WSR 09-04-064

PROPOSED RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Aging and Disability Services Administration)

[ Filed February 2, 2009, 4:23 p.m. ]

     Original Notice.

     Preproposal statement of inquiry was filed as WSR 08-17-096.

     Title of Rule and Other Identifying Information: The department is amending chapter 388-823 WAC, Division of developmental disabilities intake and determination of developmental disabilities, amending WAC 388-823-0010, 388-823-0040, 388-823-0140, 388-823-0150, 388-823-0160, 388-823-0170, 388-823-0200, 388-823-0210, 388-823-0310, 388-823-0410, 388-823-0420, 388-823-0510, 388-823-0515, 388-823-0600, 388-823-0610, 388-823-0615, 388-823-0800, 388-823-0810, 388-823-0820, 388-823-0830, 388-823-0840 and 388-823-1010; and repealing WAC 388-823-0700 and 388-823-0710.

     Hearing Location(s): Blake Office Park East, Rose Room, 4500 10th Avenue S.E., Lacey, WA 98503 (one block north of the intersection of Pacific Avenue S.E. and Alhadeff Lane. A map or directions are available at http://www.dshs.wa.gov/msa/rpau/docket.html or by calling (360) 664-6094), on March 24, 2009, at 10:00 a.m.

     Date of Intended Adoption: Not earlier than March 25, 2009.

     Submit Written Comments to: DSHS Rules Coordinator, P.O. Box 45850, Olympia, WA 98504, delivery 4500 10th Avenue S.E., Lacey, WA 98503, e-mail DSHSRPAURulesCoordinator@dshs.wa.gov, fax (360) 664-6185, by 5 p.m. on March 24, 2009.

     Assistance for Persons with Disabilities: Contact Jennisha Johnson, DSHS rules consultant, by March 10, 2009, TTY (360) 664-6178 or (360) 664-6094 or by e-mail at johnsjl4@dshs.wa.gov.

     Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: These amendments combine the eligibility rules for "another neurological condition" with "other condition closely related to mental retardation or that requires treatment similar to that required for individuals with mental retardation." The phrase "adaptive functioning" has been replaced with "functional limitations" throughout the chapter. The adaptive behavior assessment system-second edition (ABAS-II) has been added as an acceptable assessment used to demonstrate certain developmental disabilities. Minor grammatical revisions have been incorporated.

     Reasons Supporting Proposal: The department is defining the eligibility rules to conform to RCW 71A.10.020(3).

     Statutory Authority for Adoption: RCW 71A.12.030, 71A.10.020(3).

     Statute Being Implemented: Title 71A RCW.

     Rule is not necessitated by federal law, federal or state court decision.

     Name of Proponent: Department of social and health services, governmental.

     Name of Agency Personnel Responsible for Drafting: Debbie Roberts, 640 Woodland Square Loop S.E., Lacey, WA 98503-1045, P.O. Box 45310, Olympia, WA 98507-5310, e-mail roberdx@dshs.wa.gov, (360) 725-3400, fax (360) 404-0955; Implementation: Linda Lunsford, 640 Woodland Square Loop S.E., Lacey, WA 98503-1045, P.O. Box 45310, Olympia, WA 98507-5310, e-mail LunsfLL@dshs.wa.gov, (360) 725-3440, fax (360) 404-0955; and Enforcement: Don Clintsman, 640 Woodland Square Loop S.E., Lacey, WA 98503-1045, P.O. Box 45310, Olympia, WA 98507-5310, e-mail clintdl@dshs.wa.gov, (360) 725-3421, fax (360) 404-0955.

     No small business economic impact statement has been prepared under chapter 19.85 RCW. The division of developmental disabilities has analyzed the rule amendments and has concluded that small businesses and small nonprofits are not significantly affected by these rules and that no jobs will be created or lost due to the implementation of these rules. Therefore, a small business economic impact statement is not required.

     A cost-benefit analysis is required under RCW 34.05.328. A preliminary cost-benefit analysis may be obtained by contacting Debbie Roberts, 640 Woodland Square Loop S.E., Lacey, WA 98503-1045, P.O. Box 45310, Olympia, WA 98507-5310, phone (360) 725-3400, fax (360) 404-0955, e-mail roberdx@dshs.wa.gov.

