WSR 14-12-046 PERMANENT RULES DEPARTMENT OF SOCIAL AND HEALTH SERVICES (Developmental Disabilities Administration) [Filed May 29, 2014, 11:20 a.m., effective July 1, 2014] Effective Date of Rule: July 1, 2014.
Purpose: The primary purposes for these changes are to clarify rules which determine whether an individual meets the requirements for developmental disabilities administration (DDA) eligibility. Overall changes in organization and language have been made to reduce confusion for DDA, applicants and DDA clients. Amendments align eligibility requirements for autism with the Diagnostic and Statistical Manual – Fifth Edition (DSM-5). Furthermore, combining the categories of "another neurological" and "other condition" eliminate confusion between the WAC and RCW language.
Amendments to this chapter may change eligibility requirements for some individuals applying for services from DDA. In addition, housekeeping changes were made such as WAC and RCW references, [changing] division of developmental disabilities to DDA, and mental retardation to intellectual disability.
Citation of Existing Rules Affected by this Order: Repealing WAC 388-823-0030, 388-823-0040, 388-823-0060, 388-823-0070, 388-823-0110, 388-823-0120, 388-823-0130, 388-823-0140, 388-823-0150, 388-823-0160, 388-823-0170, 388-823-0215, 388-823-0220, 388-823-0230, 388-823-0320, 388-823-0330, 388-823-0420, 388-823-0515, 388-823-0615, 388-823-0700, 388-823-0710, 388-823-0800, 388-823-0810, 388-823-0820, 388-823-0830, 388-823-0840, 388-823-0850, 388-823-0900, 388-823-1040 and 388-823-1050; and amending WAC 388-823-0010, 388-823-0020, 388-823-0050, 388-823-0080, 388-823-0090, 388-823-0100, 388-823-0105, 388-823-0200, 388-823-0210, 388-823-0300, 388-823-0310, 388-823-0400, 388-823-0410, 388-823-0500, 388-823-0510, 388-823-0600, 388-823-0610, 388-823-0920, 388-823-0930, 388-823-0940, 388-823-1000, 388-823-1005, 388-823-1010, 388-823-1015, 388-823-1020, 388-823-1030, 388-823-1060, 388-823-1070, 388-823-1080, 388-823-1090, 388-823-1095, and 388-823-1100.
Statutory Authority for Adoption: RCW 71A.12.030, 71A.12.120.
Other Authority: RCW 71A.12.030, 74.08.090.
Adopted under notice filed as WSR 14-05-071 on February 18, 2014.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 11, Amended 30, Repealed 32; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.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 0, 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 11, Amended 30, Repealed 32.
Date Adopted: May 27, 2014.
Katherine I. Vasquez
Rules Coordinator
Chapter 388-823 WAC
DEVELOPMENTAL DISABILITIES ADMINISTRATION INTAKE AND ELIGIBILITY DETERMINATION APPLYING FOR A ((DETERMINATION OF A)) DEVELOPMENTAL ((DISABILITY)) DISABILITIES ADMINISTRATION ELIGIBILITY DETERMINATION
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 89.
"CAS" means the DAS-Naglieri cognitive assessment system, a clinical instrument for assessing intelligence based on a battery of cognitive tasks. The test is used for children ages five through seventeen years eleven months.
"Client" means a person with a developmental disability as defined in chapter 388-823 WAC who is currently eligible and active with the ((division of)) developmental disabilities administration (DDA).
"C-TONI" means the comprehensive test of nonverbal intelligence, a battery of six subtests, designed to measure different aspects of nonverbal intellectual abilities from ages six to eighteen years eleven months.
"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.
"DDA" means the developmental disabilities administration, an administration within department of social and health services.
(("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.))
"Documentation" means written information that provides support for certain claims, such as diagnoses, test scores, or residency for the purpose of establishing DDA eligibility.
"DSM-IV-TR" means the diagnostic and statistical manual of mental disorders, fourth edition, text revision.
"DSM-5" means the diagnostic and statistical manual of mental disorders, fifth edition.
"Eligible" means that DDA has determined that you have a ((developmental disability that meets all of the requirements in this chapter for a specific)) condition that meets all of the requirements for a developmental disability as set forth in this chapter.
"ESIT" means early support for infants and toddlers, a program administered by the department of early learning.
"Expiration date" means a specific date that your eligibility as a client of ((DDD)) DDA and all services paid by ((DDD)) DDA 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)) DDA 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.
"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.
"MPC" means medicaid personal care and is the provision of medically necessary personal care tasks as defined in chapter 388-106 WAC.
"Necessary supplemental accommodation representative" means an individual who receives copies of DDA planned action notices (PANs) and other department correspondence in order to help a client understand the documents and exercise the client's rights. A necessary supplemental accommodation representative is identified by a client of DDA when the client does not have a legal guardian and the client is requesting or receiving DDA services.
"Nonverbal" means that you do not possess sufficient verbal skills to complete a standard intellectual test.
"NSA" means necessary supplemental accommodations, which are services provided to you if you have a mental, neurological, physical, or sensory impairment or other problems that prevent you from getting program benefits in the same way that an unimpaired person would get them.
"Review" means ((DDD)) DDA must ((redetermine)) determine that ((you still have)) a current client of DDA still meets all of the requirements for a developmental disability ((according to the rules that are in place at the time of the review)) as set forth in this chapter.
