WAC 296-33-010
Attendant services. (1) What are attendant
services?
Attendant services are proper and necessary personal care
services (custodial care) provided to maintain the victim in
their residence.
(2) Who may receive attendant services?
Victims who are temporarily or permanently totally disabled
and rendered physically unable to care for themselves due to the
crime may receive attendant services.
(3) Is prior authorization required for attendant services?
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.
(4) Am I required to use other insurance coverage before the
crime victims compensation program will cover attendant services?
Yes, all other insurances both private and public must be
used first.
(5) What attendant services does the crime victims program
cover?
The program covers proper and necessary attendant services
that are provided consistent with the victim'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.
(6) What attendant services are not covered?
Services the department considers everyday environmental
needs, unrelated to the medical needs of the victim, are not
covered. The following are examples of some chore services that
not covered:
• Housecleaning;
• Laundry;
• Shopping;
• Meal planning and preparation;
• Transportation of the victim;
• Errands for the victim;
• Recreational activities;
• Yard work;
• Child care.
(7) Will the crime victims compensation program review the
attendant services being provided?
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 victim's needs, ability, and safety.
(8) Who is eligible to become a provider of attendant
services?
Any person eighteen years of age and over that maintains an
active provider account with the crime victims compensation
program. Attendant service providers can be family members or
others who the victim hires to perform nonskilled home nursing
services.
(9) Is my attendant service provider(s) an employee(s) of
the crime victims compensation program?
No. Even though the crime victims compensation program is
required by the federal government to withhold certain payroll
taxes from moneys paid to some nonagency providers, the victim is
the common law employer of attendant service provider(s).
(10) How can a provider obtain a provider account number
from the department?
In order to receive a provider account number from the
department, a provider must:
• Complete a provider 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.
(11) How many hours will be authorized for attendant
services?
The crime victims compensation program will determine the
maximum hours of authorized care based on an independent nursing
assessment conducted in the victim's residence. More than one
provider may be authorized, based on the victim's needs and the
availability of providers. Attendant service providers are
limited to a maximum of seventy hours per week per provider.
(12) What are theprovider account status definitions?
• 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.
(13) When may the department inactivate a provider account?
The department may inactivate a provider account when:
• There has been no billing activity on the account for
thirty-six 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.
(14) When may the department terminate a provider account?
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.
(15) How can a provider reactivate a provider account?
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.