Wash. Admin. Code § 296-33-010
Attendant services are proper and necessary personal care services (custodial care) provided to maintain the claimant in their residence.
Yes. To be covered by the crime victims compensation program, attendant services must be requested by the attending physician and authorized by the department before services begin.
Yes, all other insurances both private and public must be used first.
The program will stop payment of attendant care services if the service is no longer medically necessary, or the maximum benefit is reached.
The program covers proper and necessary attendant services that are provided consistent with the claimant's needs, abilities and safety. Only attendant services that are necessary due to the physical restrictions caused by the crime are covered.
The following are examples of attendant services that may be covered:
* Bathing and personal hygiene;
* Dressing;
* Administration of medications;
* Specialized skin care, including changing or caring for dressings or ostomies;
* Tube feeding;
* Feeding assistance (not meal preparation);
* Mobility assistance, including walking, toileting and other transfers;
* Turning and positioning;
* Bowel and incontinent care; and
* Assistance with basic range of motion exercises.
Services the department considers everyday environmental needs, unrelated to the medical needs of the claimant, are not covered. The following are examples of some chore services that are not covered:
*Housecleaning;
*Laundry;
*Shopping;
*Meal planning and preparation;
*Transportation of the claimant;
*Errands for the claimant;
*Recreational activities;
*Yard work;
*Child care.
Yes. Periodic evaluations by the crime victims compensation program or its designee will be performed. Evaluations may include, but not be limited to, a medical records review and an on-site review of appropriate attendant services consistent with the claimant's needs, ability, and safety.
Attendant services must be provided through an agency licensed, certified or registered to provide home care or home health services.
In order to receive a provider account number from the department, a provider must:
*Complete a provider account application;
*Sign a provider agreement;
*Provide a copy of any practice or other license held;
*Complete, sign and return Form W-9; and
* Meet the department's provider eligibility requirements.
Note: A provider account number is required to receive payment from the department but is not a guarantee of payment for services.
The crime victims compensation program will determine the maximum hours of authorized care based on an independent nursing assessment conducted in the claimant's residence. More than one provider may be authorized, based on the claimant's needs and the availability of providers. Attendant service providers are limited to a maximum of seventy hours per week per provider.
*Active - Account information is current and provider is eligible to receive payment.
*Inactive - Account is not eligible to receive payment based on action by the department or at provider request. These accounts can be reactivated.
*Terminated - Account is not eligible to receive payment based on action by the department or at provider request. These accounts cannot be reactivated.
The department may inactivate a provider account when:
*There has been no billing activity on the account for eighteen months; or
*The provider requests inactivation; or
*Provider communications are returned due to address changes; or
* The department changes the provider application or application procedures; or
*Provider does not comply with department request to update information.
The department may terminate a provider account when:
*The provider is found ineligible to treat per department rules; or
*The provider requests termination; or
*The provider dies or is no longer in active business status.
To reactivate a provider account, the provider may call or write the department. The department may require the provider to update the provider application and/or agreement or complete other needed forms prior to reactivation. Account reactivation is subject to department review. If a provider account has been terminated, a new provider application will be required.
Wash. Admin. Code § 296-33-010
Statutory Authority: Chapter 7.68 RCW. 12-23-085, § 296-33-010, filed 11/20/12, effective 1/1/13. Statutory Authority: RCW 7.68.030. 02-06-024, § 296-33-010, filed 2/25/02, effective 3/28/02.