"RHC" means ((one of five)) a residential habilitation ((centers)) center operated by the ((division: Lakeland Village, Yakima Valley School, Fircrest, Rainier School, and Francis Haddon Morgan Center)) DDA.
"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)) DDA.
"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)) DDA that stops your ((DDD)) DDA eligibility and services paid by ((DDD)) DDA. If your DDA eligibility is terminated your DDA authorized services will also be terminated. If you remain eligible for MPC and you are under the age of eighteen DDA will continue to authorize this service. If you are eighteen or older medicaid personal care will be authorized by the aging and long-term support administration.
"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.
"WJ III(r)" means the Woodcock-Johnson(r) III, a test which is designed to provide a co-normed set of tests for measuring general intellectual ability, specific cognitive abilities, scholastic aptitude, oral language, and academic achievement. The WJ III(r) is used for ages two and up.
NEW SECTION
WAC 388-823-0015 How does the state of Washington define developmental disability?
The state of Washington defines developmental disability in RCW 71A.10.020(4).
(1) To qualify for DDA you must have a diagnosed condition of intellectual disability, cerebral palsy, epilepsy, autism, or another neurological or other condition found by DDA to be closely related to intellectual disability or requiring treatment similar to that required for individuals with intellectual disability which:
(a) Originates prior to age eighteen;
(b) Is expected to continue indefinitely; and
(c) Results in substantial limitations.
(2) In addition to the requirements listed in subsection (1) of this section, you must meet the other requirements contained in this chapter.
AMENDATORY SECTION (Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)
WAC 388-823-0020 How do I become a client of the ((division of)) developmental disabilities administration?
You become a client of the ((division of)) developmental disabilities (((DDD))) administration (DDA) if you apply for eligibility with ((DDD)) DDA and ((DDD)) DDA determines that you ((have a "developmental disability")) meet all eligibility criteria required to establish a developmental disability as defined in this chapter.
(1) You apply to become a client of DDA by calling the regional DDA office or a local DDA office and requesting a DDA eligibility packet be sent to you. You may also download and print the eligibility packet at http://dshs.wa.gov/ddd/eligible.shtml.
(2) You must complete and return the required forms, along with all supporting documentation that you have, to address any disability indicated in the eligibility packet.
NEW SECTION
WAC 388-823-0025 Who can apply for DDA eligibility determination?
(1) You must be a resident of the state of Washington, as described in WAC 388-823-0050, to apply for an eligibility determination.
(2) The following individuals can apply for DDA eligibility:
(a) If a court has not appointed the child as his own decision maker, a parent or legal representative must apply on behalf of a child under the age of eighteen years;
(b) If there is a legal guardian of an applicant age eighteen years or older, the legal guardian must apply on behalf of the adult applicant; or
(c) If there is no legal guardian of an adult applicant age eighteen years or older, the adult applicant can apply on his/her own behalf.
(3) A request for eligibility determination requires the signature of the applicant or their legal representative. With the consent of the applicant, any person, agency, or advocate may assist with the application process.
AMENDATORY SECTION (Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)
WAC 388-823-0050 ((Must I be)) For DDA eligibility, who is considered to be a resident of the state of Washington?
((When you apply for eligibility with DDD, you must be a resident of the state of Washington. Proof of residency includes:
(1) The receipt of medicaid or other benefits from the department of social and health services that require residency as a condition of eligibility; or
(2) Documentation that shows you live in the state of Washington, or, if you are a child under the age of eighteen, documentation that shows your parent or legal guardian lives in the state of Washington)) (1) You must live in the state of Washington to apply or continue to be a client of DDA. If you are a child under the age of eighteen, your primary custodian or legal guardian must also live in the state of Washington. Proof that you live in the state of Washington may include documentation such as a lease agreement, school records, or mail addressed to you. Such documentation will not be considered proof of residency if you have been denied medicaid or other benefits due to failure to meet residency requirements under WAC 388-468-0005.
(2) DDA will not process your request for determination of eligibility or will terminate your eligibility if you do not live in the state of Washington.
NEW SECTION
WAC 388-823-0055 Who is responsible for obtaining the documentation needed to make my eligibility determination?
You are responsible to provide all of the information required by DDA to make a determination.
(1) If you provide DDA with a signed consent form and the sources for obtaining the documentation DDA may be able to assist you in obtaining records. Evidence required to make an eligibility determination includes, but is not limited to:
(a) School psychologist and/or licensed psychologist evaluations and reports,
(b) Evidence of medical diagnoses by a licensed physician,
(c) Cognitive and adaptive skills test results and accompanying reports, and
(d) Mental health records.
(2) DDA will not pay for the purchase of diagnostic assessments, intelligence quotient (IQ) testing, or adaptive skills testing.
(3) If DDA determines that you have a qualifying condition and your records do not include an adaptive skills assessment per WAC 388-823-0710 administered within the past thirty-six months, DDA may administer the inventory of client and agency planning (ICAP) to determine your level of adaptive functioning to meet the substantial limitation requirement. DDA will administer the ICAP at no expense to you.
NEW SECTION
WAC 388-823-0075 What if I do not have written evidence that my disability began before my eighteenth birthday?
(1) If there is no documentation available about your early developmental history, educational history, illnesses, or injuries, DDA may accept verbal information from your family or others who knew you prior to the age of eighteen to verify that your disability began prior to age eighteen. The information must be specific and reliable, and it cannot substitute for documentation that could be obtained with reasonable diligence.
