skilled nursing tasks, and all personal care services. DSHS will not authorize payment for nurse delegation services or hours provided by the in-home services agency nurses in addition to the PDN all-inclusive daily rate.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 18-08-084, § 388-106-1047, filed 4/4/18, effective 5/5/18.

Wash. Admin. Code § 388-106-1050 May I receive other long-term care services in addition to PDN?

(1) In addition to PDN services, you may be eligible to receive care through community options program entry system (COPES), or medicaid personal care (MPC), for unmet personal needs not performed by informal supports.

(2) PDN hours will be deducted from the personal care hours generated by CARE to account for services that meet some of your need for personal care services (i.e., one hour from the available hours for each hour of PDN authorized per WAC 388-106-1030).

(3) Services may not be duplicated. PDN hours may not be scheduled during the same time that personal care hours are being provided by an individual provider or home care agency provider.

(4) The PDN provider is responsible for providing assistance with activities of daily living (ADL) and instrumental activities of daily living (IADL) unless there is an informal support that is providing or assisting at the same time.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 15-03-038, § 388-106-1050, filed 1/12/15, effective 2/12/15
WSR 11-05-079, § 388-106-1050, filed 2/15/11, effective 3/18/11. Statutory Authority: RCW 74.08.090, 74.09.520 and 42 C.F.R. 440.80. WSR 05-24-091, § 388-106-1050, filed 12/6/05, effective 1/6/06.

Wash. Admin. Code § 388-106-1055 Can I choose to self-direct my care if I receive PDN services?

You may choose to self-direct part of your health-related tasks to an individual provider, as outlined in RCW 74.39.050. You may also still receive PDN services, if you meet the PDN eligibility requirements.

History

Statutory Authority: RCW 74.08.090, 74.09.520 and 42 C.F.R. 440.80. WSR 05-24-091, § 388-106-1055, filed 12/6/05, effective 1/6/06.

Wash. Admin. Code § 388-106-1100 What services can I receive under the Senior Citizens' Services Act (SCSA) fund?

You may receive community-based services, described in RCW 74.38.040.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-1100, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-1105 How do I apply for SCSA-funded services?

To receive SCSA-funded services, you or your representative must:

(1) Complete and submit a department application form, providing complete and accurate information; and

(2) Promptly submit a written report of any changes in income or resources. For the definition of income and resources, refer to chapter 182-509 WAC.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 15-03-038, § 388-106-1105, filed 1/12/15, effective 2/12/15
WSR 05-11-082, § 388-106-1105, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-1110 Am I eligible for SCSA-funded services at no cost?

To be eligible for SCSA-funded services at no cost, you must:

(1) Be age:

(a) Sixty-five or older; or

(b) Sixty or older, and:

(i) Either unemployed, or

(ii) Working twenty hours a week or less;

(2) Have a physical, mental, or other type of impairment, which without services would prevent you from remaining in your home;

(3) Have income at or below forty percent of the state median income (SMI), based on family size; and

(4) Have nonexempt resources (including cash, marketable securities, and real or personal property) not exceeding ten thousand dollars for a single person or fifteen thousand for a family of two, increased by one thousand dollars for each additional family member of the household. Household means a person living alone or a group of people living together.

(5) If you have income over forty percent of SMI, you may be eligible for services on a sliding fee basis.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-1110, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-1115 What income and resources are exempt when determining eligibility?

The following income and resources, regardless of value, are exempt when determining whether you are eligible for SCSA-funded services:

(1) Your home, and the lot it is upon;

(2) Garden produce, livestock, and poultry used for home consumption;

(3) Program benefits which are exempt from consideration in determining eligibility for needs based programs (e.g., uniform relocation assistance, Older Americans Act funds, foster grandparents' stipends or similar moneys);

(4) Used and useful household furnishings, personal clothing, and automobiles;

(5) Personal property of great sentimental value;

(6) Personal property used by the individual to earn income or for rehabilitation;

(7) One cemetery plot for each member of the family unit;

(8) Cash surrender value of life insurance;

(9) Real property held in trust for an individual Indian or Indian tribe; and

(10) Any payment received from a foster care agency for children in the home.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-1115, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-1120 What if I am not eligible to receive SCSA-funded services at no cost?

(1) Even if your income is above the forty percent SMI limit to receive SCSA-funded services at no cost, you may receive SCSA-subsidized services. The department uses a sliding fee schedule to determine what percentage the department pays for the cost of your services. You pay the remaining amount, but not more than the usual rate paid for services, as negotiated by the AAA or the department. The formula for determining the department's share of the cost of the services is:

| 100% State Median Income (SMI) - Household Income x 100 | | --- | | 100% - 40% SMI |

(2) Service providers must be responsible for collecting fees owed by eligible persons and reporting to area agencies all fees paid or owed by eligible persons.

(3) Some services are provided at no charge regardless of income or need requirements. These services include, but are not limited to, nutritional services, health screening, services under the long-term care ombudsman program, and access services. Note: Well adult clinic services may be provided in lieu of health screening services if such clinics use the fee schedule established by this section.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-1120, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-1200 What definitions apply to respite care services through the family caregiver support program?

The following definitions apply to respite care services:

"Caregivers" means a spouse, relative, or friend who has primary responsibility for the care or supervision of an adult with a functional disability without receiving direct, public or private payment for the caregiver services they provide.

"Continuous care or supervision" means daily assistance or oversight of an adult with a functional disability.

"Family caregiver support program or FCSP" means a statewide program offered by area agencies on aging to provide support for unpaid caregivers who provide care to an adult with a functional disability.

"Functional disability" means a physical, mental or cognitive condition requiring continuous care or supervision in completing activities of daily living or instrumental activities for daily living.

"Care receiver" means an adult (age eighteen and over) with a functional disability who needs daily continuous care or supervision.

"Service provider" means an agency, or organization under contract to the area agency on aging (AAA) or its subcontractor.

"Supervision" means providing oversight of an individual to assure his/her safety and well-being.

"TCARE®, tailored caregiver assessment and referral system" means the process (screening, assessment and care planning) to establish eligibility for respite care and other caregiver support services for unpaid family caregivers.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 12-13-040, § 388-106-1200, filed 6/13/12, effective 7/14/12
WSR 05-11-082, § 388-106-1200, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-1205 What are respite care services?

Respite services relieve unpaid caregivers by providing temporary care or supervision to adults with a functional disability.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-1205, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-1210 Who is eligible to receive respite care services through the family caregiver support program?

(1) To be eligible to receive respite care services, the caregivers must:

(a) Have primary responsibility for the care or supervision of an adult with a functional disability who is not receiving a state or medicaid funded, long-term care service (e.g., COPES, personal care services, DD waiver); and

(b) Provide a minimum of an average of forty hours per week of care, and/or supervision, or live with an adult who needs continuous care or supervision; and

(d) Be assessed in the TCARE®, tailored caregiver assessment and referral system and determined to meet the eligibility threshold levels determined by state level policy and have TCARE® recommend the strategy to introduce alternate sources for care to provide respite.

(2) An eligible participant is an adult who:

(a) Has a functional disability;

(b) Has a caregiver who is assessed in the TCARE® system and meets the criteria in WAC 388-106-1210(1); and

(c) Is not receiving a state or medicaid funded, long-term care service (e.g., COPES, personal care services, DD waiver).

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 12-13-040, § 388-106-1210, filed 6/13/12, effective 7/14/12
WSR 05-11-082, § 388-106-1210, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-1215 Who may provide respite care services through the family caregiver support program?

Respite care providers include, but are not limited to the following:

(1) Nursing homes (chapter 388-97 WAC).

(2) Adult day service providers, whose services includes adult day care, dementia day services and adult day health.

(3) Home care and/or home health agencies licensed through the department of health for in-home services.

(4) Hospitals.

(5) Licensed residential care facilities such as boarding homes, adult family homes, and assisted living facilities.

(6) Providers such as volunteer services, and senior companions.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 12-13-040, § 388-106-1215, filed 6/13/12, effective 7/14/12
WSR 05-11-082, § 388-106-1215, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-1220 How are respite care providers reimbursed for their services through the family caregiver support program?

The department reimburses:

(1) Respite care providers for the number of hours or days of services authorized and provided. If the provider already has a medicaid rate established for providing a similar service, that rate is to be reimbursed by the local area agency on aging. If there is no established rate for the service, one can be negotiated between the local area agency on aging and the respite care service provider.

(2) Medicaid-certified licensed residential facilities providing respite services at the medicaid rate approved for that facility. Medicaid contracted providers must not charge more than the medicaid rate for any services covered from the date of eligibility, unless authorized by the department (see RCW 18.51.070). Participants must pay for services not included in the medicaid rate.

(3) Private nursing homes at their published daily rate.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 12-13-040, § 388-106-1220, filed 6/13/12, effective 7/14/12
WSR 05-11-082, § 388-106-1220, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-1225 Are participants required to pay for the cost of their respite care services through the family caregiver support program?

(1) There is no charge to the care receiver whose income is at or below forty percent of the state median income, based on family size.

(2) If the care receiver's gross income is above forty percent of the state median income, he or she is required to pay for part or all of the cost of the respite care services. The department will determine what amount the participant must contribute based on the state median income and family size.

(3) If the care receiver's gross income is one hundred percent or more of the state median income, the participant must pay the full cost of the respite care services.

(4) If the care receiver is experiencing extreme financial hardship (e.g., high medical expenses) and cannot pay for their share of the cost of the respite care services, the area agency on aging may grant an exception to policy and then must document this in the client's records.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 12-13-040, § 388-106-1225, filed 6/13/12, effective 7/14/12
WSR 05-11-082, § 388-106-1225, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-1230 What determines emergent and nonemergent respite care services through the family caregiver support program?

(1) The department and the area agency on aging (AAA) must first consider requests for emergency respite care. An example of an emergency is when the caregiver becomes ill or injured to the extent that the caregiver's ability to care for the care receiver is impaired. AAA policies will determine how best to serve caregivers in crisis depending on available local FCSP funding. A caregiver must be screened in TCARE® within thirty days following the crisis if ongoing services exceeding five hundred dollars are requested.

(2) In nonemergency situations, respite care is allocated based upon the results of the TCARE® assessment and available local FCSP funds. If sufficient funds are not available when an eligible caregiver requests services, AAA may establish wait lists to prioritize clients receiving services as funding becomes available.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 12-13-040, § 388-106-1230, filed 6/13/12, effective 7/14/12
WSR 05-11-082, § 388-106-1230, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-1300 What rights do I have as a client of the department?

As a client of the department, you have a right to:

(1) Be treated with dignity, respect and without discrimination;

(2) Not be abused, neglected, financially exploited, abandoned;

(3) Have your property treated with respect;

(4) Not answer questions, turn down services, and not accept case management services you do not want to receive. However, it may not be possible for the department to offer some services if you do not give enough information;

(5) Be told about all services you can receive and make choices about services you want or don't want;

(6) Have information about you kept private within the limits of the laws and DSHS regulations;

(7) Be told in writing of agency decisions and receive a copy of your care plan;

(8) Make a complaint without fear of harm;

(9) Not be forced to answer questions or do something you don't want to;

(10) Talk with your social service worker's supervisor if you and your social service worker do not agree;

(11) Request a fair hearing;

(12) Have interpreter services provided to you free of charge if you cannot speak or understand English well;

(13) Take part in and have your wishes included in planning your care;

(14) Choose, fire, or change a qualified provider you want; and

(15) Receive results of the background check for any individual provider you choose.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-1300, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-1303 What responsibilities do I have as a client of the department?

As a client of the department, you have a responsibility to:

(1) Give us enough information to assess your needs;

(2) Let the social services worker into your home so that your needs can be assessed;

(3) Follow your care plan;

(4) Not act in a way that puts anyone in danger;

(5) Provide a safe work place;

(6) Tell your social services worker if there is a change in:

(a) Your medical condition;

(b) The help you get from family or other agencies;

(d) Your financial situation.

(7) Tell your social services worker if someone else makes medical or financial decision for you;

(8) Choose a qualified provider;

(9) Inform the department and your home care agency if an employee assigned by the home care agency is related to you by blood, marriage, adoption, or registered domestic partnership.

(10) Keep provider background checks private;

(11) Tell your social services worker if you are having problems with your provider; and

(12) Choose your own health care. Tell your social services worker when you do not do what your doctor says.

History

Statutory Authority: RCW 74.08.090, 74.09.520, 2009 c 571, and Washington state 2009-11 budget, section 206(17). WSR 10-06-112, § 388-106-1303, filed 3/3/10, effective 4/3/10. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.010 and 74.39A.020. WSR 06-05-022, § 388-106-1303, filed 2/6/06, effective 3/9/06.

Wash. Admin. Code § 388-106-1305 What if I disagree with the result of the CARE assessment and/or other eligibility decisions made by the department?

(1) You have a right to contest the result of your CARE assessment and/or other eligibility decisions made by the department. The department will notify you in writing of the right to contest a decision and provide you with information on how to request a hearing.

(2) Additionally, if you believe that you need more in-home personal care services than the CARE assessment has authorized for you, and you believe that your situation meets the criteria in WAC 388-440-0001(1) for an exception to rule (ETR), you may request additional personal care services.

(a) Requests may be made to your case manager or local HCS, AAA or DDA field office, either verbally or in writing.

(b) Requests that are approved at the field level will be forwarded to the ETR committee located in Olympia for a final decision.

(i) You will receive a written notification.

(ii) You may request a headquarters review of your request by contacting your case manager or local HCS, AAA or DDA field office or by contacting the headquarters committee directly.

(d) You will be notified in writing whether additional ETR hours are approved or if your request was denied.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 14-09-015, § 388-106-1305, filed 4/4/14, effective 5/5/14
WSR 05-11-082, § 388-106-1305, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-1310 When I request a fair hearing on my CARE assessment and another CARE assessment(s) is done between my fair hearing request and the fair hearing, which CARE assessment must the administrative law judge review?

When you request a fair hearing on your CARE assessment and another CARE assessment(s) is done between your fair hearing request and the fair hearing, the administrative law judge must review the most recent CARE assessment.

History

Statutory Authority: RCW 74.08.090, 74.09.520. WSR 05-11-082, § 388-106-1310, filed 5/17/05, effective 6/17/05.

Wash. Admin. Code § 388-106-1315 Do I have a right to an administrative hearing if my total in-home personal care hours or New Freedom budget approved as an exception to rule are reduced or terminated or if my increased residential payment rate approved as an exception to rule is reduced or terminated?

Notwithstanding WAC 388-440-0001(3), you have a right to an administrative hearing regarding the department's exception to rule decision if:

(1) You receive services in your own home, and:

(a) The total number of in-home personal care hours you are currently receiving includes in-home personal care hours approved as an exception to rule in addition to the number of in-home care hours determined to be available to you by CARE; and

(b) The total number of in-home personal care hours or New Freedom budget you are currently receiving is reduced because of a reduction or termination in the number of in-home personal care hours approved as an exception to rule.

(2) You receive services in a residential facility, and:

(a) You currently have an increased residential payment rate approved as an exception to rule; and

(b) Your increased residential payment rate that was approved as an exception to rule is reduced or terminated.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 13-18-039 and 13-17-125, § 388-106-1315, filed 8/29/13 and 8/21/13, effective 10/1/13. Statutory Authority: RCW 74.08.090, 74.09.520, chapters 74.39 and 74.39A RCW. WSR 07-01-046, § 388-106-1315, filed 12/14/06, effective 1/14/07.

Wash. Admin. Code § 388-106-1400 What services may I receive under New Freedom consumer directed services (NFCDS)?

(1) In order for services, supports, or items to be purchased under New Freedom, they must:

(a) Be for your sole benefit;

(b) Be at a reasonable cost;

(d) Be documented on your New Freedom spending plan defined in WAC 388-106-0010. The spending plan, which is established with the Care Consultant, documents how you will spend your service budget dollars.

(2) Your consultant may require a physician or other licensed professional, such as an occupational or physical therapist to recommend a specific purchase in writing. This recommendation is needed to ensure the service, support, or item will increase, maintain, or delay decline of functional abilities, and to ensure the purchase supports your health and welfare.

(3) Medicare or medicaid state plan benefits or other insurance must be used prior to using New Freedom funds if the goods or services are covered under these programs.

(4) You may use your individual budget to purchase services, supports, or items that fall into the following service categories:

(a) Personal assistance services, defined as supports involving the labor of another person to assist you to carry out activities you are unable to perform independently. Services may be provided in your home or in the community and may include:

(i) Direct personal care services defined as assistance with activities of daily living, as defined in WAC 388-106-0010. These must be provided by a qualified individual provider or AAA-contracted homecare agency as described in WAC 388-106-0040 (1) and (2);

(ii) Delegated nursing tasks, per WAC 246-841-405 and 388-71-05830. Providers of direct personal care services may be delegated by a registered nurse to provide nurse delegated tasks according to RCW 18.79.260 and WAC 246-840-910 through 246-840-970;

(iii) Other tasks or assistance with activities that support independent functioning, and are necessary due to your functional disability;

(iv) Personal assistance with transportation or assistance with instrumental activities of daily living (essential shopping, housework, and meal preparation).

(b) Treatment and health maintenance, defined as treatments or activities that are beyond the scope of the medicaid state plan that are necessary to promote your health and ability to live independently in the community and:

(i) Are provided for the purpose of preventing further deterioration of your level of functioning, or improving or maintaining your current level of functioning; and

(ii) Are performed or provided by people with specialized skill, registration, certification, or licenses as required by state law.

(c) Individual directed goods, services and supports, defined as services, equipment or supplies not otherwise provided through this waiver or through the medicaid state plan; and

(i) Will allow you to function more independently; or

(ii) Increase your safety and welfare; or

(iii) Allow you to perceive, control, or communicate with your environment; or

(iv) Assist you to transition from an institutional setting to your home. Transition services may include safety deposits, utility set-up fees or deposits, health and safety assurances such as pest eradication, allergen control or one-time cleaning prior to occupancy, moving fees, furniture, essential furnishings and basic items essential for basic living outside the institution. Transition services do not include rent, recreational or diverting items such as TV, cable or VCR/DVDs.

(d) Environmental or vehicle modifications, defined as alterations to your residence or vehicle that are necessary to accommodate your disability and promote your functional independence, health, safety, and welfare.

(i) Environmental modifications cannot be adaptations or improvements that are of general utility or merely add to the total square footage of the home.

(ii) Vehicles subject to modification must be owned by you or a member of your family who resides with you; must be in good working condition, licensed, and insured according to Washington state law; and be cost effective when compared to available alternative transportation.

(e) Training and educational supports, defined as supports beyond the scope of medicaid state plan services that are necessary to promote your health and ability to live and participate in the community and maintains, slows decline, or improves functioning and adaptive skills. Examples include:

(i) Training or education on your health issues, or personal skill development;

(ii) Training or education to paid or unpaid caregivers related to your needs.

