WSR 04-18-071

PROPOSED RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Aging and Disability Services Administration)

[ Filed August 30, 2004, 3:53 p.m. ]

     Supplemental Notice to WSR 04-14-099.

     Preproposal statement of inquiry was filed as WSR 04-09-089 and 04-01-087.

     Title of Rule and Other Identifying Information: Chapter 388-72A WAC, Comprehensive assessment reporting and evaluation (CARE) tool.

     Hearing Location(s): Blake Office Park East, 4500 10th Avenue S.E. (behind Goodyear Courtesy Tire), Rose Room, Lacey, WA, on October 5, 2004 at 10:00 a.m.

     Date of Intended Adoption: Not earlier than October 6, 2004.

     Submit Written Comments to: DSHS Rules Coordinator, P.O. Box 45850, Olympia, WA 98504, delivery 4500 10th Avenue S.E., Lacey, WA, e-mail fernaax@dshs.wa.gov, fax (360) 664-6185, by 5:00 p.m., October 5, 2004.

     Assistance for Persons with Disabilities: Contact Fred Swenson, DSHS Rules Consultant, by October 1, 2004, TTY (360) 664-6178 or (360) 664-6097.

     Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: Adding new sections WAC 388-72A-0042 and 388-72A-0043, Comprehensive assessment and reporting evaluation (CARE) tool, to incorporate CARE assessment criteria for children receiving state plan Medicaid personal care (MPC) services.

     The department has withdrawn proposed WAC 388-72A-0042 only from proposed rules filed under WSR 04-14-099 and scheduled for public hearing on September 7, 2004. Comments received on WSR 04-14-099 related to this WAC will be considered in the adoption of the permanent rule.

     Reasons Supporting Proposal: See above.

     Statutory Authority for Adoption: RCW 74.08.090, 74.09.520, 74.39A.095.

     Statute Being Implemented: RCW 74.08.090, 74.09.520, 74.39A.095.

     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, Implementation and Enforcement: Brooke Buckingham, P.O. Box 45600, Olympia, WA 98504-5600, (360) 725-3213.

     No small business economic impact statement has been prepared under chapter 19.85 RCW. The department has analyzed the rules and determined that no new costs will be imposed on businesses.

     A cost-benefit analysis is not required under RCW 34.05.328. The proposed rule is exempt under RCW 34.05.328 (5)(b)(vii), rules relating to client medical eligibility. The CARE tool and algorithm in the proposed rule are used to determine clients' eligibility for medical long-term care services in home and community-based settings.

August 30, 2004

Brian H. Lindgren, Manager

Rules and Policies Assistance Unit

3464.2
NEW SECTION
WAC 388-72A-0042   How are ADLs and IADLs scored for children?   For children, the following age appropriate guidelines apply. The table indicates which tasks are considered met per age of the child.
Activities of Daily Living (ADLs)
Ages
&sqbul;= Code status as Met 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
Medication Management
Independent, supervision, limited, extensive, or Total &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Locomotion in RoomNote
Independent, supervision, limited or extensive &sqbul; &sqbul; &sqbul;
Total &sqbul;
Locomotion Outside RoomNote
Independent or supervision &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Limited or extensive &sqbul; &sqbul; &sqbul;
Total &sqbul;
Walk in RoomNote
Independent, supervision, limited or extensive &sqbul; &sqbul; &sqbul;
Total &sqbul;
Bed Mobility
Independent, supervision, limited or extensive &sqbul; &sqbul;
Total &sqbul;
Transfers
Independent, supervision, limited, extensive or total & under 30 pounds &sqbul; &sqbul;
(Total & over 30 pounds=no age limit)
Toilet Use
Support provided for nighttime wetting only (Independent, supervision, limited, extensive, or total) &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Independent, supervision, limited, extensive &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Total &sqbul; &sqbul; &sqbul;
Eating
Independent, supervision, limited, extensive, or total &sqbul; &sqbul;
Bathing
Independent or supervision &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Physical assistance all/part &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Total &sqbul; &sqbul; &sqbul; &sqbul;
Dressing
Independent or supervision &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Limited or extensive &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Total &sqbul; &sqbul; &sqbul; &sqbul;
Personal Hygiene
Independent or supervision &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Limited or extensive &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Total &sqbul; &sqbul; &sqbul; &sqbul;
Instrumental Activities of Daily Living
Ages
&sqbul;= Code status as Met 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
Telephone
Independent, supervision, limited, extensive, or Total &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Transportation
Independent, supervision, limited, extensive, or total &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Shopping
Independent, supervision, limited, extensive, or total &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Wood Supply
Independent, supervision, limited, extensive, or total &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Housework
Independent, supervision, limited, extensive, or total &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Finances
Independent, supervision, limited, extensive, or total &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Meal Preparation
Independent, supervision, limited, extensive, or total &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;

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

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


Ages
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
Additional guidelines based on age
Any foot care needs
Status Need met &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Any skin care (other than feet)
Status Need met &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Speech/Hearing
Score comprehension as understood &sqbul; &sqbul;
Memory
Short term memory ok &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Long term memory ok &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Depression
Select interview= unable to obtain &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Decision making
Rate how client makes decisions= independent &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Bladder/Bowel
Support provided for nighttime wetting only - &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;
Individual management=Does not need/use
Individual management=Does not need/use &sqbul; &sqbul; &sqbul; &sqbul; &sqbul;

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

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