(2) Additional evidence of your eligible condition and the resulting substantial limitations is still required.
AMENDATORY SECTION (Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)
WAC 388-823-0080 ((Who determines that I have a developmental disability)) How does DDA determine whether I meet eligibility criteria?
((DDD)) DDA determines if you ((have a developmental disability as defined in this chapter after reviewing all documentation received by the division)) meet eligibility criteria as defined in this chapter by reviewing all information that has been submitted.
AMENDATORY SECTION (Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)
WAC 388-823-0090 How long will it take to complete a determination of my eligibility?
(((1) Once DDD receives sufficient documentation to determine you eligible, DDD)) DDA has thirty days from receipt of the final piece of documentation to make the determination of eligibility.
(((2))) (1) If ((DDD)) DDA has received all requested documentation ((but)) and it is ((insufficient)) sufficient to establish eligibility, ((DDD)) DDA will make a determination of ((ineligibility)) eligibility and send you written notice of ((denial of)) eligibility.
(2) If DDA has received all requested documentation but it is insufficient to establish eligibility, DDA will make a determination of ineligibility and send you written notice of denial of eligibility.
(3) If ((DDD)) DDA has insufficient information to determine you eligible ((but)) and has not received all of the requested documentation, ((DDD)) DDA may deny your eligibility after ninety days from the date of application. Rules governing reapplying for eligibility are in WAC 388-823-1080.
AMENDATORY SECTION (Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)
WAC 388-823-0100 What is the effective date ((that I become an eligible client of DDD)) of my eligibility determination?
(1) If ((DDD)) DDA receives sufficient information to substantiate your ((DDD)) DDA eligibility, the effective date of your eligibility as a ((DDD)) DDA client is the date of receipt of the final piece of documentation.
(2) ((Paid DDD)) DDA services cannot begin before the effective date of your ((DDD)) DDA eligibility.
AMENDATORY SECTION (Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)
WAC 388-823-0105 How will ((DDD)) DDA notify me of the results of my eligibility determination?
((DDD)) DDA will send you written notification of the final determination of your eligibility per WAC 388-825-100.
(1) If you are not eligible, the written notice will explain why you are not eligible, explain your appeal rights to this decision, and provide you with ((a fair)) an administrative hearing request form.
(2) If you are eligible, the written notice will include:
(a) Your eligibility condition(s);
(b) The effective date of your eligibility;
(c) The expiration date or review date of your eligibility, if applicable; and
(d) The name and phone number of your ((assigned case manager)) DDA primary contact.
NEW SECTION
WAC 388-823-0115 If I am eligible to be a client of DDA, will I receive DDA services?
If DDA determines that you are eligible to be a client of DDA, your access to services as a DDA client depends on your meeting eligibility requirements for the specific service. DDA paid services are described in WAC 388-825-057.
DETERMINATION OF ((A DEVELOPMENTAL DISABILITY)) ELIGIBILITY
((MENTAL RETARDATION)) INTELLECTUAL DISABILITY
AMENDATORY SECTION (Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)
WAC 388-823-0200 ((What evidence)) How do I ((need to substantiate "mental retardation")) show that I have intellectual disability 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.)) In order to be considered for eligibility under the condition of intellectual disability you must be age four or older and have a diagnosis of mental retardation as specified in the DSM-IV-TR or intellectual disability as specified in the DSM-5. This diagnosis must meet the following criteria:
(1) The diagnosis must be made by a licensed psychologist, or be a finding of intellectual disability by a Washington certified school psychologist or other school psychologist certified by the National Association of School Psychologists.
(2) An acceptable diagnostic report includes documentation of all three diagnostic criteria specified in the DSM-IV-TR or DSM-5.
AMENDATORY SECTION (Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)
WAC 388-823-0210 If I have ((mental retardation)) intellectual disability, how do I meet the definition of substantial 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.)) If you have an eligible condition of intellectual disability, in order to meet the definition of substantial limitations you must have:
(1) Documentation of a full-scale intelligence quotient (FSIQ) score of more than two standard deviations below the mean per WAC 388-823-0720, and subject to all of WAC 388-823-0720 and 388-823-0730, and
(2) Documentation of an adaptive skills test score of more than two standard deviations below the mean as described in WAC 388-823-0710 and subject to all of WAC 388-823-0740 and 388-823-0750.
AMENDATORY SECTION (Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)
WAC 388-823-0300 ((What evidence)) How do I ((need to substantiate "cerebral palsy")) show that I have cerebral palsy as an eligible condition?
((Evidence that you have an eligible)) In order to be considered for eligibility under the condition ((under "cerebral palsy" requires a diagnosis by a licensed physician of cerebral palsy, quadriplegia, hemiplegia, or diplegia with symptoms that:
(1) Existed prior to age three; and
(2) Impair control of movement.)) of cerebral palsy you must be age four or older and have a diagnosis by a licensed physician of cerebral palsy or similar brain damage which causes, quadriplegia, hemiplegia, or diplegia, with evidence of onset prior to age three.
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 limitations ((to adaptive functioning))?
If you have an eligible condition of cerebral palsy, in order to meet the definition of substantial limitations ((of adaptive functioning is)), you must demonstrate the need for direct physical assistance ((on a daily basis)), per WAC 388-823-0760, 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.