(5) You may receive comprehensive adult dental services as defined in WAC 388-106-0300(15) through December 31, 2013. The cost of the dental services will not be deducted from your individual budget.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 22-18-047, § 388-106-1400, filed 8/30/22, effective 9/30/22
WSR 13-18-039 and 13-17-125, § 388-106-1400, filed 8/29/13 and 8/21/13, effective 10/1/13
WSR 10-08-074, § 388-106-1400, filed 4/6/10, effective 5/7/10. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.030. WSR 06-16-035, § 388-106-1400, filed 7/25/06, effective 8/25/06.

Wash. Admin. Code § 388-106-1405 What services are not covered under New Freedom consumer directed services (NFCDS)?

(1) Goods, services, and supports that are not consistent with the description in WAC 388-106-1400.

(2) Services, supports or items covered by the state plan, medicare, or other programs or services.

(3) Any fees related to health or long-term care incurred by you, including co-pays, waiver cost of care (participation), or insurance.

(4) Home modifications that merely add square footage to your home.

(5) Vacation or travel expenses other than the direct cost of provision of personal care services while on vacation (and you may not use New Freedom funds to pay travel expenses for your provider).

(6) Rent or room and board.

(7) Tobacco or alcohol products.

(8) Lottery tickets.

(9) Entertainment-related items such as televisions, cable, DVD players, stereos, radios, and other electronics, that are nonadaptive in nature.

(10) Vehicle purchases, maintenance, or upgrades that do not include maintenance to modifications related to disability.

(11) Tickets and related costs to attend sporting or other recreational events.

(12) Pets, therapy animals and their related costs (including food and veterinary services).

(13) Postage outside of shipping costs related to approved spending plan items.

(14) Experimental or investigational services, procedures, treatments, devices, drugs, or application of associated services, except when the individual factors of an individual client's condition justify a determination of medical necessity under WAC 182-500-0070.

(15) Monthly service fees for utilities.

(16) Warranties (for equipment, furnishings, or installations).

(17) Cosmetic services and treatments (i.e. manicures, pedicures, face lifts, etc).

(18) Basic groceries, clothing, and footwear.

(19) Any item previously purchased through medicaid funding that is within the health care authority replacement period.

(20) Any goods, services, or supports that are considered of general utility, meaning the service/good/support is not specific to the individuals' needs based on their disabilities or health conditions.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 22-18-047, § 388-106-1405, filed 8/30/22, effective 9/30/22
WSR 13-18-039 and 13-17-125, § 388-106-1405, filed 8/29/13 and 8/21/13, effective 10/1/13
WSR 10-08-074, § 388-106-1405, filed 4/6/10, effective 5/7/10.

Wash. Admin. Code § 388-106-1410 Am I eligible for New Freedom consumer directed services (NFCDS)-funded services?

You are eligible for NFCDS-funded services if you reside in your own home and meet all of the following criteria. The department must assess your needs using CARE and determine that:

(1) You are in NFCDS HCBS waiver specified target groups of:

(a) Eighteen or older and blind or have a physical disability; or

(b) Sixty-five or older; and

(2) You meet financial eligibility requirements described in WAC 182-513-1315. This means the department will assess your finances, determine if your income and resources fall within the limits, and determine the amount you may be required to contribute, if any, toward the cost of your care as described in WAC 182-515-1505; and

(3) You:

(a) Are not eligible for medicaid personal care services (MPC); or

(b) Are eligible for MPC services, but the department determines that the amount, duration, or scope of your needs is beyond what MPC can provide; and

(4) Your CARE assessment shows you need the level of care provided in a nursing facility as defined in WAC 388-106-0355; and

(5) You live in your own home, or will be living in your own home by the time NFCDS start.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 13-18-039 and 13-17-125, § 388-106-1410, filed 8/29/13 and 8/21/13, effective 10/1/13. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.030. WSR 06-16-035, § 388-106-1410, filed 7/25/06, effective 8/25/06.

Wash. Admin. Code § 388-106-1415 When do New Freedom consumer directed services (NFCDS) start?

Your New Freedom services begin the date personal care provider(s) are authorized to begin providing services or the spending plan is approved.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 13-18-039 and 13-17-125, § 388-106-1415, filed 8/29/13 and 8/21/13, effective 10/1/13. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.030. WSR 06-16-035, § 388-106-1415, filed 7/25/06, effective 8/25/06.

Wash. Admin. Code § 388-106-1420 How do I remain eligible for New Freedom consumer directed services (NFCDS)?

(1) In order to remain eligible for NFCDS, you must be in need of services in accordance with WAC 388-106-1410, as determined through a CARE assessment, and continue to meet the financial eligibility requirements in WAC 182-513-1315.

(a) The CARE assessment must be performed at least annually or more often when there are significant changes in your functional or financial circumstances.

(b) Your continued financial eligibility is reviewed annually.

(2) When eligibility statutes, regulations, and/or rules for NFCDS change, irrespective of whether your functional or financial circumstances have changed, if you do not meet the changed eligibility requirements, the department will terminate your NFCDS services.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 13-18-039 and 13-17-125, § 388-106-1420, filed 8/29/13 and 8/21/13, effective 10/1/13. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.030. WSR 06-16-035, § 388-106-1420, filed 7/25/06, effective 8/25/06.

Wash. Admin. Code § 388-106-1422 What happens to my New Freedom service dollar budget if I am temporarily hospitalized, placed in a nursing facility, or intermediate care facilities for intellectual disability (ICF/ID)?

If you are admitted to a hospital, nursing home, or ICF/ID, you cannot access or accumulate funds to your New Freedom service budget during your stay.

If you are institutionalized for 30 days or less and you intend to return to New Freedom when discharged, your service budget will be temporarily suspended while you are temporarily hospitalized for up to 30 days. Upon discharge home, if within 30 days, your service budget will be reinstated if you are still eligible for New Freedom services.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 22-18-047, § 388-106-1422, filed 8/30/22, effective 9/30/22
WSR 13-18-039 and 13-17-125, § 388-106-1422, filed 8/29/13 and 8/21/13, effective 10/1/13
WSR 10-08-074, § 388-106-1422, filed 4/6/10, effective 5/7/10.

Wash. Admin. Code § 388-106-1425 How do I pay for New Freedom consumer directed services (NFCDS)?

(1) Depending on your income, you may be required to pay participation toward the cost of your care, as described in WAC 182-515-1505. If you have nonexempt income that exceeds the cost of NFCDS services, you may keep the difference. Since you are receiving services in your own home, you are allowed to keep some of your income for a maintenance allowance.

(2) You are responsible to pay for your goods and services received up to your participation amount determined by the department. Any approved budget expenditures for goods and services you receive, which exceed your participation amount, will be paid by the department once your participation, if any, is accounted for.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 13-18-039 and 13-17-125, § 388-106-1425, filed 8/29/13 and 8/21/13, effective 10/1/13. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.030. WSR 06-16-035, § 388-106-1425, filed 7/25/06, effective 8/25/06.

Wash. Admin. Code § 388-106-1430 Can I be employed and receive New Freedom consumer directed services (NFCDS)?

You can be employed and receive NFCDS, if eligible, per WAC 182-515-1505.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 13-18-039 and 13-17-125, § 388-106-1430, filed 8/29/13 and 8/21/13, effective 10/1/13. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.030. WSR 06-16-035, § 388-106-1430, filed 7/25/06, effective 8/25/06.

Wash. Admin. Code § 388-106-1435 Who can direct New Freedom consumer directed services (NFCDS)?

You, as an NFCDS participant, direct your services. You may also designate, or a court may appoint, a representative to assist you in directing your services, or to direct your services on your behalf. A New Freedom designated representative cannot also be your paid provider.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 10-08-074, § 388-106-1435, filed 4/6/10, effective 5/7/10. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.030. WSR 06-16-035, § 388-106-1435, filed 7/25/06, effective 8/25/06.

Wash. Admin. Code § 388-106-1440 What is an individual budget?

An individual budget means the maximum amount of funding authorized by the department and allocated to the participant for the purchase of New Freedom consumer directed services.

History

Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.030. WSR 06-16-035, § 388-106-1440, filed 7/25/06, effective 8/25/06.

Wash. Admin. Code § 388-106-1445 How is the amount of the individual budget determined?

The department will calculate your individual budget amount after you are assigned a number of monthly hours resulting from completion of the comprehensive assessment reporting and evaluation tool, CARE. The calculation will be based on the average wage, including a mileage allowance, as determined by the collective bargaining agreement for individual provider personal care multiplied by the number of units generated by the assessment, multiplied by a factor of .93, plus an amount equal to the average per participant expenditures for nonpersonal care supports purchased in the COPES waiver.

History

Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-106-1445, filed 8/30/21, effective 10/1/21. Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 13-18-039 and 13-17-125, § 388-106-1445, filed 8/29/13 and 8/21/13, effective 10/1/13
WSR 10-08-074, § 388-106-1445, filed 4/6/10, effective 5/7/10. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.030. WSR 06-16-035, § 388-106-1445, filed 7/25/06, effective 8/25/06.

Wash. Admin. Code § 388-106-1450 Is the individual budget intended to fully meet all of my needs?

The program provides funds in an amount proportionate to the amount of resources you would receive through COPES, and gives you flexibility to self-direct the purchase of goods and services to address your long-term care needs. The degree to which the budget meets your needs depends on the supports you identify and prioritize in your spending plan. Depending on your decisions, after your budget is exhausted, some of your needs may be unmet, or you may find other resources to address them.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 13-18-039 and 13-17-125, § 388-106-1450, filed 8/29/13 and 8/21/13, effective 10/1/13. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.030. WSR 06-16-035, § 388-106-1450, filed 7/25/06, effective 8/25/06.

Wash. Admin. Code § 388-106-1455 What happens to individual budget funds when I don't use them?

(1) The balance of individual budget funds that were not allocated for purchase of personal care may be used to purchase other goods and services in accordance with the approved New Freedom spending plan or saved for future purchase as described in (2) below.

(2) Up to $3,500 may be held in savings for future purchases documented in the New Freedom spending plan.

(3) Reserves in excess of $3,500 may only be maintained for exceptional, planned purchases with preapproval from the department.

(4) Unused funds will revert back to the department under the following circumstances:

(a) You have savings funds in excess of $3,500 that are not identified for exceptional, pre-approved purchases in your spending plan;

(b) You disenroll from New Freedom;

(d) You are hospitalized, in a nursing home, or ICF/ID for over 30 days; or

(e) You have personal care funds not used in the month for which you allocated them.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 22-18-047, § 388-106-1455, filed 8/30/22, effective 9/30/22
WSR 13-18-039 and 13-17-125, § 388-106-1455, filed 8/29/13 and 8/21/13, effective 10/1/13
WSR 10-08-074, § 388-106-1455, filed 4/6/10, effective 5/7/10. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.030. WSR 06-16-035, § 388-106-1455, filed 7/25/06, effective 8/25/06.

Wash. Admin. Code § 388-106-1458 How do I create and use my spending plan?

(1) You create your spending plan in collaboration with your care consultant using the CARE tool.

(2) The spending plan must be approved by both you and the care consultant.

(3) You, as the participant, must identify how many personal care service units you intend to purchase prior to the month you plan to use them (service month).

(4) The value of those units is deducted from your new freedom budget.

(5) The rest of the funds can be used for other covered goods and services or saved.

(6) Once a service month begins, the number of personal care units may not be altered during that month.

(7) The maximum number of personal care units that can be purchased from the monthly budget is calculated from the individual budget as described in WAC 388-106-1445, divided by the individual provider average wage including mileage.

(8) Prior to the service month, you may elect to use savings funds to buy additional personal care.

(9) You may choose to have your personal care provided by an individual provider (IP) or a home care agency.

(10) Each unit will be deducted from your new freedom budget at the average IP wage rate including mileage.

(11) The balance of your individual new freedom budget will be available in your NFSP to save or purchase other goods and services up to the limit described in WAC 388-106-1455(2).

(12) If you have a change of condition or situation and your new freedom budget increases due to a new assessment or exception to rule, you may purchase additional personal care from an IP or home care agency mid-month at the average IP rate, including mileage during the month your budget changed.

(13) You may assign your predetermined personal care units to a different provider during the month of service.

(14) Under chapter 388-114 WAC, individual providers for one or more department clients who work more than 40 hours in a work week, are entitled to overtime and the responsibility for paying the extra cost as follows:

(a) If the individual provider is contracted with the department and approved to work more than 40 hours per week as described in WAC 388-114-0080, the department will pay the extra cost for overtime up to the number of service hours the individual provider is approved to work and the payment for these extra costs will not be charged to your budget; and

(b) If you assign more overtime hours to your individual provider than the department approved, you must pay the extra costs for the unapproved overtime hours and the additional cost will impact your monthly budget and may reduce the number of service hours you are able to purchase from it.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 22-18-047, § 388-106-1458, filed 8/30/22, effective 9/30/22. Statutory Authority: RCW 74.08.090, 74.09.520, 43.43.832, 74.39A.270, 74.39A.056, 74.39A.074, 43.20A.710, 74.39A.525, 43.43.842, 74.39A.326, 74.39A.515, 74.39A.505, 18.88B.021, 43.43.837 and 2018 c 278. WSR 21-18-081, § 388-106-1458, filed 8/30/21, effective 10/1/21. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.270, and 2016 1st sp.s. c 30. WSR 17-08-065, § 388-106-1458, filed 3/31/17, effective 5/1/17. Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 13-18-039 and 13-17-125, § 388-106-1458, filed 8/29/13 and 8/21/13, effective 10/1/13.

Wash. Admin. Code § 388-106-1460 When can my New Freedom spending plan (NFSP) be denied?

Your NFSP may be denied when the plan you develop includes noncovered items from WAC 388-106-1405 and/or does not:

(a) Include only services in the New Freedom service definition found in WAC 388-106-1400;

(b) Address your needs as it relates to performance of activities of daily living and instrumental activities of daily living;

(d) Identify a reasonable payment rate; or

(e) Adequately describe the service.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 13-18-039 and 13-17-125, § 388-106-1460, filed 8/29/13 and 8/21/13, effective 10/1/13. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.030. WSR 06-16-035, § 388-106-1460, filed 7/25/06, effective 8/25/06.

Wash. Admin. Code § 388-106-1465 Who can deny my New Freedom spending plan (NFSP)?

Your plan can be denied by your New Freedom consultant, who assists NFCDS participants to develop and use a New Freedom spending plan to:

(a) Address identified personal care, health and safety needs;

(b) Develop options to meet those needs;

(d) Obtain identified supports and services.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 13-18-039 and 13-17-125, § 388-106-1465, filed 8/29/13 and 8/21/13, effective 10/1/13. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.030. WSR 06-16-035, § 388-106-1465, filed 7/25/06, effective 8/25/06.

Wash. Admin. Code § 388-106-1470 Are there waiting lists for New Freedom consumer directed services (NFCDS)?

The department will create a waiting list for NFCDS in accordance with caseload limits determined by legislative funding. Participants on the waiting list will gain access in the following order:

(1) Nursing home residents who are returning home and are assessed for NFCDS waiver services will be ranked first on the waiting list by date of application for services;

(2) Individuals living in the community with a higher level of need, as determined by the CARE assessment, will be ranked higher on the waitlist over participants with a lower level of need; and

(3) When two or more individuals on the waiting list have equal need levels, the individual with the earlier application for NFCDS will have priority over later applications for services.

History

Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.030. WSR 06-16-035, § 388-106-1470, filed 7/25/06, effective 8/25/06.

Wash. Admin. Code § 388-106-1475 How do I end enrollment in New Freedom consumer directed services (NFCDS)?

(1) You may choose to voluntarily end your enrollment from NFCDS without cause at any time. To do so, you must give notice to the department. If you give notice:

(a) Before the 15th of the month, the department will end your enrollment at the end of the month; or

(b) After the 15th, the department will end your enrollment the end of the following month.

(2) Your enrollment may also end involuntarily if you:

(a) Move out of the designated service area or are out of the service area for more than 30 consecutive days, unless you have documented the purpose of the longer absence in the NFSP; or

(b) Do not meet the terms for consumer direction of services outlined in the New Freedom Participant Responsibility Agreement when:

(i) Even with coaching and collaboration, you are unable to develop a NFSP or self-direct services or manage your individual budget or NFSP;

(ii) Any one factor or several factors of such a magnitude jeopardize the health, welfare, and safety of you and others, requiring termination of services under WAC 388-106-0047;

(iii) You become financially ineligible for medicaid services;

(iv) You no longer meet the nursing facility level of care requirement as defined in WAC 388-106-0355;

(v) You misuse program funds and services as determined by the department; or

(vi) You are unable to follow the responsibilities of a participant on the New Freedom program as determined by the department.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 22-18-047, § 388-106-1475, filed 8/30/22, effective 9/30/22
WSR 13-18-039 and 13-17-125, § 388-106-1475, filed 8/29/13 and 8/21/13, effective 10/1/13. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.030. WSR 06-16-035, § 388-106-1475, filed 7/25/06, effective 8/25/06.

Wash. Admin. Code § 388-106-1480 What are my hearing rights to appeal New Freedom consumer directed services (NFCDS) assessment and eligibility actions?

You have a right to a hearing under WAC 388-106-1300 through 388-106-1315, and under chapter 182-526 WAC.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 13-18-039 and 13-17-125, § 388-106-1480, filed 8/29/13 and 8/21/13, effective 10/1/13. Statutory Authority: RCW 74.08.090, 74.09.520, 74.39A.030. WSR 06-16-035, § 388-106-1480, filed 7/25/06, effective 8/25/06.

Wash. Admin. Code § 388-106-1600 What definitions apply to the nursing facility certificate of need?

"Activities of daily living", as defined in WAC 388-106-0010, includes tasks such as walking, eating, taking medications, maintaining personal hygiene, moving in bed and toileting.

"Care assessment" is an assessment tool used to determine eligibility for services and level of service need, and identify strengths, preferences and potential referrals to develop an individualized care plan.

"Certificate of need program" is a regulatory process under chapter 70.38 RCW that requires certain health care providers, including nursing homes, to receive approval from the department of health before building certain types of facilities or offering new or expanded services.

"Community residential" refers to licensed community settings such as assisted living facilities and adult family homes where long-term care services are provided to residents.

"Department" means the department of social and health services.

"Department of health" is the state agency that operates the certificate of need review program and determines the need for specific facilities and services, including nursing homes, in a manner that is consistent with the statewide health resources strategy developed under RCW 43.370.030 and chapter 70.38.

"In-home personal care" is care provided by an agency or individual provider to clients living in their own home.

"Minimum data set" or "MDS" is a tool that is used to perform the comprehensive assessment of each resident's functional capabilities, which is required for all residents in medicare or medicaid certified nursing homes.

"RUG-III score" is the classification of each nursing facility resident into a specific group based on the individual's medical condition and level of care required.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 14-05-061, § 388-106-1600, filed 2/18/14, effective 3/21/14.