January 28, 2009

Stephanie E. Schiller

Rules Coordinator

4020.5
AMENDATORY SECTION(Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)

WAC 388-823-0010   Definitions.   The following definitions apply to this chapter:

     "ABAS-II" means adaptive behavior assessment system-second edition, which is a comprehensive, norm-referenced assessment of adaptive behavior and skills of individuals from birth through age eighty-nine.

     "Client" means a person ((with)) who has a developmental disability as defined in ((chapter 388-823 WAC)) RCW 71A.10.020(3) who ((is currently eligible and active with the division of developmental disabilities)) also has been determined eligible to receive services by DDD under chapter 388-823 WAC.

     "DAS" means differential ability scales, which is a cognitive abilities battery for children and adolescents at least age two years, six months but under age eighteen.

     "DDD" means the division of developmental disabilities, a division within the aging and disability services administration, department of social and health services.

     "Department" means the department of social and health services.

     "Division" means the division of developmental disabilities.

     "Eligible" means you have a developmental disability that meets all of the requirements in this chapter for a specific condition.

     "Expiration date" means a specific date that your eligibility as a client of DDD and all services paid by DDD will stop.

     "FSIQ" means the full scale intelligence quotient which is a broad measure of intelligence achieved through one of the standardized intelligence tests included in these rules. Any standard error of measurement value will not be taken into consideration when making a determination for DDD eligibility.

     "Functional limitation" means a reduced ability or lack of ability to perform an action or activity in the manner or within the range considered to be normal as described in detail throughout this chapter.

     "ICAP" means the inventory for client and agency planning. This is a standardized assessment of functional ability. The adaptive behavior section of the ICAP assesses daily living skills and the applicant awareness of when to perform these skills. The goal is to get a snapshot of his/her ability.

     "IMR" means an institution for the mentally retarded, per chapter 388-835 WAC or chapter 388-837 WAC.

     "K-ABC" means Kaufman assessment battery for children, which is a clinical instrument for assessing intellectual development. It is an individually administered test of intelligence and achievement for children at least age two years, six months but under age twelve years, six months. The K-ABC comprises four global scales, each yielding standard scores. A special nonverbal scale is provided for children at least age four years but under age twelve years, six months.

     "Leiter-R" means Leiter international performance scale - revised, which is an untimed, individually administered test of nonverbal cognitive ability for individuals at least age two years but under age twenty-one years.

     "Review" means DDD must redetermine that you still have a developmental disability according to the rules that are in place at the time of the review.

     "RHC" means one of five residential habilitation centers operated by the division: Lakeland Village, Yakima Valley School, Fircrest, Rainier School, and Francis Haddon Morgan Center.

     "SIB-R" means the scale of independent behavior-revised which is an adaptive behavior assessment derived from quality standardization and norming. It can be administered as a questionnaire or as a carefully structured interview, with special materials to aid the interview process.

     "SOLA" means a state operated living alternative residential service for adults operated by the division.

     "Stanford-Binet" is a battery of fifteen subtests measuring intelligence for individuals at least age two years but under age twenty-three years.

     "Termination" means an action taken by DDD that stops your DDD eligibility and services paid by DDD.

     "VABS" means Vineland adaptive behavior scales, which is an assessment to measure adaptive behavior in children from birth but under age eighteen years, nine months and in adults with low functioning in four separate domains: Communication, daily living skills, socialization, and motor skills.

     "Wechsler" means the Wechsler intelligence scale, which is an individually administered 11-subtest measure of an individual's capacity for intelligent behavior. The Wechsler has both a verbal scale and a performance scale. The Wechsler is used with individuals at least age three years but under age seventy-four years. The verbal scale can be used alone with individuals who have visual or motor impairments, and the performance scale can be used alone with individuals who cannot adequately understand or produce spoken language. There are three Wechsler intelligence scales, dependent upon the age of the individual:

     • The Wechsler preschool and primary scale of intelligence - revised (WPPSI-R), for children at least age three years but under age seven years;

     • The Wechsler intelligence scale for children - third edition, (WISC-III), for children at least age six years but under age sixteen years; and

     • The Wechsler adult intelligence scale - revised (WAIS-R), for individuals at least age sixteen years but under age seventy-four years.

[Statutory Authority: RCW 71A.10.020, 71A.12.030, 71A.12.050, 71A.12.070, 71A.16.020, 71A.16.030, 71A.16.040, 71A.16.050, and chapters 71A.10, 71A.12, and 71A.16 RCW. 05-12-130, § 388-823-0010, filed 6/1/05, effective 7/2/05.]


