WSR 04-18-083

EMERGENCY RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Aging and Disability Services)

[ Filed August 31, 2004, 3:06 p.m. , effective August 31, 2004 ]


Purpose: The emergency rule revises chapter 388-72A WAC, Comprehensive assessment and reporting evaluation (CARE) tool, to incorporate CARE assessment criteria for children receiving state plan Medicaid personal care (MPC) services.

The department has withdrawn proposed WAC 388-72A-0042 filed under WSR 04-14-099 and scheduled for public hearing on September 7, 2004. This WAC is included in this emergency and has also been filed under a supplemental CR-102 proposed rule. This emergency filing of new WAC 388-72A-0042 replaces and supersedes only the same section as filed in emergency rules WSR 04-15-013. Other emergency rules in WSR 04-15-013 will remain in effect.

Statutory Authority for Adoption: RCW 74.08.090 and 74.09.520.

Other Authority: RCW 74.39A.095.

Under RCW 34.05.350 the agency for good cause finds that immediate adoption, amendment, or repeal of a rule is necessary for the preservation of the public health, safety, or general welfare, and that observing the time requirements of notice and opportunity to comment upon adoption of a permanent rule would be contrary to the public interest.

Reasons for this Finding: Based on fair hearings, the department has determined that confusion about the new CARE assessment as described under current rules in chapter 388-72A WAC is leading to inconsistent hearing decisions and is jeopardizing the fair and equitable administration of home and community programs. Additional information about the CARE algorithm needs to be included in chapter 388-72A WAC immediately in order to allay such confusion and to ensure that clients receive benefits appropriate to their assessed needs.

A supplemental CR-102, Proposed rule-making notice for adoption of permanent rules on this subject has been filed and a public hearing is scheduled for October 5, 2004, see WSR 04-18-071.

Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.

Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 2, Amended 0, Repealed 0.

Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 2, Amended 0, Repealed 0.

Date Adopted: August 30, 2004.

Brian H. Lindgren, Manager

Rules and Policies Assistance Unit

3464.2
NEW SECTION
WAC 388-72A-0042   How are ADLs and IADLs scored for children?   For children, the following age appropriate guidelines apply. The table indicates which tasks are considered met per age of the child.
Activities of Daily Living (ADLs)
Ages
&sqbul;= Code status as Met 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
Medication Management
Independent, supervision,

limited, extensive, or Total

&sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Locomotion in RoomNote
Independent, supervision,

limited or extensive

&sqbul; &sqbul; &sqbul;
Total &sqbul;
Locomotion Outside RoomNote
Independent or supervision &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Limited or extensive &sqbul; &sqbul; &sqbul;
Total &sqbul;
Walk in RoomNote
Independent, supervision,

limited or extensive

&sqbul; &sqbul; &sqbul;
Total &sqbul;
Bed Mobility
Independent, supervision,

limited or extensive

&sqbul; &sqbul;
Total &sqbul;
Transfers
Independent, supervision,

limited, extensive or total &

under 30 pounds

&sqbul; &sqbul;
(Total & over 30 pounds=no

age limit)

Toilet Use
Support provided for

nighttime wetting only

(Independent, supervision,

limited, extensive, or total)

&sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Independent, supervision,

limited, extensive

&sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Total &sqbul; &sqbul; &sqbul;
Eating
Independent, supervision,

limited, extensive, or total

&sqbul; &sqbul;
Bathing
Independent or supervision &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Physical assistance all/part &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Total &sqbul; &sqbul; &sqbul; &sqbul;
Dressing
Independent or supervision &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Limited or extensive &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Total &sqbul; &sqbul; &sqbul; &sqbul;
Personal Hygiene
Independent or supervision &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Limited or extensive &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Total &sqbul; &sqbul; &sqbul; &sqbul;
Instrumental Activities of Daily Living
Ages
&sqbul;= Code status as Met 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
Telephone
Independent, supervision,

limited, extensive, or Total

&sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Transportation
Independent, supervision,

limited, extensive, or total

&sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Shopping
Independent, supervision,

limited, extensive, or total

&sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Wood Supply
Independent, supervision,

limited, extensive, or total

&sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Housework
Independent, supervision,

limited, extensive, or total

&sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Finances
Independent, supervision,

limited, extensive, or total

&sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Meal Preparation
Independent, supervision,

limited, extensive, or total

&sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;

NOTE: If the activity did not occur, the assessor codes self performance as total and status as met.

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NEW SECTION
WAC 388-72A-0043   How are other elements in CARE scored for children age seventeen and younger and foster care clients?   (1) For children age seventeen and younger, the assessor scores their needs, using the following age appropriate guidelines.


Ages
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
Additional guidelines based

on age

Any foot care needs
Status Need met &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Any skin care (other than

feet)

Status Need met &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Speech/Hearing
Score comprehension as

understood

&sqbul; &sqbul;
Memory
Short term memory ok &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Long term memory ok &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Depression
Select interview= unable to

obtain

&sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Decision making
Rate how client makes

decisions= independent

&sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Bladder/Bowel
Support provided for

nighttime wetting only -

&sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Individual management=

Doesnot need/use

Individual management=

Does not need/use

&sqbul; &sqbul; &sqbul; &sqbul; &sqbul;

(2) For client in foster care, the assessor does not score mental health therapy, behaviors, or depression.

[]

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