AMENDATORY SECTION (Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)
WAC 388-823-0400 ((What evidence)) How do I ((need to substantiate "epilepsy")) show that I have epilepsy as an eligible condition?
((Evidence of an eligible condition under "epilepsy" requires a diagnosis of a neurological condition that produces brief disturbances in the normal electrical functions of the brain resulting in)) In order to be considered for eligibility under the condition of epilepsy you must be age four or older and have a diagnosis of epilepsy or a neurological condition that produces seizures.
(1) ((This condition requires a diagnosis of)) You must show evidence that your epilepsy or seizure disorder ((that)) originated prior to age eighteen and is expected to continue indefinitely.
(2) The diagnosis must be made by a board certified neurologist and be ((based on)) supported with documentation of medical history ((and)) with neurological testing.
(3) You must provide confirmation from your physician or neurologist that your seizures are currently uncontrolled and ongoing or recurring and cannot be controlled by medication.
(((4) DDD will not consider your seizures uncontrolled or ongoing if it is documented or reported that you refuse to take medications.
(5) Your seizures must make you physically incapacitated, requiring direct physical assistance for one or more activities as defined in WAC 388-823-0310 and 388-823-0320 during or following seizures.))
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 limitations ((to adaptive functioning))?
((A)) If you have an eligible condition of epilepsy, in order to meet the definition of substantial ((limitation to)) limitations, you must have documentation of an adaptive skills test score that reflects your daily 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) or inventory for client and agency planning (ICAP) assessment instrument as described in WAC 388-823-0420)) as described in WAC 388-823-0740 and subject to all of WAC 388-823-0740 and 388-823-0750.
AMENDATORY SECTION (Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)
WAC 388-823-0500 ((What evidence)) How do I ((need to substantiate "autism")) show that I have autism as an eligible condition?
((Evidence of an eligible)) In order to be considered for eligibility under the condition ((under "autism" requires)) of autism you must be age four or older and have a diagnosis by a qualified professional ((of autism or autistic disorder per 299.00 in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) that is expected to continue indefinitely, and evidence of onset before age three.)) which meets the conditions in subsection (1) or (2) of this section, as well as subsections (3), (4), and (5) of this section:
(1) ((The)) Autistic disorder 299.00 per the diagnostic and statistical manual of mental disorders, fourth edition, text revision (DSM-IV-TR), or
(2) Autism spectrum disorder 299.00 per the diagnostic and statistical manual of mental disorders, fifth edition (DSM-5), with a severity level of 2 or 3 in both columns of the severity level scale.
(3) The condition is expected to continue indefinitely with evidence of onset before age three.
(4) An acceptable diagnostic report includes documentation of all diagnostic criteria specified in the DSM-IV-TR or DSM-5.
(5) DDA will accept a diagnosis from any of the following professionals ((are qualified to give this diagnosis)):
(a) Board ((eligible)) certified neurologist;
(b) Board ((eligible)) certified psychiatrist;
(c) Licensed psychologist; ((or))
(d) Advanced registered nurse practitioner (ARNP) associated with an autism center or developmental center; or
(e) Board certified developmental and behavioral pediatrician.
(((2) The evidence provided by a diagnosing professional in subsection (1) above exhibits a total of six or more of the following diagnostic criteria listed in the current DSM-IV-TR for Autistic Disorder 299.00:
(a) Two or more qualitative impairments in social interactions;
(b) One or more qualitative impairments in communication; and
(c) One or more impairments in restricted repetitive and stereotypical patterns or behavior, interests, and activities.
(3) A checklist of diagnostic criteria follows:
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 limitations ((to adaptive functioning))?
((A)) If you have an eligible condition of autism, in order to meet the definition of substantial ((limitation of adaptive functioning for the condition of autism is the presence of adaptive functioning impairment as described in WAC 388-823-0515)) limitations you must meet the criteria in subsections (1) and (2) in this section:
(1) Documentation of an adaptive skills test score of more than two standard deviations below the mean as described in WAC 388-823-0740 and subject to all of WAC 388-823-0740 and 388-823-0750, and
(2) If your diagnosis is autism spectrum disorder per the DSM-5, documentation of a FSIQ of more than one standard deviation below the mean as described in WAC 388-823-0720 and subject to all of WAC 388-823-0720 and 388-823-0730.
(a) If you have a FSIQ score of one standard deviation below the mean or higher as described in WAC 388-823-0720, you may present additional documentation described in subitem (i) or (ii) in this subsection, signed by the diagnosing professional, which shows that you meet the criteria for autistic disorder 299.00 per the DSM-IV-TR:
(i) A completed autistic disorder confirmation form (available from DDA), or
(ii) Other documentation that provides the same information as required on the autistic disorder confirmation form.
(b) If you are unable to complete a FSIQ test, you may provide a statement by the diagnosing professional that your condition is so severe that you are unable to demonstrate the minimal skills required to complete testing.
ANOTHER NEUROLOGICAL OR OTHER CONDITION SIMILAR TO INTELLECTUAL DISABLITY
Reviser's note: The spelling error in the above section occurred in the copy filed by the agency and appears in the Register pursuant to the requirements of RCW 34.08.040. AMENDATORY SECTION (Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)
WAC 388-823-0600 ((What evidence)) How do I ((need to substantiate "another neurological condition" as an eligible condition)) show that I have another neurological or other condition similar to intellectual disability?
