WAC 388-825-252
Family support services. (1) The
purpose of the family support program is to reduce or
eliminate the need for out-of-home residential placement of an
individual with developmental disabilities where it is in the
best interest of the person to continue living with their
family.
(2) The department's family support services include the
following and become available only after you have used your
full benefits through medicaid, private insurance, school and
child development services:
(a) Respite care is intermittent relief to the family
caregiver and may include community activities which provide
respite;
(b) Nursing services provided by a registered nurse or
licensed practical nurse, that cannot be provided by an
unlicenced caregiver, including but not limited to,
ventilation, catheterization, insulin injections, etc.;
(c) Therapeutic services including occupational therapy,
physical therapy, communication therapy, behavior management,
or counseling needed by individuals with developmental
disabilities.
(3) Receiving family support services is based on:
(a) Funding for state paid services available in the
state operating budget;
(b) SSP funding available to the individual/family.
(4) The following rules, subsections (5) through (9),
apply only to family support services authorized by the
department and do not govern services purchased by the family
with SSP (state supplementary payment) funding (see WAC 388-827-0145 and 388-827-0170).
(5) Up to nine hundred dollars of the service need level
amount in WAC 388-825-254 may be used during a one year period
for use as follows. The requested service must be necessary
as a result of the disability of the individual and after you
have used your full benefits through medicaid, private
insurance, school and child development services:
(a) Training and supports including parenting classes and
disability related support groups. This does not include
registration or costs related to conferences;
(b) Specialized equipment and supplies including the
purchase, rental, loan or refurbishment of specialized
equipment or adaptive equipment not covered by another
resource including medicaid. Mobility devices such as walkers
and wheelchairs are included, as well as communication devices
and medical supplies such as diapers for children three years
of age and older;
(c) Environmental modification including home repairs for
damages or modifications to the home needed because of the
disability of the individual;
(d) Medical/dental services not covered by any other
resource. This may include the payment of insurance premiums
and deductibles and is limited to the premiums and deductibles
of the individual;
(e) Special formulas or specially prepared foods as
prescribed by a licensed physician and needed because of the
disability of the individual;
(f) Parent/family counseling related to the individual's
disability, dealing with a diagnosis, grief and loss issues,
genetic counseling and behavior management. Payments cannot
be approved for services occurring after the death of the
eligible individual;
(g) Specialized clothing adapted for a physical
disability, excessive wear clothing, or specialized footwear;
(h) Specialized utility costs including extraordinary
supplemental utility costs related to the individual's
disability or medical condition;
(i) If another resource is not available, transportation
costs, including gas, ferry or transit cost, so an individual
can receive essential services and appointments; per diem
costs may be reimbursed for medical appointments. Funds
cannot be used for the purchase or rental of a car or for
airfare.
(6) Recommendations will be made to the regional
administrator by a review committee. The regional
administrator will approve or disapprove the request and will
communicate reasons for denial to the committee.
(7) Payment for services specified in subsection (5)
shall cover only the portion of cost attributable to the
individual.
(8) Requests must be received by DDD no later than midway
through the service authorization period unless circumstances
exist justifying an emergency.
(9) A plan shall be developed jointly by the family and
the department for each service authorization period. The
department may choose whether to contract directly with the
vendor, to authorize purchase by another agency, or may
reimburse the parent of the individual.
(10) Emergency services. Emergency funds may be
requested for use in response to a single incident or
situation or short term crisis such as care giver
hospitalization, absence, or incapacity. The request shall
include anticipated resolution of the situation. Funds shall
be provided for a limited period not to exceed two months. All requests are to be reviewed and approved or denied by DDD.
(a) If approved, you will receive emergency services for
a limited time period, not to exceed two months.
(b) If denied, you have no appeal rights.
(11) If the individual becomes eligible and begins to
receive medicaid personal care services as defined in chapters 388-71 and 388-72A WAC or other DSHS in-home residential
support service, the family support funding will be reduced at
the beginning of the next month of service. The family will
receive notice of the reconfiguration of services at least
five working days before the beginning of the month.
(12) Family support services may be authorized below the
amount requested by the family for the period. When, during
the authorized service period, family support services are
reduced or terminated below the amount specified in service
authorizations, the department shall deem such actions as a
reduction or termination of services.
[Statutory Authority: RCW 71A.12.030, 71.A12.120
[71A.12.120], and chapter 71A.12 RCW. 04-22-068, §
388-825-252, filed 10/29/04, effective 11/29/04. Statutory
Authority: RCW 71A.12.030, 71A.10.020 and 2002 c 371. 04-02-014, § 388-825-252, filed 12/29/03, effective 1/29/04. Statutory Authority: RCW 71A.16.010, 71A.16.030, 71A.12.030,
chapter 71A.20 RCW, RCW 72.01.090, and 72.33.125. 02-16-014,
§ 388-825-252, filed 7/25/02, effective 8/25/02. 99-19-104,
recodified as § 388-825-252, filed 9/20/99, effective 9/20/99.
Statutory Authority: RCW 71A.12.030, 71A.12.040 and Title 71A RCW. 97-13-051, § 275-27-220, filed 6/13/97, effective
7/14/97. Statutory Authority: RCW 71A.12.040 and 43.43.745. 94-04-092 (Order 3702), § 275-27-220, filed 2/1/94, effective
3/4/94. Statutory Authority: RCW 71A.12.040. 92-09-114
(Order 3372), § 275-27-220, filed 4/21/92, effective 5/22/92. Statutory Authority: RCW 71.20.070. 88-05-004 (Order 2596),
§ 275-27-220, filed 2/5/88; 86-18-049 (Order 2418), §
275-27-220, filed 8/29/86.]