Wash. Admin. Code § 388-106-1610 What is the purpose of determining nursing facility comparable home and community-based long-term capacity?

The department of health's certificate of need program is required to determine the need for nursing homes under WAC 246-310-210 (6)(b)(ii). The determination of need is based in part upon the availability of home and community-based long-term services in the planning area of the proposed nursing facility. When evaluating the need for additional nursing home beds, the data considered by the department of health must include data provided by the department.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 14-05-061, § 388-106-1610, filed 2/18/14, effective 3/21/14.

Wash. Admin. Code § 388-106-1620 What methodology does the department use to determine statewide or county specific nursing home comparable home and community-based long-term services availability?

The department uses the following methodology to determine the statewide or county specific nursing home comparable home and community-based long-term services availability.

(1) The department selects a recent, one-year time period from which to use MDS assessment data.

(2) The "typical RUG-III ADL score" is determined as follows. From the MDS data, two activity of daily living (ADL) RUG-III score values are calculated: (1) the mean RUG-III ADL score, rounded to the nearest whole number, and (2) the modal RUG-III ADL score that occurs most commonly in the nursing home population in the selected time period. The "typical RUG-III ADL score" is the lower of the mean and modal values.

(3) Using the most recent month that both payment and assessment data are considered to be complete, persons receiving medicaid paid in-home personal care or community residential services are identified, and the MDS-equivalent ADL score from each home and community-based client's current CARE assessment is constructed.

(4) Using data from the month selected in subsection (3), count the number of in-home personal care clients being served by either the aging and long-term support or developmental disabilities administrations who have an MDS-equivalent score at or above the typical RUG-III ADL nursing home score that was calculated in subsection (2).

(5) Using data from the month selected in subsection (3), calculate the proportion of medicaid-paid community residential clients with an MDS-equivalent score that is at or above the typical RUG-III ADL nursing home score calculated in subsection (2).

(a) When determining county level measures of nursing home comparable home and community based capacity, the statewide average for medicaid paid community residential clients is used.

(6) Calculate the overall statewide licensed capacity of community residential facilities.

(7) The proportion calculated in subsection (5) and the community residential capacity determined in subsection (6) are multiplied to estimate the community residential capacity that is nursing home comparable.

(8) Add the numbers calculated in subsections (4) and (7) to determine the total countable nursing-home-comparable home and community-based long–term capacity to be used in reporting to the department of health the availability of other services in the community as required in RCW 70.38.115.

History

Statutory Authority: RCW 74.08.090 and 74.09.520. WSR 14-05-061, § 000-106-1620 (codified as WAC 388-106-1620), filed 2/18/14, effective 3/21/14.

Wash. Admin. Code § 388-106-1700 What definitions apply to supportive housing?

The following definitions apply to WAC 388-106-1700 through 388-106-1765:

"Supportive housing tenant" is a person utilizing voluntary supportive services who is:

(1) Living in a stable community setting of their choosing including hotels/motels; or

(2) Entitled to occupy a dwelling unit primarily for living or dwelling purposes under a rental agreement pursuant to chapter 59.18 RCW.

History

Statutory Authority: RCW 74.08.090, 74.08.283, and 74.08.390. WSR 25-20-014, s 388-106-1700, filed 9/19/25, effective 10/20/25
WSR 17-11-016, § 388-106-1700, filed 5/9/17, effective 6/9/17.

Wash. Admin. Code § 388-106-1705 What services may I receive under supportive housing?

(1) The services you may receive under supportive housing include, but are not limited to, activities that assist you to:

(a) Identify appropriate housing;

(b) Prepare for and transition to housing;

(d) Maintain your housing;

(e) Develop and maintain a positive relationship with your landlord and other tenants; and

(f) Integrate into your community and support social inclusion.

(2) The services you receive will be identified in your assessment as defined in WAC 388-106-0010.

History

Statutory Authority: RCW 74.08.090, 74.08.283, and 74.08.390. WSR 25-20-014, s 388-106-1705, filed 9/19/25, effective 10/20/25
WSR 17-11-016, § 388-106-1705, filed 5/9/17, effective 6/9/17.

Wash. Admin. Code § 388-106-1710 Where may I receive supportive housing services?

(1) You may receive supportive housing services in:

(a) Your place of residence; or

(b) The community setting where the authorized service occurs.

(2) Supportive housing services must be provided in:

(a) Washington state or a recognized out-of-state bordering city as defined in WAC 182-501-0175;

(b) An integrated setting of your choice; and

(3) Once you are a supportive housing tenant, your supportive housing services must be provided in a setting as defined in 42 C.F.R. Sec. 441.530, such as those that:

(a) Do not have the qualities of an institution;

(b) Are not located in a building that is also a publicly or privately operated facility providing inpatient institutional treatment;

(d) Do not have the effect of isolating you from community members who are not receiving medicaid services; and

(e) Are not a licensed residential care facility such as an adult family or assisted living facility.

History

Statutory Authority: RCW 74.08.090, 74.08.283 and 74.08.390. WSR 17-11-016, § 388-106-1710, filed 5/9/17, effective 6/9/17.

Wash. Admin. Code § 388-106-1715 Who may provide supportive housing services?

To provide supportive housing services, supportive housing providers must meet minimum qualifications as established by DSHS supportive housing contract language and pass a DSHS criminal history background check.

History

Statutory Authority: RCW 74.08.090, 74.08.283 and 74.08.390. WSR 17-11-016, § 388-106-1715, filed 5/9/17, effective 6/9/17.

Wash. Admin. Code § 388-106-1720 Am I eligible for supportive housing funded services?

You are eligible for supportive housing services if you meet the following criteria:

(1) Meet functional eligibility as defined in WAC 388-106-0210, 388-106-0277, 388-106-0310, 388-106-0338, or 388-106-1410;

(2) Meet financial eligibility as defined in chapters 182-513 and 182-515 WAC;

(3) Have a planned discharge or diversion from Eastern or Western State Hospital; or

(4) Meet foundational community supports program (FCS) supportive housing eligibility as defined by chapter 182-559 WAC.

History

Statutory Authority: RCW 74.08.090, 74.08.283, and 74.08.390. WSR 25-20-014, s 388-106-1720, filed 9/19/25, effective 10/20/25. Statutory Authority: RCW 74.08.090. WSR 18-08-002, § 388-106-1720, filed 3/21/18, effective 4/21/18. Statutory Authority: RCW 74.08.090, 74.08.283 and 74.08.390. WSR 17-11-016, § 388-106-1720, filed 5/9/17, effective 6/9/17.

Wash. Admin. Code § 388-106-1725 When do supportive housing services begin?

Your supportive housing services begin on the date the department authorizes your supportive housing services.

History

Statutory Authority: RCW 74.08.090, 74.08.283 and 74.08.390. WSR 17-11-016, § 388-106-1725, filed 5/9/17, effective 6/9/17.

Wash. Admin. Code § 388-106-1730 How do I remain eligible for supportive housing?

(1) To remain eligible for supportive housing you must remain functionally eligible as defined in WAC 388-106-0210, 388-106-0277, 388-106-0310, 388-106-0338, or 388-106-1410 and financially eligible as defined in chapters 182-513 and 182-515 WAC.

(2) If eligibility laws, regulations, or rules for supportive housing change, and if you do not meet the changed eligibility requirements, the department will terminate your services, even if your functional or financial circumstances have not changed.

History

Statutory Authority: RCW 74.08.090, 74.08.283 and 74.08.390. WSR 17-11-016, § 388-106-1730, filed 5/9/17, effective 6/9/17.

Wash. Admin. Code § 388-106-1735 Do I have to pay for my supportive housing services?

The department will not require you to pay toward the cost of your supportive housing services.

History

Statutory Authority: RCW 74.08.090, 74.08.283 and 74.08.390. WSR 17-11-016, § 388-106-1735, filed 5/9/17, effective 6/9/17.

Wash. Admin. Code § 388-106-1745 May I be employed and receive supportive housing services?

You may be employed and receive supportive housing services as long as you remain medicaid eligible under the categorically needy (CN) program or alternative benefit plan (ABP) program.

History

Statutory Authority: RCW 74.08.090, 74.08.283 and 74.08.390. WSR 17-11-016, § 388-106-1745, filed 5/9/17, effective 6/9/17.

Wash. Admin. Code § 388-106-1750 Are there limits to the supportive housing services I receive?

There are limits to the supportive housing services you receive. Supportive housing services must not:

(1) Exceed the amount authorized by the department;

(2) Replace or duplicate existing services already available to you such as foundational community supports as defined in WAC 182-559-100.

History

Statutory Authority: RCW 74.08.090, 74.08.283, and 74.08.390. WSR 25-20-014, s 388-106-1750, filed 9/19/25, effective 10/20/25
WSR 17-11-016, § 388-106-1750, filed 5/9/17, effective 6/9/17.

Wash. Admin. Code § 388-106-1755 Are there waiting lists for supportive housing?

The department may create a waiting list for supportive housing services in accordance with funding appropriation.

History

Statutory Authority: RCW 74.08.090, 74.08.283 and 74.08.390. WSR 17-11-016, § 388-106-1755, filed 5/9/17, effective 6/9/17.

Wash. Admin. Code § 388-106-1765 When may the department terminate or deny supportive housing services?

The department may deny or terminate supportive housing services if you are not eligible for long-term care services pursuant to WAC 388-106-0047, 388-106-0210, 388-106-0277, 388-106-0310, 388-106-0338, or 388-106-1410.

History

Statutory Authority: RCW 74.08.090, 74.08.283 and 74.08.390. WSR 17-11-016, § 388-106-1765, filed 5/9/17, effective 6/9/17.

Wash. Admin. Code § 388-106-1800 What definitions apply to LTSS PE?

"Abbreviated care plan" means the document generated using the presumptive eligibility screening tool in CARE that identifies the long-term services and supports you are eligible to receive during the presumptive eligibility period under step 1.

"Acute care hospital" as defined in chapter 182-550 WAC, may offer inpatient services, outpatient services, continuous nursing services, pharmacy services, food services, and necessary ancillary services. These hospitals may offer specialized patient care services including alcoholism and chemical dependency units or services.

"Comprehensive assessment reporting evaluation tool" or "CARE" means the department prescribed assessment tool.

"Care plan" means the document generated using the presumptive eligibility assessment tool in CARE that identifies the long-term services and supports you are eligible to receive during the presumptive eligibility period under step 2.

"Community psychiatric hospital" means a specialized psychiatric hospital or psychiatric unit within a community hospital that is certified to provide involuntary evaluation and treatment services.

"Diversion" means you have discharged from a local community psychiatric facility onto HCS LTSS and have a 90- or 180-day commitment order for further involuntary treatment; or you are detained through the Involuntary Treatment Act and are stabilized and discharged onto LTSS prior to the need to petition for a 90- or 180- day commitment order.

"Home and community services" or "HCS" means a division within the DSHS home and community living administration (HCLA).

"LTSS" means long-term services and supports as defined in WAC 182-513-1100.

"MPC" means medicaid personal care which is defined as personal care services in WAC 388-106-0010.

"NFLOC" means nursing facility level of care as defined in WAC 388-106-0355.

"PE assessment" means the questions asked, using the presumptive eligibility assessment tool within CARE, to determine the level of care that is needed and opens step 1 and 2 services.

"PE screening" means the minimum functional and financial abbreviated questionnaire to obtain the minimum information necessary, completed using the presumptive eligibility screening tool within CARE, to determine presumptive eligibility for LTSS NFLOC PE services or LTSS MPC PE services.

"Presumptive eligibility" means a determination made using a screening process completed by the department to gather preliminary information to determine if you meet the eligibility criteria described in WAC 388-106-1805 and 388-106-1815 of this section to receive services while the final eligibility determination is being completed. This is also known as PE.

History

Statutory Authority: RCW 74.08.090 and 74.39A.030. WSR 26-07-011, s 388-106-1800, filed 3/6/26, effective 4/6/26
WSR 23-21-012, § 388-106-1800, filed 10/5/23, effective 11/6/23.

Wash. Admin. Code § 388-106-1805 Am I eligible for LTSS NFLOC PE services?

You are eligible to receive LTSS NFLOC PE services if you meet the following criteria based upon the attested information in your PE screening:

(1) Meet functional eligibility requirements as defined in WAC 388-106-0355 (1)(a), (b), (c), or (d); and

(2) Meet financial eligibility requirements as defined in WAC 182-513-1315; and

(3) Live in your own home as defined in WAC 388-106-0010; and

(4) Are not receiving any other medicaid funded long-term services and supports.

History

Statutory Authority: RCW 74.08.090 and 74.39A.030. WSR 26-07-011, s 388-106-1805, filed 3/6/26, effective 4/6/26
WSR 23-21-012, § 388-106-1805, filed 10/5/23, effective 11/6/23.

Wash. Admin. Code § 388-106-1810 What services may I receive under LTSS NFLOC PE?

You may receive LTSS NFLOC PE services under either of the two steps depending on your needs and requests identified in the LTSS PE screening for step 1 or the LTSS PE assessment for step 2. Steps do not need to be used in order. For example, you may begin services at step 1 or 2. In general, step 1 services are used by clients requesting lesser supports than those using step 2 services.

(1) Step 1: After completing an LTSS PE screening and abbreviated care plan, you may receive any of the following services:

(a) Personal emergency response system (PERS), as defined in WAC 388-106-0270;

(b) Home delivered meals, as defined in WAC 388-106-0300;

(2) Step 2: After completing an LTSS PE assessment and care plan, you may receive any of the services under step 1 or one or more of the following services:

(a) Nurse delegation, as defined in WAC 388-106-0270;

(b) Specialized medical equipment and supplies, as defined in WAC 388-106-0300;

(c) Community transition or sustainability services as defined in WAC 388-106-0270, which are nonrecurring set-up items and services to assist with expenses to move from an acute care hospital or diversion from a psychiatric hospital stay to an in-home setting and may include:

(i) Security deposits that are required to lease an apartment or home;

(ii) Activities to assess need, arrange for, and obtain needed resources, including essential household furnishings;

(iii) Set-up fees or deposits for utility or services access, including telephone, electricity, heating, water, and garbage;

(iv) Services necessary for your health and safety such as pest eradication and one-time cleaning prior to occupancy;

(v) Moving expenses; and

(vi) Minor home accessibility modifications necessary for hospital discharge.

(d) Community choice guide: Specialty services providing assistance and support to ensure an individual's successful transition to the community, or maintenance of independent living, as defined in WAC 388-106-0300; and

(e) Supportive housing as defined in chapter 388-106 WAC.

(f) Up to a maximum of 103 hours a month of personal care services, as defined in WAC 388-106-0010;

(i) The number of hours of personal care services you can receive in your own home is determined by five-tier classifications using the CARE tool to assess your characteristics.

(ii) The number of hours of personal care services you may receive for the five tier classifications are:

(A) Tier 1 is a maximum of 34 hours.

(B) Tier 2 is a maximum of 47 hours.

(D) Tier 4 is a maximum of 69 hours.

(E) Tier 5 is a maximum of 103 hours.

(iii) The CARE tool uses the following criteria to place you in a tier classification group:

(A) To be eligible for tier 1 classification, you have:

(I) An unmet or partially met need with at least three of the following activities of daily living, as defined in WAC 388-106-0010: or

| For each activity of daily living, the minimum level of assistance required in each of the following categories: | | | | --- | --- | --- | | | Self-performance is: | Support provided is: | | Eating | n/a | Setup | | Toileting | Supervision | n/a | | Bathing | Supervision | n/a | | Transfer | Supervision | Setup | | Bed mobility | Supervision | Setup | | Walk in room, or locomotion in room, or locomotion outside immediate living environment | Supervision | Setup | | Medication management | Assistance required | n/a | | Your need for assistance in any activities listed in this chart did not occur because you were unable or no provider was available to assist you will be counted for the purpose of determining your functional eligibility. | | |

(II) A cognitive impairment and require supervision due to one or more of the following: disorientation, memory impairment, impaired decision making, or wandering; and

(III) An unmet or partially met need with at least one or more of the following:

| For each activity of daily living, the minimum level of assistance required in each of the following categories: | | | | --- | --- | --- | | | Self-performance is: | Support provided is: | | Eating | Supervision | One-person physical assist | | Toileting | Extensive assistance | One-person physical assist | | Bathing | Physical help with bathing | One-person physical assist | | Transfer | Extensive assistance | One-person physical assist | | Bed mobility and turning and repositioning | Limited assistance and need | One-person physical assist | | Walk in room, or locomotion in room, or locomotion outside immediate living environment | Extensive assistance | One-person physical assist | | Medication management | Assistance required daily | n/a | | Your need for assistance in any activities listed in this chart did not occur because you were unable or no provider was available to assist you will be counted for the purpose of determining your functional eligibility. | | |

(B) To be eligible for tier 2 classification, you:

(I) Require care provided by or under the supervision of a registered nurse or a licensed practical nurse on a daily basis; or

(II) Have an unmet or partially met need with at least two of the following activities of daily living, as defined in WAC 388-106-0010:

| For each activity of daily living, the minimum level of assistance required in each of the following categories: | | | | --- | --- | --- | | | Self-performance is: | Support provided is: | | Eating | Supervision | One-person physical assist | | Toileting | Extensive assistance | One-person physical assist | | Bathing | Physical help with bathing | One-person physical assist | | Transfer | Extensive assistance | One-person physical assist | | Bed mobility and turning and repositioning | Limited assistance and need | One-person physical assist | | Walk in room, or locomotion in room, or locomotion outside immediate living environment | Extensive assistance | One-person physical assist | | Medication management | Assistance required daily | n/a | | Your need for assistance in any activities listed in this chart did not occur because you were unable or no provider was available to assist you will be counted for the purpose of determining your functional eligibility. | | |

(C) To be eligible for tier 3 classification, you have an unmet or partially met need with at least three of the following activities of daily living, as defined in WAC 388-106-0010:

| For each activity of daily living, the minimum level of assistance required in each of the following categories: | | | | --- | --- | --- | | | Self-performance is: | Support provided is: | | Eating | Supervision | One-person physical assist | | Toileting | Extensive assistance | One-person physical assist | | Bathing | Physical help with bathing | One-person physical assist | | Transfer | Extensive assistance | One-person physical assist | | Bed mobility and turning and repositioning | Limited assistance and need | One-person physical assist | | Walk in room, or locomotion in room, or locomotion outside immediate living environment | Extensive assistance | One-person physical assist | | Medication management | Assistance required daily | n/a | | Your need for assistance in any activities listed in this chart did not occur because you were unable or no provider was available to assist you will be counted for the purpose of determining your functional eligibility. | | |

(D) To be eligible for tier 4 classification, you:

(I) Require care provided by or under the supervision of a registered nurse or a licensed practical nurse on a daily basis; and

(II) Have an unmet or partially met need with at least three of the following activities of daily living, as defined in WAC 388-106-0010:

| For each activity of daily living, the minimum level of assistance required in each of the following categories: | | | | --- | --- | --- | | | Self-performance is: | Support provided is: | | Eating | Supervision | One-person physical assist | | Toileting | Extensive assistance | One-person physical assist | | Bathing | Physical help with bathing | One-person physical assist | | Transfer | Extensive assistance | One-person physical assist | | Bed mobility and turning and repositioning | Limited assistance and need | One-person physical assist | | Walk in room, or locomotion in room, or locomotion outside immediate living environment | Extensive assistance | One-person physical assist | | Medication management | Assistance required daily | n/a | | Your need for assistance in any activities listed in this chart did not occur because you were unable or no provider was available to assist you will be counted for the purpose of determining your functional eligibility. | | |

(E) To be eligible for tier 5 classification, you:

(I) Are bedfast/chairfast, as defined by you are confined primarily to a bed or recliner, or if you are wheelchair dependent when not in a bed or recliner; and

(II) Require care provided by or under the supervision of a registered nurse or a licensed practical nurse on a daily basis; and

(III) Have an unmet or partially met need with at least three of the following activities of daily living, as defined in WAC 388-106-0010:

| For each activity of daily living, the minimum level of assistance required in each of the following categories: | | | | --- | --- | --- | | | Self-performance is: | Support provided is: | | Eating | Supervision | One-person physical assist | | Toileting | Extensive assistance | One-person physical assist | | Bathing | Physical help with bathing | One-person physical assist | | Transfer | Extensive assistance | One-person physical assist | | Bed mobility and turning and repositioning | Limited assistance and need | One-person physical assist | | Walk in room, or locomotion in room, or locomotion outside immediate living environment | Extensive assistance | One-person physical assist | | Medication management | Assistance required daily | n/a | | Your need for assistance in any activities listed in this chart did not occur because you were unable or no provider was available to assist you will be counted for the purpose of determining your functional eligibility. | | |

History

Statutory Authority: RCW 74.08.090 and 74.39A.030. WSR 26-07-011, s 388-106-1810, filed 3/6/26, effective 4/6/26
WSR 23-21-012, § 388-106-1810, filed 10/5/23, effective 11/6/23.