((Evidence of an eligible condition under "another neurological condition" 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:
(1) Originated before age eighteen;
(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.)) In order to be considered for eligibility under the category of another neurological or other condition similar to intellectual disability you must meet one of the three criteria below:
(1) You are age four or older and have a diagnosis by a licensed physician of a neurological or chromosomal disorder that is known by reputable authorities to cause intellectual and adaptive skills deficits. Your condition meets all of the following:
(a) Originated before age eighteen;
(b) Is expected to continue indefinitely without improvement;
(c) Is other than intellectual disability, autism, cerebral palsy, or epilepsy;
(d) Is not attributable to nor is itself a mental illness, or emotional, social, or behavior disorder; and
(e) Has resulted in substantial functional limitations.
(2) You are under the age of eighteen and are eligible for DSHS-paid in-home nursing through the medically intensive children program defined in WAC 182-551-3000.
(3) You are under the age of ten and have one or more developmental delays.
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 similar to intellectual disability, how do I meet the definition of substantial limitations ((to adaptive functioning))?
((Substantial 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.)) If you have an eligible condition of another neurological or other condition similar to intellectual disability, in order to meet the definition of substantial limitations you must have impairments in both intellectual abilities and adaptive skills which are separate from any impairment due to an unrelated mental illness, or emotional, social or behavioral disorder.
(1) For WAC 388-823-0600(1) evidence of substantial functional limitations requires documentation of (a) and (b) below:
(a) For impairment in intellectual abilities, either subitem (i) or (ii) or (iii) below:
(i) A FSIQ score of more than 1.5 standard deviations below the mean as described in WAC 388-823-0720 and subject to all of WAC 388-823-0720 and WAC 388-823-0730; or
(ii) If you are under the age of twenty, 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) A statement by a licensed physician, a licensed psychologist, or a school psychologist that your condition is so severe that you are unable to demonstrate the minimal skills required to complete testing for a FSIQ.
(b) For impairment in adaptive skills, a score of more than two standard deviations below the mean per WAC 388-823-0740 and subject to all of WAC 388-823-0740 and WAC 388-823-0750.
(2) For WAC 388-823-0600(2) you do not need additional evidence of your substantial functional limitations if your eligible condition is solely due to your eligibility and participation in the medically intensive children program offered through DDA and defined in WAC 182-551-3000.
(3) For WAC 388-823-0600(3) evidence of substantial functional limitations requires documentation of (a) or (b) or (c) below:
(a) You are under the age of three and have one or more developmental delays per WAC 388-823-0770, or
(b) You are under the age of three and meet the ESIT eligibility requirements, or
(c) You are under the age of ten and have three or more developmental delays per WAC 388-823-0770.
EVIDENCE VERIFICATION REQUIREMENTS
NEW SECTION
WAC 388-823-0720 What evidence do I need of my FSIQ?
Evidence of a qualifying FSIQ is derived from one of the tests listed in the table below.
(1) The test must be administered by a licensed psychologist or Washington certified school psychologist or other school psychologist certified by the National Association of School Psychologists.
(2) The FSIQ score cannot be attributable to mental illness or other psychiatric condition occurring at any age; or other illness or injury occurring after age eighteen:
(a) If you are dually diagnosed with a qualifying condition and mental illness, other psychiatric condition, or other illness or injury, you must provide acceptable documentation that your intellectual impairment, measured by a FSIQ test, would meet the requirements for DDA eligibility without the influence of the mental illness, other psychiatric condition, or other illness or injury.
(b) "Acceptable documentation" means written reports or statements that are directly related to the subject at issue, reasonable in light of all the evidence, and from a source of appropriate authority. The determination of whether a document is acceptable is made by DDA.
(c) If no documentation is provided or DDA determines that the documentation is not acceptable DDA will deny eligibility. The determination may be challenged through an administrative appeal.
(3) If you have a vision impairment that prevents completion of the performance portion of the IQ test, the administering professional may estimate an FSIQ using only the verbal IQ score of the appropriate Wechsler.
(4) If you have a significant hearing impairment, English is not your primary language, or you are nonverbal your FSIQ may be estimated using one of the tests shown in the table below.
(5) If you are over the age of nineteen at the time of your determination you must have a valid FSIQ obtained at age thirteen or older.
Reviser's note: The spelling error in the above section occurred in the copy filed by the agency and appears in the Register pursuant to the requirements of RCW 34.08.040. NEW SECTION
WAC 388-823-0730 If I have more than one FSIQ score, what criteria will DDA use to select the FSIQ for determining eligibility?
(1) If you have more than one FSIQ, DDA will review the pattern of FSIQ scores.
(a) If the variation among these scores is no more than five points, DDA will accept the score obtained closest to but below age eighteen.
(b) If there are differences among the FSIQ scores of more than five points, DDA will review the pattern and attempt to determine reasons for the fluctuations to ensure that the most reliable and accurate FSIQ score is used. DDA will use the most current FSIQ obtained below age eighteen, provided the FSIQ is a result of your developmental disability.
(2) DDA will exclude any FSIQ score attributable to a condition or impairment that began on or after your eighteenth birthday.
NEW SECTION
WAC 388-823-0740 What evidence do I need of my adaptive skills limitations?