AMENDATORY SECTION(Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)

WAC 388-823-0040   What is a developmental disability?   (1) A developmental disability is defined in RCW 71A.10.020(3) and must meet all of the following requirements. The developmental disability must currently:

     (a) Be attributable to mental retardation, cerebral palsy, epilepsy, autism, or another neurological or other condition found by DDD to be closely related to mental retardation or requiring treatment similar to that required for individuals with mental retardation;

     (b) Originate prior to age eighteen;

     (c) Be expected to continue indefinitely; and

     (d) Result in substantial functional limitations ((to an individual's adaptive functioning)).

     (2) In addition to the requirements listed in (1) above, you must meet the other requirements contained in this chapter.

[Statutory Authority: RCW 71A.10.020, 71A.12.030, 71A.12.050, 71A.12.070, 71A.16.020, 71A.16.030, 71A.16.040, 71A.16.050, and chapters 71A.10, 71A.12, and 71A.16 RCW. 05-12-130, § 388-823-0040, filed 6/1/05, effective 7/2/05.]


AMENDATORY SECTION(Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)

WAC 388-823-0140   What if I do not have written evidence that my disability began before my eighteenth birthday?   (1) If there is no documentation available to prove that your disability began prior to age eighteen, DDD may accept verbal information from your family or others who knew you prior to the age of eighteen about your early developmental history, educational history, illnesses, injuries or other information sufficient to validate the existence of an eligible condition prior to age eighteen.

     (2) DDD will determine if the reported verbal information is adequate for documenting the existence of your condition prior to age eighteen.

     (3) Additional evidence of your eligible condition and the resulting substantial functional limitations ((to adaptive functioning)) is still required.

[Statutory Authority: RCW 71A.10.020, 71A.12.030, 71A.12.050, 71A.12.070, 71A.16.020, 71A.16.030, 71A.16.040, 71A.16.050, and chapters 71A.10, 71A.12, and 71A.16 RCW. 05-12-130, § 388-823-0140, filed 6/1/05, effective 7/2/05.]


AMENDATORY SECTION(Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)

WAC 388-823-0150   Which rules define a developmental disability if I am a child under the age of six years?   If you are a child under the age of six years, assessment of developmental delays and other age appropriate criteria are used to ((substantiate)) demonstrate an eligible condition and substantial functional limitations ((in adaptive functioning)) as defined in WAC 388-823-0800 through 388-823-0850.

[Statutory Authority: RCW 71A.10.020, 71A.12.030, 71A.12.050, 71A.12.070, 71A.16.020, 71A.16.030, 71A.16.040, 71A.16.050, and chapters 71A.10, 71A.12, and 71A.16 RCW. 05-12-130, § 388-823-0150, filed 6/1/05, effective 7/2/05.]


AMENDATORY SECTION(Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)

WAC 388-823-0160   Which rules define a developmental disability if I am age six through nine?   If you are a child age six but under age ten, you can meet the criteria for a developmental disability under either of the two following sets of rules:

     (1) Developmental delays per WAC 388-823-0800 through 388-823-0850; or

     (2) Developmental disabilities per WAC 388-823-0200 through ((388-823-0710)) 388-823-0615.

[Statutory Authority: RCW 71A.10.020, 71A.12.030, 71A.12.050, 71A.12.070, 71A.16.020, 71A.16.030, 71A.16.040, 71A.16.050, and chapters 71A.10, 71A.12, and 71A.16 RCW. 05-12-130, § 388-823-0160, filed 6/1/05, effective 7/2/05.]


AMENDATORY SECTION(Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)

WAC 388-823-0170   Which rules define a developmental disability if I am age ten or older?   If you are age ten or older, only the rules in WAC 388-823-0200 through ((388-823-0710)) 388-823-0615 apply when deciding if you have a developmental disability.

[Statutory Authority: RCW 71A.10.020, 71A.12.030, 71A.12.050, 71A.12.070, 71A.16.020, 71A.16.030, 71A.16.040, 71A.16.050, and chapters 71A.10, 71A.12, and 71A.16 RCW. 05-12-130, § 388-823-0170, filed 6/1/05, effective 7/2/05.]


AMENDATORY SECTION(Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)

WAC 388-823-0200   What evidence do I need to ((substantiate)) demonstrate "mental retardation" as an eligible condition?   Evidence that you have an eligible condition under "mental retardation" requires a diagnosis of mental retardation by a licensed psychologist, or a finding of mental retardation by a certified school psychologist or a diagnosis of Down syndrome by a licensed physician.

