Developmental Disabilities Administration

Chapters 388-825, 388-828, 388-832 & 388-845 WAC

DDA is proposing amendments to sections from chapters 388-825, 388-828, 388-832, and 388-845 WAC. The purpose of this proposed rulemaking is to update lists of available services, their names, descriptions, limits, and qualified providers, and to increase the individual and family service (IFS) award amounts. These amendments also repeal sections about positive behavior support and consultation, which DDA no longer authorizes as of 9/1/22. *Amended text filed 10-14-24*

Preproposal filed as WSR 24-02-034
Proposed rules filed as WSR 24-21-043 

Hearing Date:  December 10, 2024

Chapter 388-828 WAC

DDA is planning to amend sections in chapter 388-828 WAC (the Supports Intensity Scale (SIS-A) portions of the DDA assessment) to align with updates the American Association of Intellectual and Developmental Disabilities (AAIDD) has made to its SIS-A assessment tool, Second Edition. Aligning with AAIDD’s Second Edition will not impact the algorithm.

Preproposal filed as WSR 24-07-054
Proposed rules filed as WSR 24-19-062  

Hearing Date:  November 5, 2024

Chapter 388-829 WAC

DDA is amending these rules primarily to ensure providers complete the skills-demonstration portion of CPR in accordance with OSHA guidelines. Other changes clarify the content of various training components, use terminology more consistently, and remove unused definitions and update others. WAC 388-829-0010 What definitions apply to this chapter?, 388-829-0015 What training is required for individuals hired or contracted to work in DDA community residential settings as a direct support professional or ISS staff on or after January 1, 2016?, 388-829-0020 What is the 75-hour certificate?, 388-829-0035 Who is exempt from the DDA community residential 75-hour training requirement?, 388-829-0040  What are the training requirements for exempt individuals?, 388-829-0050 What is basic training?, 388-829-0055 How are training entities and instructors for DDA community residential settings approved?, 388-829-0060 What are the qualifications for on-the-job training, including client-specific training?, 388-829-0065 What are the requirements for DDA community residential instructors to teach the DDA 40-hour residential training?, 388-829-0075  What is nurse delegation core training?, and 388-101D-0105 Staff training within six months of employment.

Chapter 388-833 WAC

Chapter 388-833 WAC, Intensive Habilitation Services for Children Program. DDA is amending these rules to allow DDA-contracted entities to provide Intensive Habilitation Services for Children; establish a connection between this chapter and the certification rules DDA is developing and plans to adopt under new chapter 388-825A WAC.

Chapter 388-823 WAC

Chapter 388-823 WAC – Developmental disabilities administration intake and eligibility determination.

WACs 388-825-335, 388-825-600, 388-825-610, 388-825-615 & 388-825-620

DDA is proposing to amend, WAC 388-825-335, Is a background check required of a long-term care worker employed by a home care agency licensed by the department of health?, 388-825-600, What definitions apply to WAC 388-825-600 through 388-825-690 of this chapter?, 388-825-610, Who must have a background check and a background check renewal?, 388-825-615, What type of background check is required?, and 388-825-620, How often must a background check be renewed?

Hearing Date:  June 25, 2024

WACs 388-101D-0295 & 388-101D-0330

WAC 388-101D-0295, Medication services-General, and 388-101D-0330, Storage of medications. DDA amended these rules to amend the labeling requirements for prescribed and over-the-counter medications for clients who receive services from providers under chapter 388-101D WAC – group homes, group training homes, supported living, and state-operated living alternatives for adults.

Hearing Date:  June 4, 2024

WACs 388-850-020, 388-850-025, 388-850-035 & 388-850-045

WAC 388-850-020, Plan development and submission, 388-850-025, Program operation—General provisions, 388-850-035, Services—Developmental disabilities, and 388-850-045, What is the formula for distribution of funding to the counties? These amendments are intended to increase the percentage of allocated funds for county administrative expenses and to simplify the process for county plan development. The first time these rules went to hearing there was a typo in a contact person’s email address. DDA would like to have another public hearing and public comment period to ensure stakeholders have another opportunity to provide comment.

Hearing Date:  May 21, 2024

WACs 388-850-020, 388-850-025, 388-850-035 & 388-850-045

The department is proposing to amend these rules WAC 388-850-020, Plan development and submission; 388-850-025, Program operation—General provisions; 388-850-035, Services—Developmental disabilities; and 388-850-045, What is the formula for distribution of funding to the counties? to increase the percentage of a county’s allocated funds for county administrative expenses, to remove text that duplicates requirements dictated by statute, and to update the distribution formula and other outdated service names and processes and to simplify the process for county plan development.