Wash. Admin. Code § 388-106-1815 Am I eligible for LTSS MPC PE services?

You are eligible to receive LTSS MPC PE services if you meet the following criteria based upon the attested information in your PE screening:

(1) Meet functional eligibility requirements as defined in WAC 388-106-0210; and

(2) Meet financial eligibility requirements as defined in WAC 182-513-1225; and

(3) Live in your own home as defined in WAC 388-106-0010; and

(4) Are not receiving any other medicaid funded long-term services and supports.

History

Statutory Authority: RCW 74.08.090 and 74.39A.030. WSR 26-07-011, s 388-106-1815, filed 3/6/26, effective 4/6/26
WSR 23-21-012, § 388-106-1815, filed 10/5/23, effective 11/6/23.

Wash. Admin. Code § 388-106-1820 What services may I receive under LTSS MPC PE?

Under LTSS MPC PE you may receive up to 34 hours per month of personal care services as defined in WAC 388-106-0010.

History

Statutory Authority: RCW 74.08.090 and 74.39A.030. WSR 23-21-012, § 388-106-1820, filed 10/5/23, effective 11/6/23.

Wash. Admin. Code § 388-106-1825 Who can provide long-term care services when I am eligible for LTSS NFLOC or LTSS MPC PE services?

The following types of providers can provide long-term care services:

(1) Individual providers (IPs) as defined in WAC 388-115-0503, who provide services to clients in the client's own home.

(2) Home care agencies that provide services to clients in the client's own home. Home care agencies must be licensed under chapter 70.127 RCW and chapter 246-335 WAC and contracted with the department.

(3) Providers who have contracted with the department to perform other services.

History

Statutory Authority: RCW 74.08.090 and 74.39A.030. WSR 23-21-012, § 388-106-1825, filed 10/5/23, effective 11/6/23.

Wash. Admin. Code § 388-106-1830 When will the department authorize my LTSS NFLOC or LTSS MPC PE services?

The department will authorize LTSS NFLOC PE or LTSS MPC PE services when you:

(1) Are found both financially and functionally eligible for PE services by completing your PE screening which includes the amount of participation toward the cost of your care that you must pay (if any);

(2) Have given consent for services and approved your care plan; and

(3) Have chosen a DSHS qualified provider(s), per WAC 388-71-0510.

History

Statutory Authority: RCW 74.08.090 and 74.39A.030. WSR 23-21-012, § 388-106-1830, filed 10/5/23, effective 11/6/23.

Wash. Admin. Code § 388-106-1835 When do LTSS NFLOC PE or LTSS MPC PE services end?

(1) Your LTSS NFLOC PE or LTSS MPC PE services end with the earlier date of:

(a) The date the decision was made on your application as defined in WAC 388-106-0010;

(b) The date you were confirmed by a CARE assessment to not meet functional eligibility criteria as defined in WAC 388-106-0355 or 388-106-0210; or

(c) The last day of the month following the month in which your presumptive eligibility services were authorized if you did not submit your application.

(2) You may only receive LTSS NFLOC PE or LTSS MPC PE services once within a 24-month period.

History

Statutory Authority: RCW 74.08.090 and 74.39A.030. WSR 23-21-012, § 388-106-1835, filed 10/5/23, effective 11/6/23.

Wash. Admin. Code § 388-106-1840 Where can I receive LTSS NFLOC PE or LTSS MPC PE services?

You can receive LTSS NFLOC PE or LTSS MPC PE services:

(1) In your own home as defined in WAC 388-106-0010;

(2) While you are out of your home accessing the community or working while:

(a) within the state of Washington; or

(b) in a recognized out-of-state bordering city as defined in WAC 182-501-0175.

History

Statutory Authority: RCW 74.08.090 and 74.39A.030. WSR 23-21-012, § 388-106-1840, filed 10/5/23, effective 11/6/23.

Wash. Admin. Code § 388-106-1845 What do I pay for if I receive LTSS NFLOC PE or LTSS MPC PE services?

(1) If you receive LTSS MPC PE services you are not required to pay toward the cost of care for those services.

(2) If you receive LTSS NFLOC PE, you may be required to pay toward the cost of your care as outlined in WAC 182-515-1509. You are allowed to keep some of your income for a maintenance allowance.

History

Statutory Authority: RCW 74.08.090 and 74.39A.030. WSR 23-21-012, § 388-106-1845, filed 10/5/23, effective 11/6/23.

Wash. Admin. Code § 388-106-1850 Do I have a right to an administrative hearing on LTSS NFLOC PE or LTSS MPC PE determinations?

Applicants do not have an administrative hearing right as defined in chapter 388-02 WAC on LTSS NFLOC PE or LTSS MPC PE eligibility determinations.

History

Statutory Authority: RCW 74.08.090 and 74.39A.030. WSR 23-21-012, § 388-106-1850, filed 10/5/23, effective 11/6/23.

Wash. Admin. Code § 388-106-1855 Can an exception to rule (ETR) be granted for eligibility or service determinations?

ETRs will not be granted for LTSS NFLOC PE or LTSS MPC PE eligibility determinations or service determinations.

History

Statutory Authority: RCW 74.08.090 and 74.39A.030. WSR 23-21-012, § 388-106-1855, filed 10/5/23, effective 11/6/23.

Wash. Admin. Code § 388-106-1900 What definitions apply to MAC and TSOA services?

The following definitions apply to MAC and TSOA services:

"Care plan" means the plan developed by the department in GetCare that summarizes the services described in WAC 388-106-1915 that you chose to receive.

"Care receiver" means an adult age 55 and over who has been authorized for MAC or TSOA services.

"Caregiver" means a spouse, relative, or friend (age 18 and over) who has primary responsibility for the care or supervision of an adult who meets eligibility criteria and does not receive direct, public, or private payment such as a wage for the caregiving services they provide.

"Caregiver assistance services" are services that take the place of those typically performed by an unpaid caregiver in support of the care receiver's unmet needs for assistance with activities of daily living (ADLs) and instrumental activities of daily living (IADLs).

"Caregiver phases" means the phases a caregiver experiences as the needs of the care receiver change, which in turn changes the responsibilities and tasks of caregiving. The change in responsibilities and tasks impacts the relationship between the caregiver and the care receiver. There are five phases showing the change in relationship roles from primarily family member to primarily caregiver. The five phases are:

(1) Phase one - Acting as a relative/friend almost all of the time;

(2) Phase two - Acting most often as a relative/friend, but sometimes as a caretaker;

(3) Phase three- Acting equally as a relative/friend and as a caregiver;

(4) Phase four- Acting most often as a caregiver, but sometimes you are still a relative/friend; and

(5) Phase five- Acting as a caregiver almost all of the time.

"Family caregiver" means the same as "caregiver."

"GetCare" means a statewide web-based information system that includes a client management component that includes screening and assessment tools for use by area agencies on aging (AAA) and other aging and disability network partners.

"GetCare assessment" is a process during which the department gathers information for an individual without a caregiver in the following areas: Functional needs, diagnoses and conditions, behavior health supports, oral health, and nutritional health to assist the individual with choosing step three services.

"GetCare screening" is a process during which the department gathers information for an individual without a caregiver in order to determine risk scores. The information covers the following areas: Function needs, fall risk, availability of informal help, memory and decision-making issues, and emotional well-being. The risk scores are used to determine if the individual is referred for a full GetCare assessment.

"Health maintenance and therapies" are clinical or therapeutic services that assist the care receiver to remain in their home or the caregiver to remain in their caregiving role and provide high quality care. Services are provided for the purpose of preventing further deterioration, improving, or maintaining current level of functioning.

"Identity discrepancy" means a negative psychological state that occurs when the activities and responsibilities that a caregiver assumes with regard to the care receiver are inconsistent with the caregiver's expectations or personal norms concerning these activities and responsibilities.

"MAC" means medicaid alternative care, which is a federally funded program authorized under section 1115 of the Social Security Act. It enables an array of person-centered services to be delivered to unpaid caregivers caring for a medicaid eligible person who lives in a private residence (such as their own home or a family member's home) and chooses to receive community-based services.

"Medicaid transformationproject" refers to the authority granted to the state by the federal government under section 1115 of the Social Security Act. This is a five year demonstration waiver to support health care systems prepare for and implement health reform and provide new targeted medicaid services to eligible individuals with significant needs. It includes MAC and TSOA programs.

"Personal assistance services" are supports involving the labor of another person to help the care receiver complete activities of daily living and instrumental activities of daily living that they are unable to perform independently. Services may be provided in the care receiver's home or to access community resources.

"RDAD" means reducing disability in Alzheimer's disease. This program is designed to improve the ability of the person with memory problems to complete activities of daily living while also helping caregivers provide assistance to the person.

"Service provider" means an agency or organization contracted with the department.

"Specialized medical equipment and supplies" are goods and supplies needed by the care receiver that are not covered under the medicaid state plan, medicare, or private insurance.

"TCARE" means tailored caregiver assessment and referral, which is an evidence-based caregiver coordination process designed to assist department assessors who work with family caregivers to support adults living with disabilities. TCARE is designed to tailor services to the unique needs of each caregiver to help reduce stress, depression, and burdens associated with caregiving. TCARE was developed by a research team at the University of Wisconsin-Milwaukee led by Dr. Rhonda Montgomery in collaboration with over 30 organizations serving family caregivers. The TCARE process is licensed for use by Tailored Care Enterprises, Inc.

"TCARE assessment" is a part of the TCARE process during which the department assessors gather responses to all of the TCARE screening questions and additional questions focused on both the caregiver's experience and the care receiver's situation, such as memory issues, behavioral needs, assistance needs with activities of daily living and instrumental activities of daily living, and diagnoses/conditions.

"TCARE screening" is a part of the TCARE process during which the department gathers information from the caregiver to determine scores and ranges for the caregiver's identity discrepancy, burdens, uplifts, and depression. The ranges are used to determine if the caregiver is referred for a full TCARE assessment.

"Training and education" are services and supports to help caregivers gain skills and knowledge to implement services and supports needed by the care receiver to remain at home and skills needed by the caregiver to remain in their role.

"TSOA" means tailored supports for older adults, which is a federally-funded program approved under section 1115 of the Social Security Act. It enables the delivery of person-centered services to:

(1) Caregivers who care for an eligible person as defined in WAC 388-106-1910; and

(2) Eligible persons as defined in WAC 388-106-1910, without a caregiver.

History

Statutory Authority: RCW 74.08.090 and 74.39A.030. WSR 23-15-060, § 388-106-1900, filed 7/14/23, effective 8/14/23
WSR 22-18-004, § 388-106-1900, filed 8/25/22, effective 9/25/22. Statutory Authority: RCW 74.08.090. WSR 18-08-033, § 388-106-1900, filed 3/27/18, effective 4/27/18.

Wash. Admin. Code § 388-106-1905 Am I eligible for MAC services?

(1) You are eligible to receive MAC services if you, as a care receiver, meet the following criteria:

(a) Are age 55 or older;

(b) Meet nursing facility level of care as defined in WAC 388-106-0355;

(d) Have an unpaid caregiver who:

(i) Is age 18 or older;

(ii) Has participated in the following:

(A) Care plan for step one services;

(B) TCARE screening and care plan for step two services; or

(e) Live in a private residence (such as your own home or a family member's home) and choose to receive community based services; and

(f) Do not receive any other medicaid funded long-term services and supports (LTSS) while receiving MAC services.

(2) The department may use preliminary information you provide through a presumptive eligibility screening to determine if you, as the care receiver, meet the eligibility criteria in subsection (1) of this section in order to receive services while the formal eligibility determination is being completed. This is called presumptive eligibility.

(a) Your presumptive eligibility period ends with the earlier date of:

(i) The date you were confirmed not to meet full functional eligibility criteria; or

(ii) The last day of the month following the month when your MAC services were first authorized.

(b) In the event the department implements a waitlist under WAC 388-106-1970 for MAC services, your presumptive eligibility ends.

(d) Under presumptive eligibility you may receive services as described in WAC 388-106-1915.

History

Statutory Authority: RCW 74.08.090 and 74.39A.030. WSR 22-18-004, § 388-106-1905, filed 8/25/22, effective 9/25/22. Statutory Authority: RCW 74.08.090. WSR 18-08-033, § 388-106-1905, filed 3/27/18, effective 4/27/18.

Wash. Admin. Code § 388-106-1910 Am I eligible for TSOA services?

(1) You are eligible to receive TSOA services if you, as a care receiver, meet the following criteria:

(a) Are age 55 or older;

(b) Meet nursing facility level of care as defined in WAC 388-106-0355;

(d) Live in a private residence (such as your own home or a family member's home) and choose to receive community-based services; and

(e) Meet the criteria in either (e)(i) or (ii) of this subsection:

(i) Have an unpaid caregiver who is age 18 or older and has participated in the following:

(A) A care plan for step one services;

(B) A TCARE screening and care plan for step two services; or

(ii) You do not have an available caregiver and have participated in the following:

(A) A care plan for step one services;

(B) A GetCare screening and care plan for step two services; or

(a) Your presumptive eligibility period ends with the earlier date of:

(i) The day the decision was made on your TSOA application;

(ii) The date you were confirmed not to meet full functional eligibility criteria; or

(iii) The last day of the month following the month in which your presumptive eligibility services were authorized if you did not submit your TSOA application.

(b) In the event the department implements a waitlist under WAC 388-106-1970 for TSOA services, your presumptive eligibility ends.

(d) Under presumptive eligibility, you may receive services as described in WAC 388-106-1915.

History

Statutory Authority: RCW 74.08.090 and 74.39A.030. WSR 22-18-004, § 388-106-1910, filed 8/25/22, effective 9/25/22. Statutory Authority: RCW 74.08.090. WSR 18-08-033, § 388-106-1910, filed 3/27/18, effective 4/27/18.

Wash. Admin. Code § 388-106-1915 What services may I receive in MAC and TSOA?

MAC and TSOA services include the following three benefit levels referred to as steps in subsections (1) through (3) of this section. You and your family caregiver may receive services under any of the three steps depending upon your requests and needs identified in the screening process for step two and the assessment process for step three. Steps do not need to be used in order. For example, you may begin services at step two or three. In general, step one services are used by caregivers or care receivers requesting lesser supports than those using step three services.

(1) Step one: After the department obtains your demographics and approves your program eligibility, you may receive the following services:

(a) Information and referrals to family caregiver or community resources;

(b) A selection of the following services up to a one time limit of $250:

(i) Training and education, which includes but is not limited to:

(A) Support groups;

(B) Group training;

(D) Consultation on supported decision making;

(E) Caregiver training to meet the needs of the care receiver;

(F) Financial or legal consultation; and

(G) Health and wellness consultation;

(ii) Specialized medical equipment and supplies for the care receiver, which includes but is not limited to:

(A) Supplies;

(B) Specialized medical equipment, which includes durable medical equipment; and

(iii) Caregiver assistance services, which includes but is not limited to short term respite to allow the caregiver to attend an educational event or training series; and

(iv) Health maintenance and therapy supports, which may include but are not limited to:

(A) Adult day health;

(B) RDAD and evidence based exercise programs;

(D) Counseling related to caregiving role.

(2) Step two: After the department obtains your demographics, approves your program eligibility, and completes a GetCare or TCARE screening, you may receive the following:

(a) Information and referrals to family caregiver or community resources;

(b) The following services up to an annual limit of $500 minus any expenditures for step one services:

(i) Training and education, which includes but is not limited to:

(A) Support groups;

(B) Group training;

(D) Consultation on supported decision making;

(E) Caregiver training to meet the needs of the care receiver;

(F) Financial or legal consultation; and

(G) Health and wellness consultation;

(ii) Specialized medical equipment and supplies for the care receiver, which includes but is not limited to:

(A) Supplies;

(B) Specialized medical equipment, which includes durable medical equipment;

(D) Personal emergency response system (PERS);

(iii) Caregiver assistance services, which include but are not limited to:

(A) Short-term respite and, if necessary, nurse delegation to allow the caregiver to attend an educational event or training series;

(B) Home delivered meals for the care receiver and caregiver;

(D) Home safety evaluation of the care receiver's home; and

(E) Transportation, in accordance with the assessment to facilitate access to waiver and other community services, activities, and resources as specified by the individualized care plan; and

(F) Bath aide;

(iv) Health maintenance and therapy supports, which include but are not limited to:

(A) Adult day health;

(B) RDAD and evidence based exercise programs;

(D) Counseling related to the caregiving role; and

(v) Personal assistance services for the TSOA without an unpaid caregiver, as described in WAC 388-106-1910 (e)(ii), which include but are not limited to:

(A) Adult day care;

(B) Transportation, in accordance with the assessment to facilitate access to waiver and other community services, activities, and resources as specified by the individualized care plan;

(D) Home safety evaluation of the care receiver's home; and

(E) Minor home modifications and repairs to the care receiver's home.