     (1) This diagnosis is based on documentation of a lifelong condition originating before age eighteen.

     (2) The condition results in significantly below average intellectual and adaptive skills functioning that will not improve with treatment, instruction or skill acquisition.

     (3) A diagnosis or finding of mental retardation by the examining psychologist must include an evaluation of adaptive functioning that includes the use of a standardized adaptive behavior scale indicating adaptive functioning that is more than two standard deviations below the mean, in at least two of the following areas: Communication, self care, home living, social/interpersonal skills, use of community resources, self direction, functional academic skills, work, leisure, health, and safety.

[Statutory Authority: RCW 71A.10.020, 71A.12.030, 71A.12.050, 71A.12.070, 71A.16.020, 71A.16.030, 71A.16.040, 71A.16.050, and chapters 71A.10, 71A.12, and 71A.16 RCW. 05-12-130, § 388-823-0200, filed 6/1/05, effective 7/2/05.]


AMENDATORY SECTION(Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)

WAC 388-823-0210   If I have mental retardation, how do I meet the definition of substantial functional limitations ((in adaptive functioning))?   (1) If you meet the definition of mental retardation in WAC 388-823-0200, you must have substantial limitations in adaptive functioning of two standard deviations below the mean and a full-scale intelligence quotient (FSIQ) of more than two standard deviations below the mean.

     (2) The substantial limitation in adaptive functioning must reflect your current condition.

[Statutory Authority: RCW 71A.10.020, 71A.12.030, 71A.12.050, 71A.12.070, 71A.16.020, 71A.16.030, 71A.16.040, 71A.16.050, and chapters 71A.10, 71A.12, and 71A.16 RCW. 05-12-130, § 388-823-0210, filed 6/1/05, effective 7/2/05.]


AMENDATORY SECTION(Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)

WAC 388-823-0310   If I have cerebral palsy, how do I meet the definition of substantial functional limitations ((to adaptive functioning))?   If you have an eligible condition of cerebral palsy, substantial functional limitations ((of adaptive functioning)) is the need for direct physical assistance on a daily basis with two or more of the following activities as a result of your condition:

     (1) Toileting;

     (2) Bathing;

     (3) Eating;

     (4) Dressing;

     (5) Mobility; or

     (6) Communication.

[Statutory Authority: RCW 71A.10.020, 71A.12.030, 71A.12.050, 71A.12.070, 71A.16.020, 71A.16.030, 71A.16.040, 71A.16.050, and chapters 71A.10, 71A.12, and 71A.16 RCW. 05-12-130, § 388-823-0310, filed 6/1/05, effective 7/2/05.]


AMENDATORY SECTION(Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)

WAC 388-823-0410   If I have epilepsy, how do I meet the definition of substantial functional limitations ((to adaptive functioning))?   A substantial functional limitation ((to adaptive functioning)) under epilepsy is a functional assessment score of more than two standard deviations below the mean on a Vineland adaptive behavior scales (VABS), scale of independent behavior-revised (SIB-R), adaptive behavior assessment system-second edition (ABAS-II) or inventory for client and agency planning (ICAP) assessment instrument as described in WAC 388-823-0420.

[Statutory Authority: RCW 71A.10.020, 71A.12.030, 71A.12.050, 71A.12.070, 71A.16.020, 71A.16.030, 71A.16.040, 71A.16.050, and chapters 71A.10, 71A.12, and 71A.16 RCW. 05-12-130, § 388-823-0410, filed 6/1/05, effective 7/2/05.]


AMENDATORY SECTION(Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)

WAC 388-823-0420   What evidence do I need to substantiate adaptive functioning limitations for the eligible conditions of epilepsy, autism ((and other conditions similar to)), or another neurological or other condition that is closely related to mental retardation or that requires treatment similar to that required for individuals with mental retardation?   (1) Evidence of substantial limitations of adaptive functioning for the conditions of epilepsy, autism, ((and other conditions similar to)) or another neurological or other condition that is closely related to mental retardation or that requires treatment similar to that required for individuals with mental retardation requires a qualifying score completed in the past thirty-six months in a VABS ((or)), a SIB-R, an ABAS-II or ((a qualifying score completed in the past twenty-four months in)) an ICAP.