(1) Evidence of substantial limitations of adaptive functioning requires a qualifying score completed in the past thirty-six months on one of the tests shown in the table below:
(a) Tests must be administered and scored by professionals who have a background in individual assessment, human development and behavior, and tests and measurements, as well as an understanding of individuals with disabilities.
(b) Tests must be administered following the instructions for the specific test used.
(c) Department staff or designee contracted with DDA must administer the ICAP.
(d) DDA will administer or arrange for the administration of the ICAP only if results from one of the other acceptable tests are not available.
(2) The adaptive test score cannot be a result of an unrelated mental illness or other psychiatric condition occurring at any age; or other illness or injury occurring after age eighteen.
(a) If you are dually diagnosed with a qualifying condition and mental illness, other psychiatric condition, or other illness or injury, you must provide acceptable documentation that your adaptive functioning impairment, measured by an adaptive skills test, would meet the requirements for DDA eligibility without the influence of the mental illness, other psychiatric condition, or other illness or injury.
(b) "Acceptable documentation" means written reports or statements that are directly related to the subject at issue, reasonable in light of all the evidence, and from a source of appropriate authority. The determination of whether a document is acceptable is made by DDA.
(c) If no documentation is provided or DDA determines that the documentation is not acceptable DDA will deny eligibility. The determination may be challenged through an administrative appeal.
NEW SECTION
WAC 388-823-0750 If I have more than one adaptive test score, what criteria will DDA use to select the adaptive test for determining eligibility?
If you have more than one adaptive test score during the thirty-six months prior to your determination, DDA will accept the test score obtained closest to the date of review or application providing it is a valid score and reflects adaptive functioning due to your developmental disability.
NEW SECTION
WAC 388-823-0760 What evidence do I need to show my need for direct physical assistance?
(1) The need for direct physical assistance with activities of daily living is due to your impaired motor control and means:
(a) You need the presence and physical assistance of another person on a daily basis to be able to communicate and be understood by any other person.
(i) If you are able to communicate through a communication device you will be considered independent in communication.
(ii) You must require more than "setting up" of the communication device.
(b) You need direct physical assistance from another person on a daily basis with toileting, bathing, eating, dressing, or mobility.
(i) You require more than "setting up" the task to enable you to perform the task independently.
(ii) You must require direct physical assistance for more than transferring in and out of wheelchair, in and out of the bath or shower, and/or on and off of the toilet.
(iii) Your ability to be mobile is your ability to move yourself from place to place, not your ability to walk. For instance, if you can transfer in and out of a wheelchair and are independently mobile in a wheelchair, you do not meet the requirement for direct physical assistance with mobility.
(2) Any of the following can be used as documentation of your direct physical assistance needs:
(a) The comprehensive assessment reporting evaluation (CARE) tool or other department assessments that measure direct assistance needs in the areas specified above;
(b) Assessments and reports from educational or healthcare professionals that are current and consistent with your current functioning;
(c) In the absence of professional reports or assessments, DDA may document its own observation of your direct assistance needs along with reported information by family and others familiar with you.
NEW SECTION
WAC 388-823-0770 What evidence do I need of developmental delays?
(1) Evidence of substantial functional limitations requires developmental delays of at least 1.5 standard deviations or twenty-five percent or more of the chronological age in one or more of the following developmental areas based on an assessment current within the past 12 months:
(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.
(3) Tools used to determine developmental delays must be diagnostic assessments that are designed to measure the developmental areas in subsection (1) of this section and are appropriate to the age of the child being tested.
(4) The assessment must be administered by one of the following professionals qualified to administer the assessment of developmental areas:
(a) Licensed physician;
(b) Licensed psychologist or certified school psychologist;
(c) Speech language pathologist;
(d) Audiologist;
(e) Registered occupational therapist;
(f) Licensed physical therapist;
(g) Registered nurse;
(h) Certified teacher;
(i) Masters level social worker; or
(j) Orientation and mobility specialist.
AMENDATORY SECTION (Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)
WAC 388-823-0920 What sections of the ICAP does ((DDD)) DDA or a designee contracted with ((DDD)) DDA complete and score?
(1) ((DDD)) DDA or a designee contracted with ((DDD)) DDA completes the adaptive behavior portion of the ICAP.
(2) There is a computer generated broad independence score of your motor skills, personal living skills, social and communication skills, and community living skills, based on your age.
AMENDATORY SECTION (Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)
WAC 388-823-0930 How does ((DDD)) DDA or a designee contracted with ((DDD)) DDA administer the ICAP?
(1) ((DDD)) DDA or a designee contracted with ((DDD)) DDA completes the adaptive section of the ICAP by interviewing a qualified respondent who has known you for at least three months and who sees you on a day-to-day basis. You cannot be the respondent for your own ICAP.
(2) ((DDD)) DDA or a designee contracted with ((DDD)) DDA will choose the respondent and may interview more than one respondent to ensure that information is complete and accurate.
(3) ((DDD)) DDA or a designee contracted with ((DDD)) DDA will ask you to demonstrate some of the skills in order to evaluate what skills you are able to perform. ((DDD)) DDA or a designee contracted with ((DDD)) DDA cannot administer the ICAP if no respondent is identified and available.
AMENDATORY SECTION (Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)
WAC 388-823-0940 What happens if ((DDD)) DDA or a designee contracted with ((DDD)) DDA cannot identify a qualified respondent?