(3) Step three:

(a) For MAC and TSOA care receivers with caregivers:

(i) You may receive information and referrals to family caregiver or community resources.

(ii) After the department has obtained your demographics and approved your program eligibility, your caregiver must complete a TCARE assessment in order to access step three services. In order to qualify for a TCARE assessment, the TCARE screening must result in at least three medium scores or one high score for the TCARE measures described in WAC 388-106-1932. TCARE uses an evidence-based algorithm to identify a primary goal based on your caregiver's answers to the TCARE assessment questions. The department will assist you to develop an individualized care plan containing the services chosen by you and your caregiver up to the limits established in WAC 388-106-1920.

(iii) The table below lists the available step three services. The Xs in the table indicate the services that may be recommended by the TCARE strategies, defined in WAC 388-106-1930, from your caregiver's assessment. You may request services in this step that the TCARE assessment does not list as a recommendation.

| Services | Strategies | | | | | | --- | --- | --- | --- | --- | --- | | | A | B | C | D | E | | Training and education | | | | | | | Group training | | X | | | | | Caregiver coping and skill building training | X | X | X | X | | | Consultation on supported decision making | X | X | X | | | | Caregiver training to meet needs of care receiver | X | X | X | | | | Financial or legal consultation | | X | | | | | Health and wellness consultation | | X | | | | | Support groups | X | X | X | | | | Specialized medical equipment and supplies | | | | | | | Supplies | | X | | | | | Specialized medical equipment | | X | | | | | Assistive technology | | X | | | | | Personal emergency response system | | X | | | | | Caregiver assistance services | | | | | | | Home delivered meals | | X | | | | | Minor home modifications and repairs | | X | | | | | Housework/errands and yard work | | X | | | | | In-home respite, including a bath aide | | X | | | | | OT/PT evaluation | X | X | | X | | | Home safety evaluation | | X | | | | | Out-of-home respite | | X | | | | | Transportation | | X | | | | | Pest eradication services | | X | | | | | Specialized deep cleaning services | | X | | | | | Nurse delegation, in conjunction with respite care | | X | | | | | Health maintenance and therapy supports | | | | | | | Adult day health | | X | | | | | RDAD and evidence based exercise programs | | X | | X | | | Health promotion and wellness services such as acupuncture and massage therapy | | | | X | X | | Counseling related to the caregiver role | X | | X | X | |

(b) For TSOA care receivers who do not have an available caregiver:

(i) You may receive information and referrals to community resources.

(ii) After the department has obtained your demographics and approved your program eligibility, you must complete a GetCare assessment in order to access step three services. In order to qualify for a GetCare assessment, the GetCare screening must result in a risk score of moderate or high as described in WAC 388-106-1933. The department will assist you to develop an individualized care plan that includes the services you have chosen up to the limits established in WAC 388-106-1920.

(iii) The services available include any step one and step two services noted in subsections (1) and (2) of this section (except for respite) and the following:

(A) Personal assistance services which include:

(a) Personal care;

(b) Nurse delegation; and

(B) Pest eradication services;

(D) Community choice guide services.

History

Statutory Authority: RCW 74.08.090 and 74.39A.030. WSR 23-15-060, § 388-106-1915, filed 7/14/23, effective 8/14/23
WSR 22-18-004, § 388-106-1915, filed 8/25/22, effective 9/25/22. Statutory Authority: RCW 74.08.090. WSR 18-08-033, § 388-106-1915, filed 3/27/18, effective 4/27/18.

Wash. Admin. Code § 388-106-1920 What is the maximum amount of step three services I may receive a month?

(1) Unless the department authorizes additional funds through an exception to rule under WAC 388-440-0001, beginning January 1, 2019, the maximum amount of step three services you and your caregiver may receive in MAC and TSOA will be published on the ALTSA/HCS rates website at: https://www.dshs.wa.gov/sites/default/files/ALTSA/msd/documents/All_HCS_Rates.pdf.

(2) If you are a care receiver who does not have an available unpaid caregiver, you are receiving TSOA personal assistance services, and the department has not authorized additional funds through an exception to rule under WAC 388-440-0001, beginning January 1, 2019, the maximum amount of step three services you may receive will be published on the ALTSA/HCS rates website at: https://www.dshs.wa.gov/sites/default/files/ALTSA/msd/documents/All_HCS_Rates.pdf.

History

Statutory Authority: RCW 74.08.090 and 74.39A.030. WSR 19-09-003, § 388-106-1920, filed 4/4/19, effective 5/5/19. Statutory Authority: RCW 74.08.090. WSR 18-20-001, § 388-106-1920, filed 9/19/18, effective 10/20/18
WSR 18-08-033, § 388-106-1920, filed 3/27/18, effective 4/27/18.

Wash. Admin. Code § 388-106-1921 How does the TCARE assessment determine what step three services are recommended to my caregiver?

(1) The TCARE assessment process gathers the following information reflecting the current status of both you and your caregiver in order to recommend services for your caregiver:

(a) TCARE screening scores from the five measures described in WAC 388-106-1931;

(b) Caregiver obligations;

(d) Potential risk of out-of-home placement;

(e) Care receiver's need for assistance with activities of daily living and instrumental activities of daily living;

(f) Care receiver's memory status, physical health conditions, and behavioral support needs; and

(g) Caregiver's understanding of the care receiver's level of need and the ability to safely provide care with the assistance of available resources/services.

(2) Based upon the information gathered during the TCARE assessment process described in subsection (1) of this section, one of three primary goals, as defined in WAC 388-106-1925, is established for your caregiver with at least one strategy identified for meeting that goal. One or more of the five strategies described in WAC 388-106-1930, which are linked to recommended services and supports that have the most potential to help your caregiver continue providing care safely while also addressing their needs as a caregiver, may be recommended to reach the established goal.

History

Statutory Authority: RCW 74.08.090. WSR 18-08-033, § 388-106-1921, filed 3/27/18, effective 4/27/18.

Wash. Admin. Code § 388-106-1925 What are the goals in TCARE?

The three primary goals for caregivers identified in TCARE are:

(1) Maintain current identity: The goal appropriate for caregivers who experience modest levels of identity discrepancy and stress and are willing and able to continue in their current role. Suggested support services will help caregivers make small adjustments in their personal norms and the manner in which they undertake their caregiving responsibilities.

(2) Embrace caregiver identity: The goal appropriate for caregivers who are likely to benefit from embracing a stronger identity as a caregiver and releasing, to some degree, their commitment to a familial identity. Suggested support services will encourage the caregiver to accept a greater identity with the caregiver role.

(3) Reduce caregiver identity: The goal appropriate for caregivers who are engaged in a level of caregiving that requires emotional or physical resources beyond their capability. Suggested support services will encourage caregivers to explore ways to reduce workload and stress related to their caregiving role.

History

Statutory Authority: RCW 74.08.090. WSR 18-08-033, § 388-106-1925, filed 3/27/18, effective 4/27/18.

Wash. Admin. Code § 388-106-1930 What is the purpose of the TCARE assessment?

The purpose of the TCARE assessment is to gather critical information about the caregiving context, identity, strengths, problems and concerns. These data are used to identify strategies and goals to address your caregiver's needs. Program limits are established in WAC 388-106-1915.

(1) The five strategies in TCARE are:

(a) Strategy A: Change personal rules for care, which entails encouraging and helping your caregiver to change or adjust their personal rules or norms.

(b) Strategy B: Reduce or minimize work load, which focuses on reducing the amount or intensity of your caregiver's work load and therefore aligns your caregiver's behaviors with their expectations.

(c) Strategy C: Support positive self-appraisal, which focuses on offering positive affirmation and assuring your caregiver that the behaviors that they must engage in as a caregiver are consistent with their norms.

(d) Strategy D: Reduce generalized stress, which focuses on giving your caregiver tools and skills to cope with daily stresses of caregiving.

(e) Strategy E: Improve overall health, which encourages your caregiver to seek appropriate health services.

(2) Each service is mapped to a strategy(s) that may support your caregiver's needs. A service may be mapped to more than one strategy.

(3) Assessors assist you and your caregiver to understand the evidence based strategies and recommended services, choose the services to meet the identified goals, and create an individualized care plan.

History

Statutory Authority: RCW 74.08.090. WSR 18-08-033, § 388-106-1930, filed 3/27/18, effective 4/27/18.

Wash. Admin. Code § 388-106-1931 What are the TCARE screening measures?

The following six TCARE screening measures and response options will be presented to your caregiver in order to receive step two services and to determine whether a TCARE assessment is needed for step three services:

(1) Identity discrepancy: The following are some thoughts and feelings that people sometimes experience when they assist their receiver:

(a) I am not always able to be the person I want to be when I am with my care receiver.

(b) It is difficult for me to accept all the responsibility for my care receiver.

(2) Relationship burden: Have your caregiving responsibilities:

(a) Caused conflicts with your care receiver?

(b) Increased the number of unreasonable requests made by your care receiver?

(3) Objective burden: Have your caregiving responsibilities:

(a) Changed your routine?

(b) Left you with almost no time to relax?

(4) Stress burden: Have your caregiving responsibilities:

(a) Depressed you?

(b) Caused you to worry?

(5) Depression: How many days have you felt this way in the past week?

(a) Had trouble keeping your mind on what you were doing?

(b) Felt depressed?

(d) Had restless sleep?

(6) Uplifts: Have your caregiving responsibilities:

(a) Given your life more meaning?

(b) Made you more satisfied with your relationship?

History

Statutory Authority: RCW 74.08.090 and 74.39A.030. WSR 22-18-004, § 388-106-1931, filed 8/25/22, effective 9/25/22. Statutory Authority: RCW 74.08.090. WSR 18-08-033, § 388-106-1931, filed 3/27/18, effective 4/27/18.

Wash. Admin. Code § 388-106-1932 How is the TCARE screening scored to determine if my caregiver is eligible for a TCARE assessment and related step three services?

(1) The TCARE screening measures are scored with a number value of one through six for the measure on identity discrepancy or one through five for the remaining measures based upon the caregiver's responses. Ranges for each measure determine whether the measure score is high, medium, or low. One high or three medium scores from the table in this subsection, except for the uplifts measure, will make a caregiver eligible for a TCARE assessment and step three services as described in WAC 388-106-1915 (3)(a)(ii). The following table indicates the score ranges for each measure:

| | High | Medium | Low | | --- | --- | --- | --- | | Identity discrepancy | 13-18 | 8-12 | 3-7 | | Relationship burden | 10-18 | 6-9 | 3-5 | | Objective burden | 9-12 | 5-8 | 2-4 | | Stress burden | 9-12 | 6-8 | 2-5 | | Uplifts | 10-18 | 6-9 | 3-5 | | Depression-CESD | 14-16 | 7-13 | 4-6 |

(2) The scale used to score the responses within the identity discrepancy, relationship, objective, stress, and uplift measures are:

(a) Strongly disagree = one;

(b) Disagree = two;

(d) Agree a little = four;

(e) Agree = five; and

(f) Strongly agree = six.

(3) The scale used to score the responses within the depression measures in WAC 388-106-1931 (5)(a), (b), (c), and (d) are:

(a) Rarely or none of the time (less than one day in the last week) = one;

(b) Some or a little of the time (one to two days in the last week) = two;

(d) All of the time (five to seven days in the last week) = four.

History

Statutory Authority: RCW 74.08.090 and 74.39A.030. WSR 22-18-004, § 388-106-1932, filed 8/25/22, effective 9/25/22. Statutory Authority: RCW 74.08.090. WSR 18-08-033, § 388-106-1932, filed 3/27/18, effective 4/27/18.

Wash. Admin. Code § 388-106-1933 How is the GetCare screening scored to determine if I am eligible for a GetCare assessment and related step three services?

(1) To be eligible for a GetCare assessment, care plan, and associated step three services as described in WAC 388-106-1915 (3)(b)(ii), a TSOA individual without a caregiver must have a moderate or high risk score resulting from the thirteen screening questions listed in the following table:

| No. | Question | Scoring | | | | | | | | | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | | Response | Score | Response | Score | Response | Score | Response | Score | | | | 1 | Do you need help to do the following? Bathing Bed mobility Medication management Transferring Ambulating Eating Toileting Dressing Personal hygiene | Zero to two selected | Zero | Three or more selected | Two | | | | | | 2 | Do you need help turning and repositioning? | No | Zero | Yes | Two | | | | | | 3 | Who helps you with daily activities? | No one | One | Family/friend/other/paid help | Zero | | | | | | 4 | During the last six months, have you had a fall that caused injuries? | No | Zero | Yes | Two | | | | | | 5 | Have you had a hospitalization, or been admitted to a nursing facility, or both, in the past six months? | No | Zero | Yes | Two | | | | | | 6 | Have you received rehabilitation in the past six months? | No | Zero | Yes | Two | | | | | | 7 | Have you been treated in an emergency room, called 911 in the past six months, or both? | No | Zero | Yes, one to two times | One | Yes, three or more times | Two | | | | 8 | Do you live alone? | No | Zero | Yes | Two | | | | | | | If yes, do you feel safe living alone? | No | One | Yes | Zero | | | | | | 9 | Do you plan on moving to other housing in the near future? | No | Zero | Yes | Two | | | | | | 10 | Do you or your family have concerns about your memory, thinking, ability to make decisions, or remembering to pay your bills? | No, not concerned | Zero | Yes, somewhat concerned | One | Yes, very concerned | Two | | | | 11 | Are you content with your social life? | No | Two | Somewhat | One | Yes | Zero | | | | 12 | Over the last two weeks, have you been bothered by, or have little interest in doing things? | Not at all | Zero | Several days | One | More than half the days | Two | Nearly every day | Three | | 13 | Over the last two weeks, have you been bothered by feeling down, depressed, or hopeless? | Not at all | Zero | Several days | One | More than half the days | Two | Nearly every day | Three |

(2) The risk level is calculated by totaling the points assigned to each question as determined by responses to the screening questions in subsection (1) of this section and matching the total points to the risk level in the following table:

| Risk level | Point totals | | --- | --- | | No risk | 0 | | Low risk | 1- 8 | | Moderate risk | 9-16 | | High risk | 17 and up |

History

Statutory Authority: RCW 74.08.090 and 74.39A.030. WSR 19-09-003, § 388-106-1933, filed 4/4/19, effective 5/5/19. Statutory Authority: RCW 74.08.090. WSR 18-08-033, § 388-106-1933, filed 3/27/18, effective 4/27/18.

Wash. Admin. Code § 388-106-1935 Where may I receive MAC and TSOA services?

You may receive MAC and TSOA services:

(1) In your own home; and

(2) In the community setting where the authorized service occurs:

(a) Within the state of Washington; or

(b) In a recognized out-of-state bordering city as defined in WAC 182-501-0175.

History

Statutory Authority: RCW 74.08.090. WSR 18-08-033, § 388-106-1935, filed 3/27/18, effective 4/27/18.

Wash. Admin. Code § 388-106-1940 When will my MAC or TSOA services be authorized?

Your MAC or TSOA services will be authorized when you:

(1) Have completed initial requirements for intake including but not limited to screenings and assessments;

(2) Are found to be at least presumptively eligible, both financially and functionally;

(3) Have chosen a provider(s) qualified for payment; and

(4) Have given consent for services and approved your care plan.

History

Statutory Authority: RCW 74.08.090. WSR 18-08-033, § 388-106-1940, filed 3/27/18, effective 4/27/18.

Wash. Admin. Code § 388-106-1945 When do my MAC or TSOA services begin?

Your MAC or TSOA services may begin once you have approved your care plan and as early as the date authorized by the department.

History

Statutory Authority: RCW 74.08.090 and 74.39A.030. WSR 22-18-004, § 388-106-1945, filed 8/25/22, effective 9/25/22. Statutory Authority: RCW 74.08.090. WSR 18-08-033, § 388-106-1945, filed 3/27/18, effective 4/27/18.

Wash. Admin. Code § 388-106-1950 How do I remain eligible for MAC and TSOA services?

(1) In order to remain eligible for MAC and TSOA services, you, as the care receiver must:

(a) Remain functionally eligible as defined in WAC 388-106-0355 and financially eligible as defined in WAC 182-513-1605, 182-513-1615, and 182-513-1620;

(b) Have your functional and financial eligibility reviewed at least annually; and

(2) If eligibility laws, regulations, or rules change, and if you as the caregiver or the care receiver do not meet the changed eligibility requirements, the department will terminate services, even if your circumstances have not changed. You will receive advance notice of any termination or change in your services and an opportunity to appeal.

History

Statutory Authority: RCW 74.08.090 and 74.39A.030. WSR 22-18-004, § 388-106-1950, filed 8/25/22, effective 9/25/22. Statutory Authority: RCW 74.08.090. WSR 18-08-033, § 388-106-1950, filed 3/27/18, effective 4/27/18.

Wash. Admin. Code § 388-106-1955 What do I pay for if I receive MAC or TSOA services?

You, as a caregiver or a care receiver, will not be required to pay toward the cost of your MAC or TSOA services. This means that neither estate recovery nor participation towards cost of care are required.

History

Statutory Authority: RCW 74.08.090. WSR 18-08-033, § 388-106-1955, filed 3/27/18, effective 4/27/18.

Wash. Admin. Code § 388-106-1960 May I be employed and receive MAC or TSOA services?

You, as the care receiver may be employed and receive MAC or TSOA services. Your caregiver may be employed in roles other than caregiving and receive services under MAC or TSOA.

History

Statutory Authority: RCW 74.08.090. WSR 18-08-033, § 388-106-1960, filed 3/27/18, effective 4/27/18.

Wash. Admin. Code § 388-106-1965 Are there limits to the services I may receive?

The services you may receive under MAC or TSOA will not include the following:

(1) Rent or mortgage;

(2) Groceries;

(3) Car repairs;

(4) Utility bills;

(5) Household appliances;

(6) Vacation expenses;

(7) Entertainment items such as TVs, radios, computers, cell phones;

(8) Pet care items;

(9) Gift cards;

(10) Any services not defined in WAC 388-106-1915; and

(11) Any services covered under your medicaid state plan coverage, medicare, private insurance, or other federal or state programs.

History

Statutory Authority: RCW 74.08.090. WSR 18-08-033, § 388-106-1965, filed 3/27/18, effective 4/27/18.

Wash. Admin. Code § 388-106-1970 Who may provide MAC and TSOA services?

The following providers may provide MAC and TSOA services:

(1) Durable medical equipment vendors and adult day health providers that have a core provider agreement with the health care authority; and

(2) Providers who are contracted with the department to provide goods and services.

History

Statutory Authority: RCW 74.08.090. WSR 18-08-033, § 388-106-1970, filed 3/27/18, effective 4/27/18.