WACs 388-823-0600, 388-823-0610, 388-823-1005 & 388-823-1010

WAC 388-823-0600, How do I show that I have another neurological or other condition similar to intellectual disability?, 388-823-0610, If I have another neurological or other condition similar to intellectual disability, how do I meet the definition of substantial functional limitations?, 388-823-1005, When does my eligibility as a DDA client expire?, and 388-823-1010, When will DDA review my eligibility to determine if I continue to meet the eligibility requirements for DDA? DDA is amending these rules to implement House Bill 1407 (2023), make changes to the eligibility expiration processes, and clarify language in the eligibility review section.

WACs 388-845-0045, 388-845-1105, 388-845-1505 & 388-845-3062

WAC 388-845-0045, When there is capacity to add people to a waiver, how does DDA determine who will be enrolled?, 388-845-1105, Who is a qualified provider of stabilization services - crisis diversion bed?, 388-845-1505, Who are qualified providers of residential habilitation services for the core waiver?, and 388-845-3062, Who is required to sign the person-centered service plan and how can it be signed? DDA is amending these rules to align with amendments to home and community-based services waivers as approved by the Centers for Medicare and Medicaid Services. Major changes include: adding a priority group for waiver enrollment; adding a new provider type for stabilization services; and adding signature options for person-centered service plans.

WACs 388-825-335, 388-825-615 & 388-825-620

DDA is amending these rules to comply with federal background check requirements and to align rules with recent amendments to state law passed under Senate Bill 5252. WAC 388-825-335, Is a background check required of a long-term care worker employed by a home care agency licensed by the department of health?, 388-825-615, What type of background check is required?, and 388-825-620, How often must a background check be renewed?

WACs 388-101D-0190, 388-101D-0195, 388-101D-0196, 388-101D-0197, 388-101D-0198, 388-101D-0200 & 388-101D-0201

DDA is amending rules from chapter 388-101D WAC, and creating new rules, in order to establish procedures for addressing a client’s unmet support needs, and suspending or terminating a client’s services, and to codify procedures for the client critical case protocol.

WAC 388-823-1095 & 388-823-1096

DDA is amending WAC 388-823-1096 to add the federal Medicaid requirements for integrated settings directly into DDA’s rules. DDA is amending WAC 388-823-1095 to clarify that the integrated settings requirements establish rights in addition to those established under by Chapter 71A.26 RCW. These amendments are intended to distinguish more clearly between client rights guaranteed by Washington Statute (codified in WAC 388-823-1095) and federal Medicaid requirements (codified in WAC 388-823-1096) for delivering home and community-based services in integrated settings.

WACs 388-845-0603, 388-845-0610 & 388-845-2110

WAC 388-845-0603, Who is eligible to receive community inclusion services?, 388-845-0610, Are there limits to community inclusion services you may receive? and 388-845-2110, Are there limits to the supported employment services you may receive? These changes to chapter 388-845 WAC are necessary to implement amendments to DDA’s home and community-based services (HCBS) waivers as approved by the federal Centers for Medicare and Medicaid Services (CMS). Substantive changes remove the prohibition to receive employment services and community inclusion services concurrently and remove “consecutive” to align with RCW 71A.12.200.

Chapter 388-845 WAC

These changes to chapter 388-845 WAC are necessary to implement amendments to DDA’s home and community-based services (HCBS) waivers as approved by the federal Centers for Medicare and Medicaid Services (CMS). Major changes to the chapter: adjust the yearly limits applicable to certain waivers; add assistive technology to multiple waivers; remove the positive behavior support and consultation service from all waivers except the Community Protection waiver; amend the definition of the specialized evaluation and consultation service; amend the definition of community engagement; add teleservice as a service delivery method; add remote supports to multiple waivers; and make other changes necessary to implement amendments to DDA’s HCBS waivers as approved by CMS.

Chapter 388-829Z WAC

Chapter 388-829Z WAC, Emergency Transitional Support Services. DDA is proposing new rules to regulate the emergency transitional support services provided at Rainier, a Washington state resident habilitation center. Emergency transitional support services were created in direct response to the COVID-19 public health emergency. With the declared state of emergency over, these rules are intended to inform clients about the service they are receiving and the future of that service.