If you and ((DDD)) DDA or a designee contracted with ((DDD)) DDA cannot identify a qualified respondent for the ICAP, ((DDD)) DDA or a designee contracted with ((DDD)) DDA will not be able to administer the ICAP or determine you eligible under any conditions that require an ICAP.
AMENDATORY SECTION (Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)
WAC 388-823-1000 Once I become an eligible ((DDD)) DDA client, is there a time limit to my eligibility?
While ((DDD)) DDA has the authority to review your eligibility at any time, your eligibility as a ((DDD)) DDA client will expire or have required reviews as indicated in WAC 388-823-1005 and 388-823-1010.
AMENDATORY SECTION (Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)
WAC 388-823-1005 When does my eligibility as a ((DDD)) DDA client expire?
(1) If you are determined eligible prior to age ((four)) three, your eligibility expires on your fourth birthday.
(((a) DDD will notify you at least ninety days before your eligibility expiration date.
(b) You must reapply for eligibility with DDD.))
(2) If you are determined ((or redetermined)) eligible at age three but under age ten ((per WAC 388-823-0810 through 388-823-0850,)) under developmental delays or Down syndrome your eligibility expires on your tenth birthday.
(((a) DDD will notify you at least ninety days before your eligibility expiration date.
(b) You must reapply for eligibility with DDD.
(3) If your eligibility determination was prior to July 2005 under developmental delays, Down syndrome, or medically intensive program and you are age four or older as of June 30, 2005, your eligibility expires on your tenth birthday.
(a) DDD will notify you at least ninety days before of your eligibility expiration date.
(b) You must reapply for eligibility with DDD.)) (3) If you are determined eligible under another neurological or other condition similar to intellectual disability and have used academic delays as evidence of your substantial limitations, your eligibility expires on your twentieth birthday.
(4) If your eligibility determination ((was made after July 2005 and)) is based solely ((due to)) on your need for nursing through the medically intensive children program, your eligibility expires when you are no longer eligible for the program ((but no later than)) or your eighteenth birthday, whichever comes first.
(((a) DDD)) (5) DDA will notify you at least ((ninety days)) six months before your ((eighteenth birthday)) eligibility expiration date.
(((b) You)) (6) If your eligibility expires you must reapply ((for)) in order to maintain eligibility with ((DDD)) DDA.
(7) If you fail to reapply before your expiration date or if DDA receives your reapplication less than sixty days prior your expiration date and DDA does not have sufficient time to make an eligibility determination by the date of expiration, DDA eligibility will expire and your DDA paid services will stop.
(a) If DDA determines you eligible after your eligibility expires, your eligibility will be reinstated on the date that DDA determines you eligible pursuant to WAC 388-823-0100.
(b) If DDA determines you eligible after your eligibility expires, your eligibility will not be retroactive to the expiration date.
(8) This expiration of eligibility takes effect even if DDA is unable to locate you to provide written notification that eligibility is expiring.
(9) There is no appeal right to eligibility expiration.
AMENDATORY SECTION (Amending WSR 05-12-130 [14-07-028], filed 6/1/05 [3/10/14], effective 7/2/05 [4/10/14])
WAC 388-823-1010 When will ((DDD)) DDA review my eligibility to determine if I continue to ((have a developmental disability)) meet the eligibility requirements for DDA?
(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)) DDA will review your eligibility ((will be reviewed)) at age ((seventeen)) nineteen with termination occurring no sooner than your ((eighteenth)) twentieth birthday if your most current eligibility determination was at sixteen or younger under ((mental retardation)) intellectual disability, cerebral palsy, epilepsy, autism, or another neurological ((condition,)) or other condition similar to ((mental retardation)) intellectual disability.
(((3) DDD)) (2) DDA will review your eligibility prior to the initial authorization of any paid service from ((DDD)) DDA when you are not currently receiving paid services and((:
(a) You)) you are age ((eighteen)) nineteen 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)) was made prior to ((July)) June 1, 2005.
(((4) DDD)) (3) DDA will review your eligibility if ((DDD)) DDA discovers:
(a) Your eligibility determination was made in error; or
(b) 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))) (c) New diagnostic information becomes available that does not support your current eligibility ((and you are under the age of eighteen)) determination.
(4) If DDA requires additional information to make a determination of eligibility during a review and you do not respond to the request for additional information, DDA will terminate your eligibility and any DDA services you are receiving either:
(a) On your twentieth birthday if the review is because you will be turning twenty; or
(b) Ninety days after DDA requests the information if the review is because you have requested a paid service.
Reviser's note: The bracketed material preceding the section above was supplied by the code reviser's office. 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 388-823-1015 What is the definition of "((DDD)) DDA paid services" in WAC ((388-823-1010(3))) 388-823-1010(2)?
((DDD paid services are defined by one or more of the following:
(1))) Authorization of a paid service within the last ninety days as evidenced by a social services ((payment system (SSPS))) authorization in the DSHS payment system, a county authorization for day program services, a ((waiver plan of care approving a DDD paid service, or)) DDA individual service plan approving a DDA service or program, residence in a SOLA, RHC, or ((IMR (authorization of a state supplementary payment through SSPS does not meet the definition of a DDD paid service);
(2) Authorization of family support services within the last twelve months.