Wash. Admin. Code § 388-106-1975 Will there be a waitlist for MAC and TSOA?

(1) The department will implement a statewide waitlist if program expenditures or enrollment exceeds availability of demonstration funding.

(2) If the department implements a waitlist for new MAC and TSOA applicants:

(a) We will stop conducting presumptive eligibility determinations and financial and functional eligibility assessments.

(b) We may reduce benefit limits for step one, two, and three to maintain department spending within available demonstration funding. If we reduce benefit limits, individuals currently receiving benefits will maintain their current benefit level, including those with approved presumptive eligibility.

(c) If additional funding becomes available, applicants on a waitlist for MAC or TSOA services will be considered on a first come first serve basis based upon their request date for MAC or TSOA services.

History

Statutory Authority: RCW 74.08.090. WSR 18-08-033, § 388-106-1975, filed 3/27/18, effective 4/27/18.

Wash. Admin. Code § 388-106-1980 When may the department terminate or deny MAC or TSOA services?

(1) The department will deny or terminate MAC or TSOA services if you are not eligible for services pursuant to WAC 388-106-1905, 388-106-1910, and 388-106-1945.

(2) The department may deny or terminate your MAC or TSOA services if, after exhaustion of standard case management activities and the approaches delineated in the department's challenging cases protocol that must include an attempt to reasonably accommodate your disability or disabilities, one or more of the following conditions exist:

(a) Your rights and responsibilities as a client of the department are reviewed with you by a department representative under WAC 388-106-1300 and 388-106-1303, and you refuse to accept those services identified in your care plan that are vital to your health, welfare, or safety.

(b) You choose to receive services in your own home and you or others in your home demonstrate behaviors that are substantially likely to cause serious harm to you or your care provider.

(i) Threatening, uncontrolled animals (such as dogs);

(ii) The manufacture, sale, or use of illegal drugs;

(iii) The presence of hazardous materials (such as exposed sewage, evidence of a methamphetamine lab).

(3) The department may terminate services if the department does not receive consent of the care plan within sixty days of the completion of your care plan. Written consent for step one and step two care plans may be provided by secure email or other electronic means.

History

Statutory Authority: RCW 74.08.090. WSR 18-08-033, § 388-106-1980, filed 3/27/18, effective 4/27/18.

Wash. Admin. Code § 388-106-1985 Do I have the right to an administrative hearing regarding MAC or TSOA services?

Yes, you may request an administrative hearing based on the rules outlined in WAC 388-106-1305 to contest the department's decisions regarding MAC or TSOA services except for presumptive eligibility determinations described in WAC 388-106-1905(2) and 388-106-1910(2).

History

Statutory Authority: RCW 74.08.090. WSR 18-08-033, § 388-106-1985, filed 3/27/18, effective 4/27/18.

Wash. Admin. Code § 388-106-1990 May I choose to receive traditional medicaid long-term services and supports instead of services under the MAC program?

Yes. You, as the care receiver, may choose to apply for traditional medicaid long term services and supports such as community first choice, community option program entry system (COPES), new freedom, and residential support waiver, instead of services under the MAC program. You must contact your case manager who will assist you with this process. You may only receive services that you are eligible for under the applicable rules. You may not receive services under MAC and a traditional medicaid long-term services and supports program at the same time.

History

Statutory Authority: RCW 74.08.090. WSR 18-08-033, § 388-106-1990, filed 3/27/18, effective 4/27/18.

Wash. Admin. Code § 388-106-2000 What definitions apply to the civil transitions program?

"Aging and long-term support administration (ALTSA)" is an administration within the department of social and health services that promotes choice, independence, and safety through innovative services and partnerships with tribes, advocates, providers, and caregivers to support seniors, and people with disabilities so they can live with good health, independence, dignity, and control over decisions that affect their lives.

"Behavioral health administration (BHA)" is an administration within the department of social and health services that supports sustainable recovery, independence, and wellness. This is done by funding and supporting effective prevention and intervention services for youth and family, and treatment and recovery support for youth and adults with addiction and mental health conditions (also known as behavioral health). BHA operates three state psychiatric hospitals and the office of forensic mental health services that deliver high quality services to adults and children with complex needs.

"Civil transitions program" is a program implemented according to Engrossed Second Substitute Senate Bill 5440 to provide support services to individuals recently subject to criminal charges and found incompetent to stand trial due to an intellectual or developmental disability, traumatic brain injury, or dementia.

"Competency evaluation" is an assessment of the ability of a defendant to understand and rationally participate in a court process under the United States criminal justice system.

"Conditional services" is a term that describes the services available under the civil transitions program for an individual who does not meet functional eligibility criteria under medicaid personal care level of care under WAC 388-106-0210 or nursing facility level of care under WAC 388-106-0355 or is not financially eligible for Washington apple health, or is not functionally or financially eligible.

"Dementia" is a general term for loss of memory, language, problem-solving, and other thinking abilities that are severe enough to interfere with daily life. The term "dementia" is no longer used to refer to the etiological subgroups for which it is standard, but it is instead included under the newly titled term significant neurocognitive disease. For consistency, the term "dementia" is still used in the DSM-5 and can be applied in situations where patients and doctors are familiar with it. The phrase neurocognitive disorder is commonly used, while dementia is the standard word for illnesses such as the degenerative dementias that typically impact older persons (DSM-5-TR).

Neurocognitive disorder is characterized by the progressive and persistent deterioration of cognitive function. Cognitive deficits are sufficient to interfere with independence, do not occur exclusively in the context of a delirium, and are not attributable to another mental disorder (e.g. major depressive disorder, schizophrenia).

Specific major neurocognitive diagnosis, primary diagnosis:

(a) Major neurocognitive disorder due to Alzheimer's disease;

(b) Major frontotemporal neurocognitive disorder (Pick's);

(d) Major vascular neurocognitive disorder (Vascular);

(e) Major neurocognitive disorder due to traumatic brain injury;

(f) Substance or medication-induced major neurocognitive disorder (alcohol-related);

(g) Major neurocognitive disorder due to HIV infection;

(h) Major neurocognitive disorder due to Prion disease;

(i) Major neurocognitive disorder due to Parkinson's disease;

(j) Major neurocognitive disorder due to Huntington's disease.

"Not Competent" means a legal determination has been made by a court that a defendant is unable to stand trial based on being diagnosed with a mental disease or defect which prevents them from understanding court proceedings or being able to rationally assist in their own defense per chapter 10.77 RCW.

"Not Restorable" means a court has found that a person lacks the capacity to have competency restored via inpatient or outpatient treatment.

"Office of forensic mental health services (OFMHS)" is a division of the department of social and health services' behavioral health administration that oversees the state's adult forensic mental health system.

"Washington apple health" means the public health insurance programs for eligible Washington residents defined in WAC 182-500-0120. Washington apple health or apple health is the name used in Washington state for medicaid, the children's health insurance program (CHIP), and state-only funded health care programs.

History

Statutory Authority: RCW 10.77.202, 74.08.090, and 74.09.520. WSR 24-16-002, § 388-106-2000, filed 7/24/24, effective 8/24/24.

Wash. Admin. Code § 388-106-2005 Who is eligible to apply to receive services under the civil transitions program?

You are eligible to apply for services under the civil transitions program if you:

(1) Are referred to ALTSA from the BHA starting December 1, 2023;

(2) Have been determined by a court as not competent to stand trial due to a diagnosis of dementia, a traumatic brain injury, or an intellectual or developmental disability, and your competency is not restorable;

(3) Complete an assessment of your functional eligibility using the comprehensive assessment reporting evaluation (CARE) tool under WAC 388-106-0050 to determine if you are functionally eligible for:

(a) Nursing facility level of care under WAC 388-106-0355; or

(b) Medicaid personal care level of care under WAC 388-106-0210; and

(4) File an application for Washington apple health so the department can determine if you are financially eligible for medicaid-funded long-term services and supports. The application process is described in WAC 182-503-0005.

History

Statutory Authority: RCW 10.77.202, 74.08.090, and 74.09.520. WSR 24-16-002, § 388-106-2005, filed 7/24/24, effective 8/24/24.

Wash. Admin. Code § 388-106-2010 What services may I receive under the civil transitions program if I am not functionally and financially eligible for long-term services and supports?

(1) If you meet the criteria in WAC 388-106-2005 but are not functionally eligible for medicaid personal care level of care under WAC 388-106-0210 or nursing facility level of care under WAC 388-106-0355, or you are not financially eligible for Washington apple health, you may receive conditional services, subject to available funds, under the civil transitions program.

(2) If you meet the criteria in WAC 388-106-2005 but have yet to complete a CARE assessment and are, or at risk of becoming a "homeless person" as defined in RCW 43.185C.010, you may receive supportive housing services under the civil transitions program, as funding allows.

(3) Conditional services are described in WAC 388-106-2020.

History

Statutory Authority: RCW 10.77.202, 74.08.090, and 74.09.520. WSR 24-16-002, § 388-106-2010, filed 7/24/24, effective 8/24/24.

Wash. Admin. Code § 388-106-2015 What services may I receive under the civil transitions program if I am functionally and financially eligible for long-term services and supports?

If you are referred to ALTSA for services under the civil transitions program and you are both functionally eligible for long-term services and supports under chapter 388-106 WAC and financially eligible for medicaid-funded long-term services and supports, you are eligible for any service offered by ALTSA based on your assessment and identified in your plan of care. Financial eligibility criteria for long-term services and supports is determined under chapters 182-513 and 182-515 WAC.

History

Statutory Authority: RCW 10.77.202, 74.08.090, and 74.09.520. WSR 24-16-002, § 388-106-2015, filed 7/24/24, effective 8/24/24.

Wash. Admin. Code § 388-106-2020 What conditional services may I receive under the civil transitions program?

The legislature has appropriated specific funding for the civil transitions program for the provision of conditional services. If you meet the criteria in WAC 388-106-2005 you are eligible for conditional services as described below, subject to available funding.

(1) If you do not meet medicaid personal care level of care under WAC 388-106-0210 or nursing facility level of care under WAC 388-106-0355, and you are not financially eligible for Washington apple health, you can receive the following conditional services:

(a) Community transition or sustainability services; and

(b) Supportive housing as defined in WAC 388-106-1705.

(2) If you are determined functionally eligible for medicaid personal care level of care under WAC 388-106-0210, but you are not financially eligible for Washington apple health, you may receive the following conditional services if they are included in your plan of care:

(a) Personal care services as defined in WAC 388-106-0010;

(b) Community transition or sustainability services; and

(3) If you are determined functionally eligible for nursing facility level of care under WAC 388-106-0355 but you are not financially eligible for Washington apple health, you may receive the following conditional services if they are included in your plan of care:

(a) Personal care services as defined in WAC 388-106-0010;

(b) Nurse delegation as defined in WAC 388-106-0270;

(d) Assistive technology as defined in WAC 388-106-0270;

(e) Supportive housing as defined in WAC 388-106-1705;

(f) Community transition services as defined in WAC 388-106-0270; and

(g) Community transition or sustainability services.

History

Statutory Authority: RCW 10.77.202, 74.08.090, and 74.09.520. WSR 24-16-002, § 388-106-2020, filed 7/24/24, effective 8/24/24.

Wash. Admin. Code § 388-106-2025 Who can provide long-term services and supports when I am eligible for the civil transitions program conditional services?

The following types of providers can provide conditional services under the civil transitions program:

(1) Individual providers (IPs) who provide services to clients in their own home as defined in WAC 388-106-0040 and 388-106-0010.

(2) Home care agencies that provide services to clients in their own home. Home care agencies must be licensed under chapter 70.127 RCW and chapter 246-335 WAC and be contracted with the department of social and health services.

(3) Providers who are contracted with the department to provide goods and services.

(4) Durable medical equipment vendors that have a core provider agreement with the health care authority.

(5) Supportive housing providers as defined in WAC 388-106-1715 or 182-559-200.

History

Statutory Authority: RCW 10.77.202, 74.08.090, and 74.09.520. WSR 24-16-002, § 388-106-2025, filed 7/24/24, effective 8/24/24.

Wash. Admin. Code § 388-106-2030 Where can I receive civil transitions program conditional services?

You can receive conditional services under the civil transitions program:

(1) In your own home as defined in WAC 388-106-0030, or an interim setting while you secure permanent housing; and

(2) While you are out of your home accessing the community or working while:

(a) within the state of Washington; or

(b) in a recognized out of state bordering city as defined in WAC 182-501-0175.

History

Statutory Authority: RCW 10.77.202, 74.08.090, and 74.09.520. WSR 24-16-002, § 388-106-2030, filed 7/24/24, effective 8/24/24.

Wash. Admin. Code § 388-106-2035 When will the department authorize my civil transitions program conditional services?

Within available funds, the department will authorize conditional services under the civil transitions program when you have:

(1) Completed an assessment of your functional eligibility using the comprehensive assessment reporting evaluation (CARE) tool under WAC 388-106-0050;

(2) Applied for Washington apple health;

(3) Been found eligible for conditional services under WAC 388-106-2010 and 388-106-2020;

(4) Given consent for services and approved your care plan; and

(5) Chosen a DSHS qualified provider per WAC 388-71-0510.

History

Statutory Authority: RCW 10.77.202, 74.08.090, and 74.09.520. WSR 24-16-002, § 388-106-2035, filed 7/24/24, effective 8/24/24.

Wash. Admin. Code § 388-106-2040 When will my civil transitions program conditional services end?

(1) If, at the time of your initial assessment you were found ineligible for medicaid-funded long-term services and supports, your civil transitions program conditional services, except supportive housing, will end the earlier of:

(a) The date you are found both functionally and financially eligible for medicaid-funded long-term services and supports;

(b) Six months from the start date of your services; or

(2) For conditional supportive housing services, your eligibility will be reviewed in six-month increments based upon available funding, up to a maximum of 24 months.

History

Statutory Authority: RCW 10.77.202, 74.08.090, and 74.09.520. WSR 24-16-002, § 388-106-2040, filed 7/24/24, effective 8/24/24.

Wash. Admin. Code § 388-106-2045 Do I have a right to an administrative hearing on civil transitions program conditional services?

You have a right to an administrative hearing if you disagree with a decision made by the department about your eligibility for services under the civil transitions program. The department will notify you in writing of the right to contest a decision and provide you with information on how to request a hearing.

History

Statutory Authority: RCW 10.77.202, 74.08.090, and 74.09.520. WSR 24-16-002, § 388-106-2045, filed 7/24/24, effective 8/24/24.

Wash. Admin. Code § 388-106-2050 Can an exception to rule (ETR) be granted for civil transitions program conditional services?

If you receive conditional services under the civil transitions program, an exception to rule under WAC 388-440-0001 will not be granted.

History

Statutory Authority: RCW 10.77.202, 74.08.090, and 74.09.520. WSR 24-16-002, § 388-106-2050, filed 7/24/24, effective 8/24/24.

Wash. Admin. Code § 388-106-2100 What is the home and community services guardianship and conservatorship assistance program?

(1) Subject to available state only funds, the department of social and health services (DSHS) pays for certain fees and costs for professional guardianship and conservatorship services for eligible persons as described in WAC 388-106-2110.

(2) The amounts paid and which services and costs are covered are determined by DSHS in its sole discretion and are contained in contracts with certified professional guardians and conservators (CPGCs).

(3) Subject to available funds, and in its sole discretion, DSHS may file petitions for guardianship with a Washington state superior court for certain patients occupying beds in acute care hospitals who no longer require inpatient hospital care or who require assistance in accessing or maintaining long-term support and services (LTSS) services due to the person's inability to give consent.

History

Statutory Authority: RCW 43.17.060, 43.20B.030, and 74.08.090. WSR 24-16-044, § 388-106-2100, filed 7/30/24, effective 8/30/24.

Wash. Admin. Code § 388-106-2105 Definitions.

(1) "Aging and long-term support administration" or "ALTSA" means an administration within DSHS.

(2) "Client" means a person who is an applicant for, or recipient of, any Washington apple health program, including managed care and long-term care. See definitions for "applicant" and "recipient" in RCW 74.09.741.

(3) "Contractor" means a certified professional guardian and conservator who has met contractor eligibility criteria and has executed a contract with DSHS to provide guardianship and conservatorship services through the state funded home and community services guardianship and conservatorship assistance program.

(4) "Court order" means any judgment, decree, instruction, or order of a Washington state superior court, a court of comparable jurisdiction of an Indian tribe, another state, or country.

(5) "Decision-making assistance" means support for an individual with diminished decision-making ability in making decisions affecting health, safety, or to manage financial affairs. Assistance includes, without limitation, acting as a representative payee, fiduciary, an attorney-in-fact, a trustee, or a certified professional guardian or conservator.

(6) "DSHS" means the department of social and health services.

(7) "Due diligence" means the acute care hospital has adequately investigated whether a family member or friend would be able and willing to serve as a lay guardian, and, if not, has contacted agencies and individuals providing professional guardianship and conservatorship services, has submitted a referral to the statewide guardianship listserv managed by the office of public guardianship (OPG) through the administrative office of the courts (AOC), and at least 14 days have elapsed without identification of a potential professional guardian for nomination.

(8) "Estate Recovery" means the state's process for recapturing the cost of long-term care services, related hospital, and prescription drug services from a recipient's estate. Federal and state laws allow states to recover state-funded services and certain medicaid costs.

(9) "Guardian" or "Conservator" means a professional individual, agency, or a corporate fiduciary (such as a nonprofit corporation or bank trust department) appointed by a court to assist and protect an individual who the court has determined requires assistance in managing their own affairs.

(10) "Home and community services" or "HCS" means a division within the DSHS aging and long-term support administration.

(11) "LTSS" means long-term support and services under the home and community services division.

(12) "Neuro-cognitive disorder" means a primary diagnosis of dementia, Alzheimer's, Parkinson's, Huntington's, traumatic brain injury, or stoke which results in the individual's lack of decision-making capacity impacting accessibility for long-term care benefits.

(13) "Notice of department decisions" means a generated written notice provided to an individual client or their legal representative or both identifying them of:

(a) The action taken by DSHS that impacts the individual client's benefits;

(b) The reason DSHS took said action;

(d) Date of the notice;

(e) Effective date of the action taken;

(f) Department representative contact information;

(g) Hearing rights; and

(h) Information about continued benefits, if any.

(14) "Overpayment" means any payment or benefit to a recipient or to a vendor in excess of that to which is entitled by law, rule, or contract, including amounts in dispute as outlined in chapter 41.05A RCW.

(15) "Participation" means the portion of the client's responsibility or financial obligation paid by the client to the provider to cover part or all of their cost of care.

(16) "Private pay" means the status for any period of time in which a client is ineligible for medicaid-funded LTSS and must use their own personal resources to pay for their services.

