Washington Administrative Code
Title 182 - Health Care Authority
WASHINGTON APPLE HEALTH
Chapter 182-513 - Client not in own home-Institutional medical
Section 182-513-1530 - Maximum guardianship fee and related cost deductions allowed from a client's participation or room and board on or after June 1, 2018
Universal Citation: WA Admin Code 182-513-1530
Current through Register Vol. 24-18, September 15, 2024
(1) General information.
(a) This section sets the
maximum guardianship fee and related cost deductions when:
(i) A court order was entered on or after
June 1, 2018; or
(ii) The client
under guardianship began receiving medicaid-funded long-term services and
supports on or after June 1, 2018.
(b) This section only applies to a client who
is:
(i) Eligible for and receives
institutional services under chapter 182-513 WAC or home and community-based
waiver services under chapter 182-515 WAC, and who is required to pay
participation under WAC
182-513-1380,
182-515-1509,
or
182-515-1514;
or
(ii) Eligible for long-term
services and supports under chapter 182-513 or 182-515 WAC, and who is required
to pay only room and board.
(c) All requirements of this section remain
in full force whether or not the agency appears at a guardianship
proceeding.
(d) In this section,
the agency does not delegate any authority in determining eligibility or
post-eligibility for medicaid clients.
(i)
Under the authority granted by
RCW
11.92.180, the agency does not deduct more
than the amounts allowed by this section from participation or room and
board.
(ii) The eligibility rules
under Title 182 WAC remain in full force and effect.
(e) The agency does not reduce a client's
participation or room and board under this section for guardianship fees or
related costs accumulated during any month that a client was not required to
pay:
(i) Participation under WAC
182-513-1380,
182-515-1509,
or
182-515-1514;
or
(ii) Room and board under
chapter 182-513 or 182-515 WAC.
(f) If the client has another fiduciary,
payee, or other principal-agency relationship and the agent is allowed
compensation, any monthly guardianship fee approved under this section is
reduced by the agent's compensation.
(2) Maximum guardianship fee and related cost deductions.
(a) The maximum guardianship fee
and related cost deductions under this section include all guardianship
services provided to the client, regardless of the number of guardians
appointed to a client during a period of time, or whether the client has
multiple guardians appointed at the same time.
(b) Maximum guardianship fees and related
cost deductions are as follows:
(i) The total
deduction for costs directly related to establishing a guardianship for a
client cannot exceed $1,850;
(ii)
The total deduction for guardianship-related costs cannot exceed $1,200 during
any three-year period; and
(iii)
The amount of the monthly deduction for guardianship fees cannot exceed $235
per month.
(3) For people under subsection (1)(b)(i) of this section -Participation deductions.
(a)
After receiving the court order, the agency or its designee adjusts the
client's current participation to reflect the deductions under WAC
182-513-1380,
182-515-1509,
or
182-515-1514.
(b) The amounts of the participation
deductions are the amounts under subsection (2) of this section, or the court
order, whichever are less.
(c) For
clients who pay room and board in addition to participation, if the client's
amount of participation is insufficient to allow for the amounts under
subsection (2) of this section, then, regardless of any provision of chapter
182-513 or 182-515 WAC, the client's room and board will be adjusted to allow
the amounts under subsection (2) of this section.
(4) For people under subsection (1)(b)(ii) of this section - Room and board deductions.
(a)
The agency adjusts the client's room and board after receiving the court order,
regardless of any provision of chapter 182-513 or 182-515 WAC.
(b) The amounts of the room and board
deductions are the amounts under subsection (2) of this section, or the court
order, whichever are less.
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