WSR 05-17-088

EMERGENCY RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Aging and Disability Services Administration)

[ Filed August 12, 2005, 4:21 p.m. , effective August 22, 2005. ]


Purpose: The purpose of new chapter 388-824 WAC, Division of Developmental Disabilities mini-assessment process, is to govern and support the implementation of requirements per ESSB 6090, section 205 (e)(iii), chapter 518, Laws of 2005, requiring that DDD collect client need(s) and client/family financial information for implementation of a flexible family support pilot program to address the health, safety and general welfare needs of up to 1400 clients during the 2006 fiscal year. The mini-assessment is the only automated application tool that DDD currently has available to collect legislatively mandated information on severity of need and family income to ensure that families identified to participate in the flexible family support pilot are eligible to receive these services. Without this automated application, DDD will not be able to consistently and easily monitor information that DDD is required to report to the legislature regarding client needs and family income. Consequently the division's ability to authorize services to this pilot population will be jeopardized. In addition, DDD will not be able to complete the necessary analysis, required by the legislature, regarding the results, successes and failures, of the pilot. The legislature has required DDD to collect this information so that it will be available in making policy recommendations for future biennia regarding family support services. Therefore, it is essential that these rules be adopted by August 22, 2005, to complete the steps necessary to be able to meet the legislative requirement that the mini-assessment be used to implement the flexible family support pilot project. These rules have been proposed for permanent adoption and a public hearing has been scheduled for September 6, 2005 (see WSR 05-16-085).

Statutory Authority for Adoption: RCW 71A.12.030.

Other Authority: ESSB 6090, section 205, chapter 518, Laws of 2005, and 2005-07 Conference Budget.

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

Reasons for this Finding: DDD is adopting chapter 388-824 WAC on an emergency basis, effective August 22, 2005, in order to comply with the legislative mandate that the department's mini-assessment tool be used to implement the flexible family support pilot program per SB 6090, section 205 (2)(iv), chapter 518, Laws of 2005. The purpose of the mini-assessment is to electronically capture information regarding a client's income and crisis levels so that the client's eligibility for flexible family support can be verified. Without these rules DDD will be not able to identify clients and families who: Have unmet needs, may be in crisis; and are not receiving paid services. Consequently, without the emergency rule, these clients will not receive available flexible family support services to address their needs, resulting in these clients being at increased risk for out-of-home placement and/or institutional services.

In addition, the Joint Legislative Audit and Review Committee (JLARC) in 2003 recommended DSHS to develop an assessment process for developmentally disabled clients designed to be consistently applied, to all clients, in all parts of the state. Section 205 (1)(iii), chapter 518, Laws of 2005, states that: Eligibility for, and the amount of, renewable awards and one-time awards shall be redetermined annually and shall correspond with the application of the department's mini-assessment tool.

Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 29, 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 29, Amended 0, Repealed 0.

Date Adopted: August 12, 2005.

Andy Fernando, Manager

Rules and Policies Assistance Unit

3542.10
Chapter 388-824 WAC

DIVISION OF DEVELOPMENTAL DISABILITIES MINI-ASSESSMENT PROCESS


NEW SECTION
WAC 388-824-0001   What definitions apply to this chapter?   The following definitions apply to this chapter:

"Algorithm" means a numerical formula used by the mini-assessment software application to assign a client to a level of need group.

"CARE" means the Comprehensive Assessment Reporting Evaluation as defined in Chapter 388-106 WAC.

"Client" means a person with a developmental disability as defined in Chapter 388-823 WAC. For purposes of this chapter, the term "client" may include the client's representative.

"Crisis" means a serious and imminent threat exists or will exist without immediate intervention and the client lacks the resources to address the situation. The threat may be:

(1) To the life, health and/or safety of the client; or

(2) To the safety of the client's family; or

(3) To the safety of the community.

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

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

"Domain" means a specific area of the client's life. For mini-assessment purposes only, domains are identified in WAC 388-824-0025.

"Full assessment" means an inventory and evaluation of client needs using a department approved tool to determine service eligibility and amount of services that may be authorized.

"Full assessment referral database" means a report that contains client identification information and mini-assessment results.

"ICF/MR" means a facility certified as an intermediate care facility for the mentally retarded by Title XIX to provide services to individuals diagnosed as having mental retardation or persons with related conditions as defined in chapter 388-825 WAC.