(17) "Program hold" means an intervention taken by DSHS to place future payment authorizations on hold whenever an approved state funded guardianship and conservatorship assistance program recipient is identified as financially ineligible for medicaid LTSS per chapter WAC 182-513-1315 (1)-(3). Under a program hold, a recipient's state funded guardianship and conservatorship assistance program slot can be held for up to 90 days from date of financial ineligibility discovery.

(18) "Program recipient" means an individual meeting eligibility criteria for inclusion into the state funded home and community services guardianship and conservatorship assistance program.

(19) "Program slot" means a program vacancy based on timeframe of needed resources as designated by "tier 1" and "tier 2". A tier 1 program slot is a slot with a maximum service benefit of up to 12 months duration. A tier 2 program slot is a continuous slot for individuals not required to pay participation towards their cost of care based on financial thresholds per WAC 182-513-1315 (1)-(3) or individuals who are not United States citizens.

(20) "Provider one" means the invoice processing system used by DSHS to process and pay some social service providers and contractors who provide care or services to medicaid clients.

(21) "Provisional approval" means the process of allowing clients a conditional approval for accessing the state funded guardianship and conservatorship assistance program under medicaid long-term services and supports (LTSS), without having to wait for the full functional and financial medicaid eligibility determination.

(22) "Split appointment" means when two or more individuals are appointed to serve as either a guardian, a conservator, co-guardians, or co-conservators on a single case appointed under chapter 11.130 RCW.

(23) "Successor guardian or conservator" means a successor or replacement guardian or conservator appointed by the court to act on behalf of an individual subject to either guardianship, conservatorship, or both if the existing guardian or conservator resigns, dies, becomes incapacitated, is determined no longer qualified to serve, declines to serve the individual, or due to noncompliance with court reporting requirements or duties.

(24) "Termination" means the final termination order of a preestablished guardianship or conservatorship judicial matter or both which negates the previous orders of case establishment. Such an order restores the individual's civil rights and decision-making authority. A termination is completed through a judicial process by which the court determines that a preestablished guardianship or conservatorship matter or both no longer meets judicial grounds under RCW 11.130.265, that termination would be in the best interest of the adult based on a change in functionality or circumstances, or that less restrictive alternative protective arrangement is available to meet the needs of the individual.

(25) "The certified professional guardian and conservator review board" or "CPGCRB" means the regulatory board tasked by the administrative offices of the court (AOC) to oversee the statutory and regulatory requirements and to investigate guardian and conservator complaints of certified professional guardians and conservators (CPGCs) statewide.

(26) "The guardianship or conservatorship" means the establishment of a guardianship or conservatorship matter from the date of appointment of a guardian or conservator agent, not from the date of original petition.

(27) "Tier 1" means a one-year contract term for state-funded guardianship and conservatorship services under the state funded guardianship and conservatorship assistance program.

(28) "Tier 2" means an ongoing, renewable contract term for state-funded guardianship and conservatorship services under the state funded guardianship and conservatorship assistance program:

(a) When an individual is determined to:

(i) Not have financial ability to pay monthly guardianship or conservatorship fees through alternative participation reduction procedures due to lack of or limited income; or

(ii) Be a noncitizen approved for long-term care through the state-funded long-term care services program for noncitizens under WAC 182-507-0125.

(b) When starting the 13th month from the original appointment date, a contractor will be paid a monthly rate of $235.00, or a medicaid aligned guardianship or conservatorship monthly rate, whichever is greater, for a tier 2 client.

History

Statutory Authority: RCW 43.17.060, 43.20B.030, and 74.08.090. WSR 24-16-044, § 388-106-2105, filed 7/30/24, effective 8/30/24.

Wash. Admin. Code § 388-106-2110 Eligibility criteria.

(1) To be eligible to participate as a contractor in the program a person must:

(a) Hold certification as a professional guardian and conservator approved by the state of Washington supreme court;

(b) Be in good standing with the certified professional guardian and conservator review board (CPGCRB);

(d) Hold a program contract with DSHS; and

(e) Comply with the requirements of the program as described in this chapter.

(2) To be eligible to participate as a recipient in the program a person must:

(a) Meet long-term care services and supports (LTSS) medicaid functional eligibility requirements in chapter 388-106 WAC and financial eligibility requirements in WAC 182-513-1315 (1)-(3) or be determined provisionally approved;

(b) Not have financial resources to pay for guardianship services, fees, or costs from their estate;

(d) At the time of referral and acceptance into the program, be occupying an acute care hospital bed, and not be in a restricted subgroup including current occupancy in a bed readiness program, skilled nursing facility, inpatient rehabilitation, inpatient mental health, emergency department, long-term acute care hospital bed, facility bed under observation status, or in a facility bed under a single bed certification pursuant to a cause under chapter 71.05 RCW;

(e) At the time of referral, no longer requires an inpatient level of care at an acute care hospital;

(f) Likely requires the appointment of a guardian or conservator to be able to access and maintain long-term services and support; and

(g) Not have a professional or lay guardian or conservator willing to accept nomination.

(3) To remain eligible to participate as a recipient in the program a person must:

(a) Remain functionally and financially eligible for DSHS LTSS benefits; and

(b) Receive a DSHS LTSS service.

History

Statutory Authority: RCW 43.17.060, 43.20B.030, and 74.08.090. WSR 24-16-044, § 388-106-2110, filed 7/30/24, effective 8/30/24.

Wash. Admin. Code § 388-106-2115 Referral process.

(1) An acute care hospital may submit a referral to home and community services under the following circumstances:

(a) Acute care hospital clinicians have determined that the person likely needs a guardian or conservator;

(b) The acute care hospital has a good faith belief that the person meets the eligibility requirements to participate in the program;

(d) The acute care hospital has submitted a long-term care medicaid application to DSHS on behalf of the person;

(e) The acute care hospital provides complete referral documents as required by DSHS; and

(f) The acute care hospital has, or will file, a petition for guardianship or conservatorship.

(2) DSHS, in its sole discretion, and subject to available funds, may waive the requirement of subsection (f) of this section and file a petition for guardianship or conservatorship or both instead of the referring acute care hospital.

History

Statutory Authority: RCW 43.17.060, 43.20B.030, and 74.08.090. WSR 24-16-044, § 388-106-2115, filed 7/30/24, effective 8/30/24.

Wash. Admin. Code § 388-106-2120 Acceptance into the program.

(1) Within available resources, home and community services will accept a person into the guardianship and conservatorship assistance program if DSHS determines that the person meets the eligibility requirements, the referral packet is complete, and there is a program slot available at the time of acceptance.

(2) DSHS prioritizes acceptance into the program on a first-come, first-served basis determined by the date DSHS receives a complete referral packet and DSHS completes an eligibility determination for the person.

(3) If there is not an appropriate program slot available for an eligible person, DSHS will put them on the waitlist for the determined tier slot. Placement on the waitlist does not guarantee that a person will be accepted into the program.

(4) Waitlist priority is determined based on a first-come basis utilizing the date DSHS receives a complete referral packet and DSHS completes an eligibility determination for the person.

(5) In the event that a person is found eligible for a tier 2 slot, but at the time of acceptance only a tier 1 slot is available, DSHS will accept the person into the tier 1 slot while simultaneously placing the person on the waitlist for a tier 2 slot. Acceptance into the tier 2 waitlist does not guarantee that a person will be accepted into the program under a tier 2 slot designation.

(6) Once a person is accepted into a program slot, DSHS makes a referral to all program contracted certified professional guardians and conservators for consideration of acceptance of nomination. DSHS has the sole discretion to remove a person from the program if after two months of initial contractor referral, no program contracted certified professional guardian or conservator agrees to accept the case for nomination by the court.

(7) Removal from the guardianship and conservatorship assistance program in no way affects the person's ability to be rereferred and reconsidered for inclusion onto the guardianship and conservatorship assistance program at a future date.

History

Statutory Authority: RCW 43.17.060, 43.20B.030, and 74.08.090. WSR 24-16-044, § 388-106-2120, filed 7/30/24, effective 8/30/24.

Wash. Admin. Code § 388-106-2125 Reconsideration of acceptance determination.

A referring acute care hospital may request that DSHS reconsider its decision to accept a person onto the guardianship and conservatorship assistance program. A request for reconsideration must be supported by the referring acute care hospital submission of supplemental documentation to support the person's eligibility. An acute care hospital does not have a right to an administrative hearing to contest any department decision made under this chapter.

History

Statutory Authority: RCW 43.17.060, 43.20B.030, and 74.08.090. WSR 24-16-044, § 388-106-2125, filed 7/30/24, effective 8/30/24.

Wash. Admin. Code § 388-106-2130 Notice of department decisions.

DSHS will provide an applicant or participant in the program, and their guardian or conservator as applicable, with written notice about department decisions about eligibility for acceptance onto, or continuation on, the program.

History

Statutory Authority: RCW 43.17.060, 43.20B.030, and 74.08.090. WSR 24-16-044, § 388-106-2130, filed 7/30/24, effective 8/30/24.

Wash. Admin. Code § 388-106-2135 Appeal of acceptance determination or discontinuation of program participation.

The person who is the subject of a referral for acceptance into or a recipient of services under the guardianship and conservatorship assistance program may request an administrative hearing to contest a department decision that they are not eligible for acceptance or continuation in the program. The person does not have a right to a hearing to contest the adequacy of the services, costs covered, or the amounts paid to the contracted guardian or conservator.

History

Statutory Authority: RCW 43.17.060, 43.20B.030, and 74.08.090. WSR 24-16-044, § 388-106-2135, filed 7/30/24, effective 8/30/24.

Wash. Admin. Code § 388-106-2140 Overpayment.

If DSHS or the guardian or conservator discovers that the person's estate has available and adequate resources to pay for guardianship fees or costs, the payments made under this program on behalf of the client are overpayments to the extent a court determines that the person's estate is able to pay for guardianship fees and costs paid for by the state funded guardianship and conservatorship assistance program.

History

Statutory Authority: RCW 43.17.060, 43.20B.030, and 74.08.090. WSR 24-16-044, § 388-106-2140, filed 7/30/24, effective 8/30/24.

Wash. Admin. Code § 388-106-2145 Program hold and reinstatement or forfeiture of program participation.

If a client ceases to remain financially eligible as required by WAC 182-513-1315 (1)-(3) while occupying a program slot, their program slot can be held for up to a maximum of 90 days from the date it is discovered the client is overresourced. This process is referred to as a "program hold". In the event that a client becomes financially reeligible for LTSS medicaid as outlined in WAC 182-513-1315 (1)-(3) within the designated 90-day hold period, they will be reinstated to their program slot for the remaining portion of the originally approved tier slot term; however, if at the end of the designated 90-day hold period, the client continues to be financially ineligible for the program, DSHS terminates their eligibility for the program.

History

Statutory Authority: RCW 43.17.060, 43.20B.030, and 74.08.090. WSR 24-16-044, § 388-106-2145, filed 7/30/24, effective 8/30/24.

Wash. Admin. Code § 388-106-2150 Estate recovery.

Services provided under this program are exempt from estate recovery as outlined in WAC 182-527-2742.

History

Statutory Authority: RCW 43.17.060, 43.20B.030, and 74.08.090. WSR 24-16-044, § 388-106-2150, filed 7/30/24, effective 8/30/24.

Wash. Admin. Code § 388-106-2155 Exception to rule (ETR).

Services provided under this program are exempt from the exception to rule process in WAC 388-440-0001.

History

Statutory Authority: RCW 43.17.060, 43.20B.030, and 74.08.090. WSR 24-16-044, § 388-106-2155, filed 7/30/24, effective 8/30/24.

Wash. Admin. Code § 388-106-2160 Personal needs allowance increase or participation reduction.

Services provided under this program are paid by state only funds. While DSHS is paying for services under this contract for a client, there will be no reduction in the amount a client must pay towards client responsibility to account for costs and fees associated with establishing and maintaining guardianship or conservatorship as outlined in WAC 182-513-1380 and 388-79A-005.

History

Statutory Authority: RCW 43.17.060, 43.20B.030, and 74.08.090. WSR 24-16-044, § 388-106-2160, filed 7/30/24, effective 8/30/24.

Wash. Admin. Code § 388-106-2165 Split appointment.

This program only pays for guardianship and conservatorship services of one contractor per case. In the event that the court orders a split appointment amongst multiple contracted providers, DSHS will only pay the guardian.

History

Statutory Authority: RCW 43.17.060, 43.20B.030, and 74.08.090. WSR 24-16-044, § 388-106-2165, filed 7/30/24, effective 8/30/24.

Chapter 388-107 Licensing requirements for enhanced services facilities.

Wash. Admin. Code § 388-107-0001 Definitions.

The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.

"Abandonment" means action or inaction by a person with a duty of care for a vulnerable adult that leaves the vulnerable person without the means or ability to obtain necessary food, clothing, shelter, or health care.

"Abuse" means the willful action or inaction that inflicts injury, unreasonable confinement, intimidation, or punishment on a resident. In instances of abuse of a resident who is unable to express or demonstrate physical harm, pain, or mental anguish, the abuse is presumed to cause physical harm, pain, or mental anguish. Abuse is also defined in RCW 74.34.020. Abuse includes sexual abuse, mental abuse, physical abuse, and exploitation of a resident, which have the following meanings:

(1) "Mental abuse" means any willful action or inaction of mental or verbal abuse. Mental abuse includes, but is not limited to, coercion, harassment, inappropriately isolating a resident from family, friends, or regular activity, and verbal assault that includes ridiculing, intimidating, yelling, or swearing;

(2) "Physical abuse" means the willful action of inflicting bodily injury or physical mistreatment. Physical abuse includes, but is not limited to, striking with or without an object, slapping, pinching, choking, kicking, shoving, prodding, or the use of chemical restraints or physical restraints except as described in section 388-107-0420;

(3) "Sexual abuse" means any form of nonconsensual sexual contact, including, but not limited to, unwanted or inappropriate touching, rape, sodomy, sexual coercion, sexually explicit photographing, and sexual harassment. Sexual contact may include interactions that do not involve touching, including but not limited to, sending a resident sexually explicit messages, or cuing or encouraging a resident to perform sexual acts. Sexual abuse includes any sexual contact between a staff person and a resident, whether or not it is consensual;

(4) "Exploitation" means an act of forcing, compelling, or exerting undue influence over a resident causing the resident to act in a way that is inconsistent with relevant past behavior, or causing the resident to perform services for the benefit of another.

"Activities of daily living" means the following tasks related to basic personal care: Bathing; toileting; dressing; personal hygiene; mobility; transferring; and eating.

"Administrative hearing" means a formal hearing proceeding before a state administrative law judge that gives:

(1) A licensee an opportunity to be heard in disputes about licensing actions, including the imposition of remedies, taken by the department; or

(2) An individual an opportunity to appeal a finding of abandonment, abuse, neglect, financial exploitation of a resident, or misappropriation of a resident's funds.

"Administrator" means an enhanced services facility administrator who must be in active administrative charge of the enhanced services facility as required in this chapter. Unless exempt under RCW 18.88B.041, the administrator must complete long-term care worker training and home care aide certification.

"Advance directive," as used in this chapter, means any document indicating a resident's choice with regard to a specific service, treatment, medication, or medical procedure option that may be implemented in the future such as power of attorney health care directive, limited or restricted treatment cardiopulmonary resuscitation (CPR), do not resuscitate (DNR), and organ tissue donation.

"Aggressive behavior" means actions by the individual that constitute a threat to the individual's health and safety or the health and safety of others in the environment.

"Antipsychotic medications" means that class of medications primarily used to treat serious manifestations of mental illness associated with thought disorders, which includes, but is not limited to, atypical antipsychotic medications.

"Applicant" means the individual or entity, as defined in this section that has submitted, or is in the process of submitting, an application for an enhanced services facility license.

"Capacity" means the maximum amount an enhanced services facility can serve is 16 residents.

"Caregiver" means the same as "long-term care worker" as defined in RCW 74.39A.009, as follows: "Long-term care workers" include all persons who provide paid, hands-on personal care services for the elderly or persons with disabilities, including but not limited to, individual providers of home care services, direct care workers employed by home care agencies, providers of home care agencies to persons with developmental disabilities under Title 71A RCW, all direct care workers in state-licensed enhanced services facilities, assisted living facilities, and adult family homes, respite care providers, direct care workers employed by community residential service businesses, and any other direct care worker providing home or community-based services to the elderly or persons with functional disabilities or developmental disabilities.

"Challenging behavior" means a persistent pattern of behaviors that inhibit the individual's functioning in public places, in the facility and integration within the community, or uncontrolled symptoms of a physical or mental condition. These behaviors may have been present for long periods of time or have manifested as an acute onset.

"Chemical dependency" means alcoholism, medication addiction, or dependence on alcohol and one or more other psychoactive chemicals, as the context requires and as those terms are defined in RCW 70.83C.010.

"Chemical dependency professional" means a person certified as a chemical dependency professional by the department of health under chapter 18.205 RCW.

"Deficiency" means an enhanced services facility's practice, action, or inaction that violates any or all of the requirements of chapter 70.97 RCW or this chapter.

"Department" means the department of social and health services.

"Direct supervision" means oversight by a person on behalf of the enhanced services facility who has met training requirements, demonstrated competency in core areas, or has been fully exempted from the training requirements, is on the premises, and is quickly and easily available to the caregiver.

"Enhanced services facility" or "ESF" means a facility licensed under chapter 70.97 RCW that provides treatment and services to persons for whom acute inpatient treatment is not medically necessary and who have been determined by the department to be inappropriate for placement in other licensed facilities due to the complex needs that result in behavioral and security issues. For the purposes of this chapter, an enhanced services facility is not an evaluation and treatment facility certified under chapter 71.05 RCW.

"Essential Support Person" means an individual who is: at least 18 years of age; designated by the resident, or by the resident's representative, if the resident is determined to be incapacitated or otherwise legally incapacitated; and necessary for the resident's emotional, mental, or physical well-being during situations that include, but are not limited to, circumstances involving compassionate care of end-of-life care, circumstances where visitation from a familiar person will assist with important continuity of care or the reduction of confusion and anxiety for residents with cognitive impairments, or other circumstances were the presence of an essential support person will prevent or reduce significant emotional distress to the resident.

"Facility" means an enhanced services facility.

"Holding technique" means using the least amount of force necessary to manually hold all or part of a person's body in a way that restricts the person's free movement; also includes any approved controlling maneuvers identified in the person-centered service plan. Examples include holds taught in approved training for deescalation techniques and control of self-harm or aggressive behavior. This definition does not apply to briefly holding, without force, a person in order to calm the person, or holding a person's hand to escort the person safely from one area to another.

"Inspection" means the process by which department staff evaluates the enhanced services facility licensee's compliance with applicable statutes and regulations.

"License suspension" means an action taken by the department to temporarily revoke an enhanced services facility license in accordance with RCW 70.97.120 and this chapter.

"Licensee" means the individual or entity, as defined in this chapter, to whom the department issues the enhanced services facility license.

"Licensed physician" means a person licensed to practice medicine or osteopathic medicine and surgery in the state of Washington.