     (a) Professionals who administer and score the VABS must have a background in individual assessment, human development and behavior, and tests and measurements, as well as an understanding of individuals with disabilities.

     (b) Department staff or designee contracted with DDD must administer the ICAP.

     (c) DDD will administer or arrange for the administration of the ICAP if VABS ((or)), SIB-R or ABAS-II results are not submitted.

     (d) Qualifying scores for each assessment are as follows:


ASSESSMENT STANDARD DEVIATION QUALIFYING SCORE
Vineland Adaptive Behavior Scales (VABS) 15 An adaptive behavior composite score of 69 or less
Scales of Independent Behavior-Revised (SIB-R) 15 A broad independence standard score of 69 or less for the adaptive behaviors
Inventory for Client and Agency Planning (ICAP) 15 Pursuant to WAC 388-823-0900, the broad independence domain score based on the applicant's birth date and the date the test is administered.
Adaptive Behavior Assessment System-Second Edition (ABAS-II) 15 General Adaptive Composite of 69 or less

     (2) If DDD is unable to determine that your current adaptive functioning impairment is the result of your developmental disability because you have an unrelated injury or illness that is impairing your current adaptive functioning:

     (a) DDD will not accept the results of a VABS ((or)), SIB-R or ABAS-II administered after that event and will not administer the ICAP; and

     (b) Your eligibility will have to be determined under a different condition that does not require evidence of adaptive functioning per a VABS, SIB-R, ABAS-II or ICAP.

[Statutory Authority: RCW 71A.10.020, 71A.12.030, 71A.12.050, 71A.12.070, 71A.16.020, 71A.16.030, 71A.16.040, 71A.16.050, and chapters 71A.10, 71A.12, and 71A.16 RCW. 05-12-130, § 388-823-0420, filed 6/1/05, effective 7/2/05.]


AMENDATORY SECTION(Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)

WAC 388-823-0510   If I have autism, how do I meet the definition of substantial functional limitations ((to adaptive functioning))?   A substantial functional limitation ((of adaptive functioning)) for the condition of autism is the presence of ((adaptive functioning impairment)) a substantial functional limitation as described in WAC 388-823-0515.

[Statutory Authority: RCW 71A.10.020, 71A.12.030, 71A.12.050, 71A.12.070, 71A.16.020, 71A.16.030, 71A.16.040, 71A.16.050, and chapters 71A.10, 71A.12, and 71A.16 RCW. 05-12-130, § 388-823-0510, filed 6/1/05, effective 7/2/05.]


AMENDATORY SECTION(Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)

WAC 388-823-0515   What evidence do I need to ((substantiate adaptive functioning)) demonstrate substantial functional limitations for the condition of autism?   Evidence of the substantial functional limitations ((of adaptive functioning)) for the condition of autism is both (1) and (2) below:

     (1) Evidence of delay or abnormal functioning prior to age three years in at least one of the following areas:

     (a) Social interaction;

     (b) Language as used in social interaction;

     (c) Communication; or

     (d) Symbolic or imaginative play.

     (2) Eligible scores in adaptive functioning per WAC 388-823-0420 (1)(d) and subject to all of WAC 388-823-0420.

[Statutory Authority: RCW 71A.10.020, 71A.12.030, 71A.12.050, 71A.12.070, 71A.16.020, 71A.16.030, 71A.16.040, 71A.16.050, and chapters 71A.10, 71A.12, and 71A.16 RCW. 05-12-130, § 388-823-0515, filed 6/1/05, effective 7/2/05.]

ANOTHER NEUROLOGICAL OR OTHER CONDITION THAT IS CLOSELY RELATED TO MENTAL RETARDATION OR THAT REQUIRES TREATMENT SIMILAR TO THAT REQUIRED FOR INDIVIDUALS WITH MENTAL RETARDATION
AMENDATORY SECTION(Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)

WAC 388-823-0600   What evidence do I need to substantiate "another neurological or other condition((" as an eligible condition)) that is closely related to mental retardation or that requires treatment similar to that required for individuals with mental retardation"?   Evidence of ((an eligible condition under)) "another neurological or other condition that is closely related to mental retardation or that requires treatment similar to that required for individuals with mental retardation" ((requires a diagnosis by a licensed physician of an impairment of the central nervous system involving the brain and/or spinal cord that meets all of the following:)) must meet either (1) or (2) below:

     (1) You have a diagnosis by a licensed physician of an impairment of the central nervous system involving the brain and/or spinal cord or a chromosomal disorder that meets all of the following:

     (a) Originated before age eighteen;

     (b) Is expected to continue indefinitely;

     (c) You have substantial functional limitations which are a result of your condition or disorder; and

     (d) The diagnosis is other than mental retardation, autism, cerebral palsy, or epilepsy.