WAC 388-829-0087

WAC 388-829-0087, What continuing education credit is granted to direct support professionals employed during the pandemic and when must continuing education be completed? DDA is amending WAC 388-829-0087 to extend due dates for continuing education credits required under chapter 388-829 WAC. Direct service providers hired during the COVID-19 public health emergency (PHE) were required to complete 12 hours of continuing education annually. As a result of the PHE, the number of training programs available to provide department-approved continuing education significantly diminished. Changing rules, standards, and a sudden shift to electronic training resulted in both a delay in available training and an increased demand. Providers have reported that there are still a significant number of workers who need to complete continuing education hours that were due while PHE-related training waivers were in place. This is affecting their ability to meet requirements for current renewal cycles because hours must be applied to the older renewal cycles first. Without an extension, direct service providers could end up out of compliance, which could limit client access to qualified providers.

WACs 388-829C-131, 388-829C-230, 388-829C-232, 388-829C-233, 388-829C-234, 388-829C-235, 388-829R-005, 388-829R-011, 388-829R-165 & 388-829R-170

The purpose of these amendments is to allow companion home providers to access: respite through overnight planned respite services (OPRS) providers; and planned respite through residential habilitation centers. Other changes notification to a primary caregiver when a client receiving OPRS experiences an emergency. The proposed amendments will give companion home providers more options for accessing respite services.

WACs 388-828-1020 & 388-828-1520

The Developmental Disabilities Administration (DDA) is amending these rules to add and revise definitions for the chapter; add options for how an assessment is completed; clarify when and where home visits occur; and require home visits for all clients receiving a paid service. Requiring DDA to conduct a home visit for all clients receiving a paid service will give clients the opportunity to see their case manager in-person when completing an assessment or home visit. Expanding these visits to more clients could result in increased health and safety oversight.

WAC 388-101D-0065 and chapter 388-825 WAC

The department is proposing these amendments to WAC 388-101D-0065 to replace details about background checks in WAC 388-101D-0065 with cross-references to chapter 388-113 and 388-825 WAC for consistency. Amendments to Chapter 388-825 WAC replace inaccurate cross references; add, remove, and amend definitions; clarify service eligibility for state-only funded services, medicaid state plan services, DDA services provided to children in foster care; update rules about home care agencies and individual providers to align with chapters 388-71, 388-113, and 388-115 WAC; amend appeal related rules; add exemptions allowable under statute for enrolled members of federally recognized Indian tribes; amend background check rules, particularly those for RHC employees; create comprehensive lists of DDA-authorized services. Amendments to these rules are necessary to: align with the creation of the consumer-directed employer; require new background check processes for Residential Habilitation Center (RHC) employees; align with amendments to chapters 388-71, 388-113, and 388-115 WAC; and clarify processes for hearings, authorizing state-only funded services, correct outdated language and broken cross-references.

*Please note that WAC 388-825-615(4) was corrected on January 17, 2023.

WACs 388-829B-200, 388-829B-300, 388-829B-400 & 388-829B-600

The department is proposing these amendments to comply with direction from the Legislature, help identify clients who might be at increased risk of abuse and neglect, serve an increased number of clients on the enhanced case management program (ECMP) caseload, and clarify appeal rights regarding enrollment onto the ECMP caseload. This chapter is how DDA enrolls a client on the caseload, how often the CRM must visit the client, and when DDA may disenroll a client from the caseload.

WACs 388-828-9235, -9340, -9360, 388-845-1035, & -2105

The department’s Developmental Disability Administration is proposing to amend WAC 388-828-9235, How does DDA determine your environmental support score?, 388-828-9340, How does your employment service type affect how your employment service hours are used?, 388-828-9360, What is short-term employment support?, 388-845-1035, Who are qualified providers of individualized technical assistance services?, and 388-845-2105, Who are qualified providers of supported employment services?

WACs 388-101D-0030, -0070, -0075, & -0080

The department’s Developmental Disability Administration is proposing to amend WAC 388-101D-0030, Staffing requirements., 388-101D-0070, Background checks—National fingerprint background checks., 388-101D-0075, Background checks—Requirements for service providers, and 388-101D-0080, Background checks—Provisional hire—Pending results.  This is a supplemental notice to WSR 22-05-014 & 22-07-077.

WAC 388-829-0085, 388-829-0086 and 388-829-0087

The department is proposing to amend WAC 388-829-0085 to clarify when continuing education credits must be completed and proposing new WACs 388-829-0086 and 388-829-0087 to establish training and continuing education requirements for people employed during the COVID-19 public health emergency.

WAC 388-823-0510

WAC 388-823-0510, What constitutes substantial limitation due to autism? The department’s Developmental Disability Administration (DDA) is proposing amendments to this section to expand the list of professionals from whom DDA accepts a statement that a person’s autism prevents the person from completing a full-scale intellectual quotient test.

WAC 388-101D-0030

The department’s Developmental Disabilities Administration (DDA) is proposing to amend this rule to allow providers to hire an employee without a high school diploma or GED: WAC 388-101D-0030, Staffing requirements.  

