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STATE OF WASHINGTON

DEPARTMENT OF SOCIAL AND HEALTH SERVICES

Aging and Long-Term Support Administration

Home and Community Services Division

PO Box 45600, Olympia, WA 98504-5600

H14-098 – Policy/Procedure

May 22, 2014

|TO: |Area Agency on Aging (AAA) Directors |

| | |

| |Home and Community Services (HCS) Division Regional Administrators |

| | |

| |Developmental Disability Administration (DDA) Regional Administrators |

|FROM: |Bea Rector, Director, Home and Community Services Division |

| | |

| |Don Clintsman, Deputy Assistant Secretary, Developmental Disabilities Administration |

|SUBJECT: |Notice letter to recipients of in-home personal care services regarding Exception to Rule (ETR) requests |

|Purpose: |To inform and provide direction to staff about notice letters being mailed to in-home personal care |

| |recipients regarding ETR requests. |

|Background: |Facing severe budget shortfalls in late 2010, DSHS announced reductions to in-home personal care services. |

| |The reduction took effect on January 1, 2011. A group of individual personal care recipients, together with |

| |the provider union and other organizations, filed legal action in federal court. The Plaintiffs requested a |

| |preliminary order restoring the December 2010 base hours pending a trial on their legal claims. In October |

| |2011, the Ninth Circuit Court of Appeals ordered that the individuals named as plaintiffs in the lawsuit |

| |should have their hours restored pending trial. Following the Ninth Circuit's decision, and discussions with|

| |the U.S. Department of Justice and Department of Health and Human Services, DSHS issued Home and Community |

| |Services Management Bulletin H13-001 Exception to Rule Requests for In-Home Personal Care Services. |

| | |

| |The Ninth Circuit remanded the case to trial court. After a series of negotiations, the parties entered into|

| |a settlement agreement dismissing the lawsuit. |

| | |

| |On December 8, 2013 DSHS issued HCS Management Bulletin H13-078, Settlement Agreement in M.R. V. Dreyfus |

| |which outlined the Department’s agreement with Plaintiffs and dismissal of the lawsuit. |

|What’s new, changed, or |As part of the settlement agreement, the Department agreed to provide notice to all Washington recipients of |

|Clarified |in-home personal care regarding the ETR request process, including the consideration of an individual’s |

| |serious risk of institutionalization in determining whether to request an ETR. Beginning November 1, 2013, |

| |the notice was provided to recipients as they were assessed. The notice was included with their CARE |

| |assessment Service Summary. For recipients who have not had a face-to-face assessment since November 1, 2013,|

| |notice letters will be mailed no later than May 31, 2014. |

|ACTION: |Notice letters |

| |ADS HQ: |

| |ADS HQ will send a letter to in-home personal care recipients who have an open SSPS authorization as of April|

| |15, 2014, the date the data was pulled, and who have not had an Initial, Annual, or Significant Change |

| |assessment moved to current after November 1, 2013. Clients identified in CARE as having a written language |

| |other than English will receive a letter in English and in their identified written language. If an NSA or |

| |guardian is identified, he or she will receive a copy of the letter translated in the client’s identified |

| |written language and in English. |

| | |

| |Field Staff: |

| |Field Staff must send the notice letter (attached below) from their local offices in the following |

| |circumstances: |

| |Clients who have not had an Initial, Annual, or Significant Change assessment since 11/1/2013 AND did not |

| |have an open SSPS authorization on 4/15/2014, but remain eligible for personal care services. |

| |Clients on an exception list. Regions/AAAs will receive an exception list for clients whose: |

| |Mailing data was incomplete |

| |Translation was needed but the language was marked as “other” in CARE |

| |Translation was unavailable in specified written language. Translations were unavailable in a few languages |

| |due to lack of professional translation resources available. If a client was on an exception list for this |

| |reason the CM/CRM will need to send the English letter to the client and contact the client or NSA/guardian |

| |using a language phone line service and read the letter over the phone. Document this phone call in a SER. |

| | |

| |When CM/CRMs mail a notice letter, they must note in a SER that the notice letter was mailed and place a copy|

| |of it in the client’s electronic file. |

| | |

| |If CM/CRMs need to mail a notice letter to a client whose mailing data was incomplete and whose identified |

| |written language is something other than English, the CM/CRM must send a translated letter and an English |

| |letter to the client and NSA/Guardian. If a client is on an exception list because their language was marked |

| |as “other” in CARE, CM/CRMs need to identify the appropriate language and send both a translated letter and |

| |English letter to the client and NSA/Guardian. You can request translated templates from Patty McDonald. |

| |Email Patty mcdonPM@dshs. and provide her with the requested language. |

|Related |WAC 388-440-0001 |

|REFERENCES: |CR-103P Amendment to 388-440-0001: |

|ATTACHMENT(S): |HB H13-001: |

| |[pic] |

| | |

| |HB H13-078: |

| |[pic] |

| | |

| |Recipient ETR Letter: |

| |[pic] |

|CONTACT(S): |Rachelle Ames, HCS Program Manager |

| |(360) 725-2353 |

| |amesrl@dshs. |

| | |

| |Debbie Roberts, DDA Program Manager |

| |(360) 725-3525 |

| |debbie.roberts@dshs. |

| | |

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HCS MANAGEMENT BULLETIN

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