     (2) ((Results in both physical disability and intellectual impairment;

     (3) Is expected to continue indefinitely; and

     (4) Is not attributable to a mental illness or psychiatric disorder)) You are under the age of eighteen and are eligible for DSHS-paid in-home nursing through the medically intensive children's program defined in WAC 388-551-3000.

[Statutory Authority: RCW 71A.10.020, 71A.12.030, 71A.12.050, 71A.12.070, 71A.16.020, 71A.16.030, 71A.16.040, 71A.16.050, and chapters 71A.10, 71A.12, and 71A.16 RCW. 05-12-130, § 388-823-0600, filed 6/1/05, effective 7/2/05.]


AMENDATORY SECTION(Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)

WAC 388-823-0610   If I have "another neurological or other condition((,)) that is closely related to mental retardation or that requires treatment similar to that required for individuals with mental retardation" how do I meet the definition of substantial functional limitations ((to adaptive functioning))?   (1) Substantial functional limitations ((to adaptive functioning)) for ((the condition of another neurological condition require both intellectual impairment and the need for direct physical assistance with activities of daily living per WAC 388-823-0615 (1) and (2) below)) "another neurological or other condition that is closely related to mental retardation or that requires treatment similar to that required for individuals with mental retardation" require impairments in both intellectual abilities and functional skills which are separate from any impairment due to a mental illness, or emotional, social or behavioral disorder.

     (2) Criteria for impairment in both intellectual abilities and functional skills are described in WAC 388-823-0615 below.

[Statutory Authority: RCW 71A.10.020, 71A.12.030, 71A.12.050, 71A.12.070, 71A.16.020, 71A.16.030, 71A.16.040, 71A.16.050, and chapters 71A.10, 71A.12, and 71A.16 RCW. 05-12-130, § 388-823-0610, filed 6/1/05, effective 7/2/05.]


AMENDATORY SECTION(Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)

WAC 388-823-0615   What evidence do I need to ((substantiate adaptive functioning)) demonstrate substantial functional limitations for "another neurological or other condition that is closely related to mental retardation or that requires treatment similar to that required for individuals with mental retardation"?   ((Evidence of substantial limitations to intellectual functioning for another neurological condition is all of the following:))

     (1) ((You must have an)) Substantial functional limitations for "another neurological or other condition that is closely related to mental retardation or that requires treatment similar to that required for individuals with mental retardation" require evidence of both intellectual impairment and deficits in functional skills as described in (a) and (b) below.

     (a) Evidence of intellectual impairment requires documentation of either (i) and (ii) or (iii) below:

     (i) A FSIQ score of 1.5 or more standard deviations below the mean on one of the following acceptable assessments in addition to the other criteria in this section. The acceptable assessments, the standard deviation and the qualifying scores are contained in the following table:


ASSESSMENT STANDARD DEVIATION QUALIFYING SCORE
Stanford-Binet

4th edition

16 76 or less
Stanford-Binet

5th edition

15 78 or less
Wechsler 15 78 or less
Differential Abilities Scale (DAS) 15 78 or less
Kaufman Assessment Battery for Children (K-ABC) 15 78 or less
Leiter-R (([for persons with significant hearing impairments or when English is not primary language])) for persons with significant hearing impairments or when English is not primary language 15 78 or less

     (ii) Significant academic delays defined as delays of more than two standard deviations below the mean at the time of testing in both broad reading and broad mathematics; or

     (iii) If records cannot be obtained to substantiate (i) and (ii) above, DDD may consider other evidence in order to validate your intellectual deficits. DDD will determine whether such evidence is reliable, and whether it is sufficient to demonstrate intellectual deficits as severe as the deficits that would be demonstrated by (i) and (ii) above.

     (iv) IQ scores and evidence of academic delays obtained prior to age eighteen will be given precedence over testing results after age eighteen.

     (b) Evidence of deficits in functional skills requires documentation described below:

     (i) A score of more than two standard deviations below the mean on a VABS, ABAS-II, SIB-R or ICAP current within the past three years.

     (ii) The qualifying scores for these tests are based on composite or broad independence scores as defined in WAC 388-823-0420 (1)(d).

