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STATE OF WASHINGTON
DEPARTMENT OF SOCIAL AND HEALTH SERVICES
AGING AND DISABILITY SERVICES ADMINISTRATION
PO Box 45600 ( Olympia, WA 98504-5600
H09- 050 - Procedure
August 18, 2009
|TO: |Home and Community Services (HCS) Division Regional Administrators |
| |Division of Developmental Disabilities (DDD) Regional Administrators |
| |Area Agency on Aging (AAA) Directors |
|FROM: |Bill Moss, Director, Home and Community Services Division |
| |Linda Rolfe, Director, Division of Developmental Disabilities |
|SUBJECT: |Resume Implementation of SHB 2361 regarding Payment to Home Care Agencies for Services when the Employee |
| |Providing Care is a Family Member of the Client |
|Purpose: |To notify staff that on August 12, 2009, the Temporary Restraining Order stopping implementation of SHB 2361 |
| |has ended. The request for a temporary injunction was denied by the U.S. District Court. Implementation of |
| |SHB 2361 will resume immediately. |
|Background: |Based on changes made by the State Legislature in the 2009 session, the department was prohibited from paying|
| |home care agencies for in-home, Medicaid-funded, personal care or DDD respite services if the agency employee|
| |was a family member of the client served. An exception to this rule is possible, if necessary for the |
| |client’s health and safety. |
| | |
| |These changes were incorporated into the Home Care Agency Statement of Work (SOW) which was implemented July |
| |1, 2009. |
| | |
| |On July 1, 2009, the Department received a Temporary Restraining Order from the U.S. District Court in Tacoma|
| |requiring the Department to postpone implementation of SHB 2361. The TRO was in effect through August 12, |
| |2009 and the Department suspended activities to transition home care agency family member caregivers to |
| |Individual Providers until a ruling was made. The TRO is now terminated. |
|What’s new, changed, or |Effective August 13, 2009, the department may resume implementation of SHB 2361 as outlined in MB H09-024. |
|Clarified |Deadline dates for completion have been adjusted and are noted below. |
|ACTION: |Actions to be taken by AAA and DDD offices: |
| |AAA and DDD offices will ensure they have a complete list from all contracted home care agencies identifying |
| |clients who are currently served by a family member. |
| |Resume contacting clients immediately to notify them of their choices and to determine if they want to hire |
| |their family member as an Individual Provider. |
| |The process of either contracting a family member as an Individual Provider or having the agency assign a |
| |non-family member employee shall begin immediately and must be completed for all clients no later than |
| |November 1, 2009. This process should be phased in and caregivers should be contracted and authorized in each|
| |of the next three months. As clients are contacted and choose Individual Provider or Home Care Agency care, |
| |their choice will be acted upon and services will transition on the 1st of the month. It is expected that |
| |transitions will occur proportionately on September 1, October 1 and November 1, 2009. |
| |Once the case manager has determined how a client affected by the new law will continue to receive their |
| |personal care (either through a family member as an IP, or through a home care agency employee, other than a |
| |family member) payment for family members providing care to a Medicaid-funded, personal care or DDD Respite |
| |client through home care agencies will not be authorized beginning the first of the next month following the |
| |client’s transition, unless the client has been approved through the Exception to Rule process. |
| |The attachment, Revised Contracting Procedures, provides contracting instructions for clients that choose to |
| |hire a family member as an Individual Provider. Included in the attachment are instructions related to health|
| |insurance coverage. Agency caregivers that previously had health insurance coverage through the agency will |
| |have the three month waiting period for the Individual Provider health insurance coverage waived if they |
| |choose to take the coverage. Please pay special attention to the SSPS instructions. |
| |Additionally, an MB outlining the IP wage scale for those caregivers affected by SHB 2361 will be posted. |
| |There are no administrative hearing rights related to this change. Clients will continue to have their |
| |choice of qualified providers. |
| |The department may make Exceptions to Rule (ETR) through the Personal Care ETR committee at headquarters, on |
| |a case-by-case basis, based on the client’s health and safety to authorize payment. ETR requests are to be |
| |forwarded to headquarters for review. Exception to Rule decisions are made on the basis of WAC 388-440-0001. |
| |The department and/or the AAA shall take appropriate enforcement action against a home care agency found to |
| |have charged the state for hours of care for which the department is not authorized to pay. These actions |
| |may include requiring recoupment of any payment made for hours of care provided by an employee who is related|
| |to the client being served. |
| |A resource booklet for clients who hire a family member as their IP will be issued through a Management |
| |Bulletin in the next week. |
| |Notify home care agencies if copies of background checks completed within the last year will be needed. (See |
| |Revised Contracting Procedures) |
| |Clients that were authorized home care agency services and have an agency family member providing services |
| |since the TRO took effect need to be notified of the prohibition outlined in SHB 2361. |
| | |
| |Actions to be taken by Home Care Agency Providers: |
| |Agencies who have not done so must immediately submit the Agency List form that was in MB H09-024 identifying|
| |agency clients that are served by family members to the AAA, DDD offices and ADSA. The lists are due no |
| |later than August 21. |
| |Agencies that submitted lists must send a list of any client served by a family member that was not |
| |identified on previous lists to the AAA, DDD and ADSA by August 28th. |
| |Employees transitioning to IPs may keep their health insurance benefits. Agencies are encouraged to offer |
| |payroll deductions to facilitate the transition process. |
| |Have employees complete an attestation form and keep record of completion in each employee’s personnel file. |
| |A sample form that can be used is attached to MB H09-024. |
| |Send copies of all training certificates for those family members becoming Individual Providers to the |
| |appropriate AAA or DDD office. For clients on New Freedom, training certificates should be sent to Asian |
| |Counseling and Referral Service (ACRS). The training certificates are due by the end of the month following |
| |termination of agency authorization. |
| |Provide copies of any background check that has been run within the last year for employees transitioning to |
| |become an IP, if requested by the authorizing agency. |
| |Implement policies and procedures sufficient to assure compliance with this new contract requirement. |
| | |
| |Actions for Contract Management Staff: |
| |Ensure that the TRO language attached to the SOW is annulled. |
|Related | |
|REFERENCES: | |
|ATTACHMENT(S): |Revised Contracting Instructions: |
| |[pic] |
| |Statement of Work: |
| |[pic] |
| |MB H09-024: |
| |[pic] |
|CONTACT(S): |Brent Apt, State Unit on Aging |
| |(360) 725-2560 |
| |AptBR2@dshs. |
| | |
| |Geri-Lyn McNeill, State Unit on Aging |
| |(360) 725-2611 |
| |mcneigl@dshs. |
| | |
| |Debbie Johnson, Division of Developmental Disabilities |
| |(360) 725-3525 |
| |JohnsDA2@dshs. |
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HCS MANAGEMENT BULLETIN
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