WAC 388-845-2019

The department is proposing this rule that makes temporary allowances necessary to address the health and safety of waiver recipients and help control the spread of COVID-19. The allowances in this rule were approved by the Centers for Medicare and Medicaid Services in an Appendix K waiver, the purpose of which is to address the effects of the COVID-19 public health emergency. These temporary allowances will end according to direction from CMS.

WAC 388-829-0085, WAC 388-829-0086, and WAC 388-829-0087

WAC 388-829-0085, How many hours of continuing education must DDA community residential staff complete each year?; WAC 388-829-0086, When must a direct support professional employed during the COVID-19 public health emergency complete training?; WAC 388-829-0087, When must continuing education be completed when public health emergency waivers are lifted, and what continuing education credit is granted to direct support professionals employed during the pandemic?  The department is proposing to amend  WAC 388-829-0085 to clarify when continuing education credits must be completed and proposing to add new WACs 388-829-0086 and 388-829-0087 establish training and continuing education requirements for people employed during the COVID-19 public health emergency.

Preproposal filed as WSR 21-20-130
Proposed rules filed as WSR 22-06-012
Hearing Date: April 5, 2022

WITHDRAWN as  WSR 22-08-064

Chapter 388-847 WAC

Chapter 388-847 WAC, Stabilization, Assessment, and Intervention Facility (SAIF). The department is proposing to add new sections of rules that establish eligibility criteria for admission to a stabilization, assessment, and intervention facility (SAIF), and other service delivery requirements.

WAC 388-101D-0070

DDA amended WAC 388-101D-0070 to align it with 28 C.F.R. Section 20.33(d). 

WACs 388-829C-131 and 135

DDA is amending this rule to remove the daily rate multiplier from rule, to remove the DSHS 10-234 requirement, and to establish requirements for clients who require a positive behavior support plan and receive services from a companion home provider.

WAC 388-845-2110

The department is planning to amend WAC 388-845-2110, Are there limits to the supported employment services you may receive? The proposed amendments adjust the criteria for who can receive supported employment services. Rather than requiring a person to be graduated from high school, the criteria in subsection (1)(b) has been broadened to “no longer eligible to enroll in high school.” Additional proposed amendments align with approved HCBS waivers by: replacing “community access” with the service’s new name, “community inclusion;” and removing prevocational services, which are no longer available through DDA’s HCBS waivers.

WACs 388-823-0500, 0720

The department is proposing to amend WAC 388-823-0500 establish criteria for an acceptable diagnostic report. Amendments to WAC 388-823-0720 replace the Woodcock-Johnson Test of Achievement with the Woodcock-Johnson Test of Cognitive Abilities.

WAC 388-101D-0500

DDA is amending this section primarily to require approval of a community protection (CP) client’s home location by the CP provider’s administrator. Other proposed amendments require documentation of: the administrator’s approval; the client’s new address; and the security precautions the provider will implement.

Chapter 388-828 WAC

DDA is amending this chapter to update the DDA assessment rules to reflect the switch from a desktop application to a web-based application. These changes do not affect any algorithms in the assessment that determine eligibility for a service or a client’s benefit level. DDA also amended the definition of “contracted provider” to include both CDE-employed individual providers. Additional amendments replace outdated terminology, such as “DDD,” “ISP,” “ADSA,” “ICF/MR,” “SSPS,” etc., and update and clarify language that was inaccurate or ambiguous.

Chapter 388-845 WAC

Amendments to chapter 388-845 WAC align rules with the amendments approved by the Centers for Medicare and Medicaid Services (CMS). The amendments affect all five of DDA’s Home and Community-Based Services (HCBS) waivers and: update service definitions and service names; change some service limits; add services to various waivers; remove services from various waivers; change eligibility criteria for specific services; change qualified provider criteria for various services; and repeal several sections.

Chapter 388-826 WAC

The proposed amendments align with recent amendments to chapter 74.13 RCW, and align with new chapter 71A.28 RCW, Out-of-Home Services.

WAC 388-823-0500, 0510, 0720

The Developmental Disabilities Administration (DDA) is proposing to amend these rules to align with changes to the Diagnostic Statistical Manual, extend the age range for acceptable evidence of onset, remove the severity level criteria requirement, and add more FSIQ assessment types.

WAC 388-829-0005

The Developmental Disabilities Administration (DDA) is proposing to amend WAC 388-829-0005, Who do the training requirements in this chapter apply to?

Chapter 388-101D WAC

The Developmental Disabilities Administration (DDA) is amending these rules primarily to update policy on when functional assessments and positive behavior support plans are required.