     (2) ((You must have evidence of need for direct physical assistance on a daily basis with two or more of the following activities: Toileting, bathing, eating, dressing, mobility, or communication as a result of your condition as defined in WAC 388-823-0320 and 388-823-0330.

     (3) The intellectual impairment and physical assistance needs must be the result of the central nervous system impairment and not due to another condition or diagnosis)) You do not need the additional evidence of your substantial functional limitations in (1)(a) and (b) above if your eligible condition is solely due to your eligibility and participation in the medically intensive children's program offered through DDD, defined in WAC 388-551-3000.

[Statutory Authority: RCW 71A.10.020, 71A.12.030, 71A.12.050, 71A.12.070, 71A.16.020, 71A.16.030, 71A.16.040, 71A.16.050, and chapters 71A.10, 71A.12, and 71A.16 RCW. 05-12-130, § 388-823-0615, filed 6/1/05, effective 7/2/05.]


AMENDATORY SECTION(Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)

WAC 388-823-0800   Which eligible developmental disability conditions apply at what age?   (1) Children under the age of six must meet the definition of having a developmental disability by meeting the requirements listed in WAC 388-823-0810 through 388-823-0850.

     (2) Children at least age six but under the age of ten can meet the definition of developmental disability by:

     (a) Meeting the requirements listed in WAC 388-823-0200 through ((388-823-0710)) 388-823-0615; or

     (b) Meeting the requirements listed in WAC 388-823-0810 through 388-823-0850.

     (3) Children age ten and older must meet the requirements in WAC 388-823-0200 through ((388-823-0710)) 388-823-0615.

     (4) The following chart summarizes the applicable eligibility conditions by age.


Eligible Conditions Age 0-5 Age 6-9 Age 10-17 Age 18 and older
Developmental Delays X X
Down Syndrome X X
Too severe to be assessed X X
Medically Intensive Children's Program X X X
Mental Retardation (MR) X X X
Cerebral Palsy X X X
Epilepsy X X X
Autism X X X
Another Neurological or other condition X X X
((Other condition similar to MR)) ((X)) ((X)) ((X))

[Statutory Authority: RCW 71A.10.020, 71A.12.030, 71A.12.050, 71A.12.070, 71A.16.020, 71A.16.030, 71A.16.040, 71A.16.050, and chapters 71A.10, 71A.12, and 71A.16 RCW. 05-12-130, § 388-823-0800, filed 6/1/05, effective 7/2/05.]

     Reviser's note: RCW 34.05.395 requires the use of underlining and deletion marks to indicate amendments to existing rules. The rule published above varies from its predecessor in certain respects not indicated by the use of these markings.
AMENDATORY SECTION(Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)

WAC 388-823-0810   If I am a child under age ten, what evidence do I need to meet the definition for ((an)) "another neurological or other condition((" similar to mental retardation)) that is closely related to mental retardation or that requires treatment similar to that required for individuals with mental retardation"?   If you are a child under age ten, evidence of one of the following substantiates that you have ((an eligible "other condition" similar to mental retardation)) "another neurological or other condition that is closely related to mental retardation or that requires treatment similar to that required for individuals with mental retardation":

     (1) Developmental delay measured by developmental assessment tools administered by qualified professionals as described in WAC 388-823-0850.

     (2) A diagnosis of Down syndrome by a licensed physician;

     (3) A determination of eligibility for the DSHS medically intensive children's program defined in WAC 388-551-3000;

     (4) A diagnosis by a licensed physician or licensed psychologist of a condition that is so severe the child is unable to demonstrate the minimal skills required to complete a developmental evaluation or assessment.

[Statutory Authority: RCW 71A.10.020, 71A.12.030, 71A.12.050, 71A.12.070, 71A.16.020, 71A.16.030, 71A.16.040, 71A.16.050, and chapters 71A.10, 71A.12, and 71A.16 RCW. 05-12-130, § 388-823-0810, filed 6/1/05, effective 7/2/05.]


AMENDATORY SECTION(Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)

WAC 388-823-0820   If I am a child under age ten with an eligible condition under the medically intensive children's program, Down syndrome, or a diagnosed condition that is too severe for developmental testing, how do I meet the definition of substantial functional limitations ((to adaptive functioning))?   You do not need additional evidence of substantial functional limitations if you are a child under the age of ten with an eligible condition based on the medically intensive children's program, Down syndrome, or a diagnosed condition that is too severe for developmental testing.