"Likelihood of serious harm" means a substantial risk that:

(1) Physical harm will be inflicted by an individual upon their own person, as evidenced by threats or attempts to commit suicide or inflict physical harm on oneself;

(2) Physical harm will be inflicted by an individual upon another, as evidenced by behavior that has caused such harm or that places another person or persons in reasonable fear of sustaining such harm; or

(3) Physical harm will be inflicted by an individual upon the property of others, as evidenced by behavior that has caused substantial loss or damage to the property of others.

"Long-term care worker" as defined in RCW 74.39A.009, has the same meaning as the term "caregiver."

"Management agreement" means a written, executed agreement between the licensee and the manager regarding the provision of certain services on behalf of the licensee.

"Mandated reporter":

(1) Is an employee of the department, law enforcement officer, social worker, professional school personnel, individual provider, an employee of a facility, an operator of a facility, an employee of a social service, welfare, mental health, adult day health, adult day care, home health, home care, or hospice agency, county coroner or medical examiner, Christian Science practitioner, or health care provider subject to chapter 18.130 RCW; and

(2) For the purpose of the definition of mandated reporter, "facility" means a residence licensed or required to be licensed under chapter 18.20 RCW, Assisted living facility; chapter 18.51 RCW, Nursing homes; chapter 70.128 RCW, Adult family homes; chapter 72.36 RCW, Soldiers' homes; chapter 71A.20 RCW, Residential habilitation centers; chapter 70.97 RCW, Enhanced services facility or any other facility licensed by the department.

"Medically fragile" means a chronic and complex physical condition which results in prolonged dependency on specialized medical care that requires frequent daily skilled nursing interventions. If these medically necessary interventions are interrupted or denied, the resident may experience irreversible damage or death. Examples of specialized medical care and treatment for medically fragile residents include, but are not limited to: IV therapies requiring monitoring of vital signs and dose titration dependent on lab values; wound care requiring external vacuum or other mechanical devices for debridement; complicated wound care requiring other specialized or extensive interventions and treatment; ventilator or other respiratory device dependence and monitoring; dependence on licensed staff for complex respiratory support; and peritoneal or hemodialysis (on-site).

"Medication administration" means the direct application of a prescribed medication whether by injection, inhalation, ingestion, or other means, to the body of the resident by an individual legally authorized to do so.

"Medication service" means any service provided either directly or indirectly by an enhanced services facility related to medication administration, medication assistance, or resident self-administration of medication.

"Mental disorder" means any organic, mental, or emotional impairment that has substantial adverse effects on an individual's cognitive or volitional functions.

"Mental health professional" means a psychiatrist, psychologist, psychiatric nurse, licensed mental health counselor, licensed mental health counselor-associate, licensed marriage and family therapist, licensed marriage and family therapist-associate, licensed independent clinical social worker, licensed independent clinical social worker-associate, licensed advanced social worker, or licensed advanced social worker-associate and such other mental health professionals as may be defined by rules adopted by the secretary under the authority of chapter 71.05 RCW.

"Misappropriation of resident property" means the deliberate misplacement, exploitation, or wrongful, temporary or permanent use of a resident's belongings or money.

"Neglect" means:

(1) A pattern of conduct or inaction by a person or entity with a duty of care that fails to provide the goods and services that maintain physical or mental health of a resident, or that fails to avoid or prevent physical or mental harm or pain to a resident; or

(2) An act or omission by a person or entity with a duty of care that demonstrates a serious disregard of consequences of such a magnitude as to constitute a clear and present danger to the resident's health, welfare, or safety, including but not limited to, conduct prohibited under RCW 9A.42.100.

"Prescriber" means a health care practitioner authorized by Washington state law to prescribe medications.

"Professional person" means a mental health professional and also means a physician, registered nurse, and such others as may be defined in rules adopted by the secretary pursuant to the provisions of this chapter.

"Psychopharmacologic medications" means a class of prescription medications that affect the mind, emotions, and behavior, including, but not limited to, antipsychotics, antianxiety medication, and antidepressants.

"Reasonable accommodation" and "reasonably accommodate" have the meaning given in federal and state antidiscrimination laws and regulations which include, but are not limited to, the following:

(1) Reasonable accommodation means that the enhanced services facility must:

(a) Not impose an admission criterion that excludes individuals unless the criterion is necessary for the provision of enhanced services facility services;

(b) Make reasonable modification to its policies, practices, or procedures if the modifications are necessary to accommodate the needs of the resident;

(2) Reasonable accommodations are not required if:

(a) The resident or individual applying for admission presents a significant risk to the health or safety of others that cannot be eliminated by the reasonable accommodation;

(b) The reasonable accommodations would fundamentally alter the nature of the services provided by the enhanced services facility; or

"RCW" means Revised Code of Washington.

"Records" means:

(1) "Active records" means the current, relevant documentation regarding residents necessary to provide care and services to residents; or

"Registration records" include all the records of the department, regional support networks, treatment facilities, and other persons providing services to the department, county departments, or facilities which identify individuals who are receiving or who at any time have received services for mental illness.

"Resident" means a person admitted to an enhanced services facility.

"Resident representative" means:

(1) A court-appointed guardian or conservator of a resident, if any;

(a) Agents under power of attorney;

(b) Representative payees; and

"Secretary" means the secretary of the department or the secretary's designee.

"Significant change" means:

(1) A deterioration in a resident's physical, mental, or psychosocial condition that has caused or is likely to cause clinical complications or life-threatening conditions; or

(2) An improvement in the resident's physical, mental, or psychosocial condition that may make the resident eligible for discharge or for treatment in a less intensive or less secure setting.

"Significant medication error" means any failure to administer or receive a medication according to an authorized health care provider's order, or according to the manufacturer's directions for nonprescription medications, that results in an error involving the wrong medication, wrong dose, wrong patient, wrong time, wrong rate, wrong preparation, or wrong route of administration.

"Social worker" means a person with a master's or further advanced degree from a social work educational program accredited and approved as provided in RCW 18.320.010.

"Staff" or "staff person" means any person who:

(1) Is employed or used by an enhanced services facility, directly or by contract, to provide care and services to any resident.

(2) Staff must meet all of the requirements of chapter 388-112A WAC.

"Stop placement" or "stop placement order" means an action taken by the department prohibiting enhanced services facility admissions, readmissions, and transfers of patients into the enhanced services facility from the outside.

"Temporary restraining order" means restraining order or order of protection that expired without a hearing, was terminated following an initial hearing, or was terminated by stipulation of the parties in lieu of an initial hearing.

"Treatment" means the broad range of emergency, detoxification, residential, inpatient, and outpatient services and care, including diagnostic evaluation, mental health or chemical dependency education and counseling, medical, physical therapy, restorative nursing, psychiatric, psychological, and social service care, vocational rehabilitation, and career counseling.

"Violation" means the same as "deficiency" as defined in this section.

"Volunteer" means an individual who interacts with residents without reimbursement.

"Vulnerable adult" means a person:

(1) Sixty years of age or older who has the functional, mental, or physical inability to care for themselves; or

(2) Found incapacitated under RCW 74.34.020; or

(3) Who has a developmental disability as defined under RCW 71A.10.020; or

(4) Admitted to any facility, including any enhanced services facility; or

(5) Receiving services from home health, hospice, or home care agencies licensed or required to be licensed under chapter 70.127 RCW; or

(6) Receiving services from an individual provider.

(7) Who self-directs their own care and receives services from a personal aide under chapter 74.39 RCW.

(8) For the purposes of requesting and receiving background checks pursuant to RCW 43.43.832, it shall also include adults of any age who lack the functional, mental, or physical ability to care for themselves.

"WAC" means Washington Administrative Code.

History

Statutory Authority: RCW 18.20.090, 18.51.070, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 26-05-046, s 388-107-0001, filed 2/12/26, effective 3/15/26. Statutory Authority: RCW 18.20.090, 70.97.230, 70.128.040, chapters 70.129, 74.42, and 74.39 RCW. WSR 25-16-099, s 388-107-0001, filed 8/6/25, effective 9/6/25. Statutory Authority: Chapter 70.97 RCW. WSR 18-20-040, § 388-107-0001, filed 9/25/18, effective 10/26/18. Statutory Authority: RCW 70.97.230 and HCBS Final Rule 42 C.F.R. WSR 16-14-078, § 388-107-0001, filed 7/1/16, effective 8/1/16. Statutory Authority: Chapter 70.97 RCW. WSR 14-19-071, § 388-107-0001, filed 9/12/14, effective 10/13/14.

Wash. Admin. Code § 388-107-0010 Scope and purpose.

This implements chapter 70.97 RCW and sets the minimum health and safety standards for licensure and operations of enhanced services facilities. An enhanced services facility will provide treatment and services to a maximum of sixteen residents for whom acute inpatient treatment is not medically necessary and who have been determined by the department to be inappropriate for placement in other licensed facilities due to the complex needs that result in behavioral and security issues.

History

Statutory Authority: Chapter 70.97 RCW. WSR 14-19-071, § 388-107-0010, filed 9/12/14, effective 10/13/14.

Wash. Admin. Code § 388-107-0020 Department authority.

(1) Chapter 70.97 RCW authorizes the department to develop rules to implement the chapter, and to license enhanced services facilities. At a minimum the rules are to be written to promote safe treatment and necessary care of individuals residing in each facility, to provide for safe and clean conditions and to establish licensee qualifications, licensing and enforcement standards, and license fees sufficient to cover the cost of licensing and enforcement.

(2) The department, in its sole discretion and after taking into consideration the circumstances of a particular facility such as size or location, may approve alternate staffing, administration, physical plant, or other arrangements that have been proposed in writing by an ESF applicant or licensee. An ESF's failure to comply with a department-approved alternate plan is a violation of this chapter and may result in enforcement actions under WAC 388-107-1430.

History

Statutory Authority: RCW 70.97.230 and HCBS Final Rule 42 C.F.R. WSR 16-14-078, § 388-107-0020, filed 7/1/16, effective 8/1/16. Statutory Authority: Chapter 70.97 RCW. WSR 14-19-071, § 388-107-0020, filed 9/12/14, effective 10/13/14.

Wash. Admin. Code § 388-107-0030 Admission criteria.

The enhanced services facility will only admit residents who:

(1) Are at least eighteen years old; and

(2) Require:

(a) Daily care by or under the supervision of a mental health professional, chemical dependency professional, or nurse; or

(b) Assistance with three or more activities of daily living; and

(3) Have any of the following:

(a) A mental disorder, chemical dependency disorder, or both;

(b) An organic or traumatic brain injury; or

(4) Will benefit from the staffing levels and professional supports provided in this setting.

(5) If at a state hospital, has been deemed stable and ready for discharge.

(6) Does not meet the requirement for active treatment at a state hospital, but has not found appropriate placement in other community settings due to a history of two or more of the following:

(a) Self-endangering behaviors that are frequent or difficult to manage;

(b) Aggressive, threatening, or assaultive behaviors that create a risk to the health or safety of other residents or staff, or a significant risk to property and these behaviors are frequent or difficult to manage;

(d) Complex medication needs which include psychotropic medications;

(e) A history of or likelihood of unsuccessful placements in either a licensed facility or other state facility or a history of rejected applications for admission to other licensed facilities based on the resident's behaviors, history, or security needs;

(f) A history of frequent or protracted mental health hospitalizations; and/or

(g) A history of offenses against a person or felony offenses that created substantial damage to property.

History

Statutory Authority: Chapter 70.97 RCW. WSR 14-19-071, § 388-107-0030, filed 9/12/14, effective 10/13/14.

Wash. Admin. Code § 388-107-0040 Preadmission assessment.

(1) The enhanced services facility must complete a face to face preadmission assessment at the hospital with each potential resident prior to admission which includes the following minimum information:

(a) Resident identification information such as but not limited to the name, address and telephone number of the resident's:

(i) Representative;

(ii) Health care providers;

(iii) Significant family members identified by the resident;

(iv) Other individuals the resident wants involved or notified; and

(b) Presenting issues;

(d) Necessary and contraindicated medications, including psychotropic;

(e) A licensed medical or health professional's physical and mental health diagnoses;

(f) Significant known behaviors such as but not limited to aggressive, threatening, intrusive, assaultive, self-endangering including attempted suicide and/or homicide or other symptoms that may cause concern or require special care and staffing;

(g) Chemical dependency history, including tobacco;

(h) Level of personal care needs, assistance with activities of daily living;

(i) Activities and service preferences;

(j) Preferences regarding other issues important to the prospective resident, such as food and daily routine;

(k) Information that a potential resident is or is not court-ordered for treatment or under the supervision of the department of corrections;

(l) Individual's anticipated level of need for supervision in the community;

(m) Cognitive impairments that result in symptoms of behaviors requiring supervision and facility services;

(n) History of unsuccessful placement in the community settings; and

(o) Treatment recommendations or recommendations for additional program-specific assessment.

(p) A transition plan that:

(i) Allows the facility to work with the state hospital staff to understand what the resident responds to in difficult situations; and

(ii) Allows the facility to request hospital staff to visit resident in new environment and teach enhanced services facility staff techniques that have been successful in the hospital.

(2) The enhanced services facility will integrate information from the state's last comprehensive assessment reporting evaluation (CARE) into the facility's preadmission assessment.

History

Statutory Authority: Chapter 70.97 RCW. WSR 14-19-071, § 388-107-0040, filed 9/12/14, effective 10/13/14.

Wash. Admin. Code § 388-107-0050 Timing of preadmission assessment.

The assessor must complete the preadmission assessment of the prospective resident before the resident moves into the enhanced services facility.

History

Statutory Authority: Chapter 70.97 RCW. WSR 14-19-071, § 388-107-0050, filed 9/12/14, effective 10/13/14.

Wash. Admin. Code § 388-107-0060 Comprehensive assessment required.

(1) The enhanced services facility must complete a comprehensive assessment for each resident within fourteen days of admission.

(2) The assessment will be repeated when there is a significant change in the resident's condition or, at a minimum, every one hundred eighty days if there is no significant change in condition.

History

Statutory Authority: Chapter 70.97 RCW. WSR 14-19-071, § 388-107-0060, filed 9/12/14, effective 10/13/14.

Wash. Admin. Code § 388-107-0070 Comprehensive assessment.

The enhanced services facility must obtain sufficient information to be able to assess the capabilities, needs, and preferences for each resident, and must complete a comprehensive assessment. The assessment addresses the following, within fourteen days of the resident's move-in date:

(1) Individual's recent medical history, including, but not limited to:

(a) Diagnoses from a licensed medical or health professional, unless the resident objects for religious reasons;

(b) Chronic, current, and potential skin conditions; or

(d) Other considerations for providing care or services.

(2) Currently necessary and contraindicated medications and treatments for the individual, including any prescribed medications, over-the-counter medications, and antipsychotic medications.

(3) The individual's nursing needs.

(4) Significant known challenging behaviors or symptoms of the individual causing concern or requiring special care, including:

(a) History of substance abuse;

(b) History of harming self, others, or property;

(d) Individual's ability to leave the enhanced services facility unsupervised;

(e) Any court order or court stipulation regarding activities, surroundings, behaviors, and treatments; and

(f) Other safety considerations that may pose a danger to the individual or others, such as use of medical devices or the individual's ability to smoke unsupervised, if smoking is permitted outdoors in a specific location on the premises.

(5) Individual's special needs, by evaluating available information, or if available information does not indicate the presence of special needs, selecting and using an appropriate tool to determine the presence of symptoms consistent with, and implications for, care and services of:

(a) Mental illness, or needs for psychological or mental health services;

(b) Developmental disability;

(i) Base any determination that the resident has short-term memory loss upon objective evidence; and

(ii) Document the evidence in the resident's record.

(d) Other conditions affecting cognition, such as traumatic brain injury or other neurological conditions.

(6) Individual's activities, typical daily routines, habits and service preferences.

(7) Individual's personal identity and lifestyle, to the extent the individual is willing to share the information, and the manner in which they are expressed, including preferences regarding food, community contacts, hobbies, spiritual preferences, or other sources of pleasure and comfort.

(8) Who has decision-making authority for the individual, including:

(a) The presence of any advance directive or other legal document that will establish a substitute decision maker in the future;

(b) The presence of any legal document that establishes a current substitute decision maker or court orders for treatment, or documents indicating resident is under the supervision and care of the department of corrections; and

(9) A plan to use antipsychotic medications as prescribed and documented in the clinical record in accordance with chapters 71.05 and 70.97 RCW.

(10) If the resident is a medicaid client the assessment must include elements of the CARE assessment.

History

Statutory Authority: Chapter 70.97 RCW. WSR 14-19-071, § 388-107-0070, filed 9/12/14, effective 10/13/14.

Wash. Admin. Code § 388-107-0080 Ongoing comprehensive assessments.

(2) The enhanced services facility must:

(a) Complete a comprehensive assessment, addressing the elements set forth in WAC 388-107-0070, upon a significant change in the resident's condition or at least every 180 days if there is no significant change in condition;

(b) Complete an assessment specifically focused on a resident's identified strengths, preferences, limitations, and related issues:

(i) Consistent with the resident's change of condition as specified in WAC 388-107-0060;

(ii) When the resident's person-centered service plan no longer addresses the resident's current needs and preferences; and

(iii) When the resident has an injury requiring the intervention of a practitioner;

(i) No longer needs the level of behavioral support provided by the facility; or

(ii) Expresses the desire to move to a different type of community based setting;

(d) Ensure that the person-centered service planning team discusses all available placement options; and

(e) Ensure the staff person performing the ongoing assessments is a qualified assessor.

History

Statutory Authority: Chapter 18.51 RCW. WSR 23-14-029, § 388-107-0080, filed 6/26/23, effective 7/27/23. Statutory Authority: RCW 70.97.230 and HCBS Final Rule 42 C.F.R. WSR 16-14-078, § 388-107-0080, filed 7/1/16, effective 8/1/16. Statutory Authority: Chapter 70.97 RCW. WSR 14-19-071, § 388-107-0080, filed 9/12/14, effective 10/13/14.

Wash. Admin. Code § 388-107-0081 Ongoing comprehensive assessments—Requirements in effect from January 18, 2022, through June 8, 2023, in response to the state of emergency related to COVID-19.

(1) In response to the state of emergency related to the COVID-19 pandemic, the department adopted emergency rules under RCW 34.05.320 on January 18, 2022, to amend a portion of WAC 388-107-0080. The emergency rules remained in effect until June 8, 2023. The amended rules in place at that time were:

(2) The enhanced services facility must:

(a) Complete a comprehensive assessment, addressing the elements set forth in WAC 388-107-0070 on the following timelines:

(i) Upon a significant change in the resident's condition; or

(ii) At least every 180 days if there is no significant change in condition, except beginning January 18, 2022, assessments for residents whose care is state funded may be extended an additional 12 months during the COVID-19 public health emergency.