(3) Documentation)) ICF/ID, or documentation of ((DDD)) DDA approval of your absence from ((DDD)) DDA paid services for more than ninety days with available funding for your planned return to services.
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 388-823-1020 Can ((DDD)) DDA terminate my eligibility if I no longer am a resident of the state of Washington?
((DDD)) DDA will terminate your eligibility if you lose residency in the state of Washington as defined in WAC 388-823-0050.
AMENDATORY SECTION (Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)
WAC 388-823-1030 How will I know that my eligibility is expiring or is due for review?
If your eligibility has a required expiration or review date, ((DDD)) DDA will send you prior written notification with reapplication or review information.
AMENDATORY SECTION (Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)
WAC 388-823-1060 How will ((DDD)) DDA notify me of its decision?
((DDD)) DDA will notify you and your legal representative or one other responsible party in writing of its determination of eligibility, ineligibility, or expiration of eligibility per WAC 388-825-100.
AMENDATORY SECTION (Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)
WAC 388-823-1070 What are my appeal rights to a department decision that I ((do not have a developmental disability)) am not eligible to be a client of DDA?
Your appeal rights to a department decision that you are not eligible to be a ((DDD)) DDA client because you do not ((have)) meet the requirements for a developmental disability as outlined in this WAC chapter are limited to those described in WAC 388-825-120 through 388-825-165.
AMENDATORY SECTION (Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)
WAC 388-823-1080 If ((DDD)) DDA decides that I do not ((have a developmental disability, how soon)) meet the requirements for eligibility, can I reapply for another decision?
If ((DDD)) DDA decides that you do not ((have a developmental disability)) meet the requirements for eligibility, as defined in this chapter, ((you may reapply)) DDA will only accept a new application if:
(1) Your eligibility was terminated because ((DDD)) DDA could not locate you and you have subsequently contacted ((DDD)) DDA;
(2) Your eligibility was terminated because you lost residency in the state of Washington and you have reestablished residency;
(3) You have additional or new information relevant to the determination that ((DDD)) DDA did not review for the previous determination of eligibility((; or
(4) DDD denied or terminated your eligibility based solely on your ICAP score and it has been more than twenty-four months since your last ICAP)).
(a) The only acceptable new information considered is diagnostic information, FSIQ tests, or adaptive skills tests.
(b) DDA will only accept adaptive skills tests as new information if you provide evidence that your prior scores were invalid or if you provide evidence of a loss of functioning related to your qualifying condition.
(c) DDA will not administer an ICAP if you have a previous, valid ICAP or adaptive skills test score that is current within the past thirty-six months.
AMENDATORY SECTION (Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)
WAC 388-823-1090 If I am already eligible, how do these new rules affect me?
If you are an eligible ((DDD)) DDA client on the effective date of these rules, you continue to be an eligible ((DDD)) DDA client but you are subject to the expiration and required eligibility reviews per WAC 388-823-1000 through ((388-823-1050)) 388-823-1030.
AMENDATORY SECTION (Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)
WAC 388-823-1095 What are my rights as a ((DDD)) DDA client?
As a ((DDD)) DDA client, you have the following rights:
(1) The right to be free from any kind of abuse or punishment (verbal, mental, physical, and/or sexual); or being sent to a place by yourself, if you do not choose to be alone;
(2) The right to appeal any decision by ((DDD)) DDA that denies, reduces, or terminates your eligibility, your services or your choice of provider;
(3) The right to receive only those services you agree to;
(4) The right to meet with and talk privately with your friends and family;
(5) The right to personal privacy and confidentiality of your personal and other records;
(6) The right to choose activities, schedules, and health care that meet your needs;
(7) The right to be free from discrimination because of your race, color, creed, national origin, religion, sex, age, disability, marital status, gender identity, or sexual orientation;
(8) The right to set your own rules in your home and to know what rules your providers have when you are living in their house or working in their facility;
(9) The right to request information regarding services that may be available from ((DDD)) DDA;
(10) The right to know what your doctor wants you to do or take and to help plan how that will happen;
(11) The right to be free from unnecessary medication, restraints and restrictions;
(12) The right to vote and help people get elected to office;
(13) The right to complain and not to have someone "get even";
(14) The right to have your provider listen to your concerns including those about the behavior of other people where you live;
(15) The right to receive help from an advocate;
(16) The right to manage your money or choose other persons to assist you;
(17) The right to be part of the community;
(18) The right to make choices about your life;
(19) The right to wear your clothes and hair the way you want;
(20) The right to work and be paid for the work you do; and
(21) The right to decide whether or not to participate in research after the research has been explained to you, and after you or your guardian gives written consent for you to participate in the research((;)).
AMENDATORY SECTION (Amending WSR 05-12-130, filed 6/1/05, effective 7/2/05)
WAC 388-823-1100 How do I complain to ((DDD)) DDA about my services or treatment?
If you have a complaint or grievance about your services or treatment, follow these steps in this order:
(1) First, contact your case resource manager or social worker by phone, in writing, e-mail, or in person and explain your problem.
(2) If you are not happy with the results from speaking with your case resource manager or social worker, you may ask to speak with their supervisor.
(3) If steps (1) and (2) do not solve your problem, you submit your complaint in writing to the regional office.
(4) If you do not reach a solution with the regional office, you can request that your complaint be forwarded to the ((DDD)) DDA headquarters in Olympia.
REPEALER
The following sections of the Washington Administrative Code are repealed:
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