[Statutory Authority: RCW 71A.10.020, 71A.12.030, 71A.12.050, 71A.12.070, 71A.16.020, 71A.16.030, 71A.16.040, 71A.16.050, and chapters 71A.10, 71A.12, and 71A.16 RCW. 05-12-130, § 388-823-0820, filed 6/1/05, effective 7/2/05.]


AMENDATORY SECTION(Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)

WAC 388-823-0830   If I am a child under age ten with an eligible condition based on developmental delays, how do I meet the definition of substantial functional limitations ((to adaptive functioning))?   (1) If you are a child under age ten with an eligible condition based on developmental delays, evidence of substantial ((handicap)) functional limitations requires developmental delays of at least 1.5 standard deviations or twenty-five percent or more of the chronological age in the following developmental areas:

     (a) Physical skills (fine or gross motor);

     (b) Self help/adaptive skills;

     (c) Expressive or receptive communication, including American sign language;

     (d) Social/emotional skills; and

     (e) Cognitive, academic, or problem solving skills.

     (2) The number of areas in which you are required to have delays to meet the evidence is specific to your age.

[Statutory Authority: RCW 71A.10.020, 71A.12.030, 71A.12.050, 71A.12.070, 71A.16.020, 71A.16.030, 71A.16.040, 71A.16.050, and chapters 71A.10, 71A.12, and 71A.16 RCW. 05-12-130, § 388-823-0830, filed 6/1/05, effective 7/2/05.]


AMENDATORY SECTION(Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)

WAC 388-823-0840   If I am a child under age ten, how many areas of developmental delays meet the definition of substantial functional limitations ((to adaptive functioning))?   If you are a child under the age ten, eligible based on developmental delays, the number of delays required for substantial functional limitations ((to adaptive functioning)) is specific to your age.

     (1) A child from birth but under age three must have a developmental delay in one or more developmental areas.

     (2) A child age three but under age ten must have developmental delays in three or more developmental areas.


AGE NUMBER of AREAS of DELAY
Birth but under age three One or more
Age three but under age ten Three or more

[Statutory Authority: RCW 71A.10.020, 71A.12.030, 71A.12.050, 71A.12.070, 71A.16.020, 71A.16.030, 71A.16.040, 71A.16.050, and chapters 71A.10, 71A.12, and 71A.16 RCW. 05-12-130, § 388-823-0840, filed 6/1/05, effective 7/2/05.]


AMENDATORY SECTION(Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)

WAC 388-823-1010   When will DDD review my eligibility to determine if I continue to have a developmental disability?   (1) Your eligibility can be reviewed at any time if your eligibility effective date is prior to July 2005 and you are age ten or older and were eligible under a condition of developmental delay or Down syndrome.

     (2) Your eligibility will be reviewed at age seventeen with termination occurring no sooner than your eighteenth birthday if your most current eligibility determination was at sixteen or younger under mental retardation, cerebral palsy, epilepsy, autism, or another neurological condition((,)) or other condition that is closely related to mental retardation or that requires treatment similar to that required for individuals with mental retardation.

     (3) DDD will review your eligibility prior to the initial authorization of any paid service from DDD when you are not currently receiving paid services and:

     (a) You are age eighteen or older and your most current eligibility determination is more than twenty-four months old; or

     (b) You are age four but under age eighteen and your eligibility was established under the eligible conditions of developmental delay or Down syndrome and your eligibility effective date is prior to July 2005.

     (4) DDD will review your eligibility if DDD discovers:

     (a) The evidence used to make your most recent eligibility determination completed in 1992 or later appears to be insufficient, in error, or fraudulent; or

     (b) New diagnostic information becomes available that does not support your current eligibility and you are under the age of eighteen.

[Statutory Authority: RCW 71A.10.020, 71A.12.030, 71A.12.050, 71A.12.070, 71A.16.020, 71A.16.030, 71A.16.040, 71A.16.050, and chapters 71A.10, 71A.12, and 71A.16 RCW. 05-12-130, § 388-823-1010, filed 6/1/05, effective 7/2/05.]


REPEALER

     The following sections of the Washington Administrative Code are repealed:
WAC 388-823-0700 How do I meet the definition for an "other condition" similar to mental retardation?
WAC 388-823-0710 What evidence do I need to meet the definition of substantial limitations for an "other condition" similar to mental retardation?

© Washington State Code Reviser's Office