"Information and referral" means a service directing clients to appropriate DSHS and generic community resources based on reported and/or assessed needs. This includes client/family education and problem solving related to reported and/or identified needs. This does not include authorizing a paid service.

"Mini-assessment" means a brief computerized assessment tool using a set of questions and responses scored by an algorithm. A mini-assessment identifies the relative level of need that exists in specific domains of the client's life.

"Paid services" is defined as 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, a county authorization for day program services, a Waiver Plan of Care approving a DDD paid service, or residence in a SOLA or ICF/MR.

(2) Authorization of family support services within the last twelve months.

(3) Documentation of DDD approval of your absence from DDD paid services for more than ninety days with available funding for your planned return to services.

"Reassessment" means any additional mini-assessment that the client receives after the initial mini-assessment.

"Respondent" means a client's parent(s) or another person who participates in the mini-assessment interview by answering questions and providing information.

"Significant change" means a reported change, for better or worse, in the client's medical condition, caregiver status, or need for support that differs from what was reported in the client's initial mini-assessment.

"SOLA" means a state operated living alternative program for adults that is operated by DDD.

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NEW SECTION
WAC 388-824-0010   What is the DDD mini-assessment?   (1) The mini-assessment is a brief computerized assessment tool that case managers use to identify the relative level of need that exists in specific domains of your life.

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NEW SECTION
WAC 388-824-0015   How do you and/or your respondent(s) obtain information about the mini-assessment?   Upon request, your case manager must provide you with a written copy and/or information on how to obtain a copy of the mini-assessment and associated algorithm.

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NEW SECTION
WAC 388-824-0020   What is the purpose of the mini-assessment?   The purpose of the mini-assessment is to:

(1) Identify major domains in which needs may exist, as identified in WAC 388-824-0010;

(2) Identify clients with no current unmet needs;

(3) Identify clients who are not in crisis and who will receive information and referral services alone;

(4) Identify clients who need employment or other county services;

(5) Determine whether a client is in crisis;

(6) Identify clients who may be eligible for Medicaid Personal Care;

(7) Assign clients to one of the following level of need groups for referral to the Full Assessment Referral Database:

(a) High level of need;

(b) Moderate level of need; or

(c) Low level of need; and

(8) Assist supervisors and case resource managers to make decisions about whom to refer for a full assessment.

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NEW SECTION
WAC 388-824-0025   What domains does the mini-assessment evaluate to identify your relative level of need?   The mini-assessment evaluates information you report regarding the following specific domains:

(1) Housing;

(2) Caregiver/support system;

(3) Safety;

(4) Community protection;

(5) Behavior;

(6) Financial/subsistence;

(7) Physical health;

(8) Mental health;

(9) Personal care assistance;

(10) Education;

(11) Employment;

(12) Social/community participation;

(13) Legal;

(14) Communication;

(15) Adaptive equipment; and

(16) Transportation.

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NEW SECTION
WAC 388-824-0030   Does the mini-assessment affect other DDD assessments?   The mini-assessment does not replace or change other assessments that DDD uses.

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NEW SECTION
WAC 388-824-0040   Who receives a mini-assessment?   (1) DDD conducts a mini-assessment if you have been determined eligible to be a client of the division of developmental disabilities per WAC 388-823-0020 and meet the requirements of WAC 388-824-0050; or

(2) You are eligible to be a client of DDD per WAC 388-823-0020 and are eligible for the Medicaid Categorically Needy Program (CNP) but you have been determined ineligible for Medicaid Personal Care by a CARE assessment, or have declined Medicaid Personal Care Services.

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NEW SECTION
WAC 388-824-0050   Who does not receive a mini-assessment?   DDD does not conduct a mini-assessment in any of these situations:

(1) Your child is under age of three, since your child:

(a) May be eligible for services through the federally funded Infant Toddler Early Intervention Program; and

(b) May be referred for county-funded child development services.

(2) You are under the age of seventeen years and receiving private duty nursing services as defined by WAC 388-551-3000.

(3) You have been authorized to receive a State Supplementary Payment, through SSPS.

(4) You are currently living in or being discharged from a state-paid residential program or facility.

(5) You are in crisis and have been referred directly for a full assessment by a supervisor or case resource manager.

(6) You are receiving paid services as defined in WAC 388-824-0001.

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NEW SECTION
WAC 388-824-0055   Who participates in the mini-assessment?   You and your respondent(s) participate in the mini-assessment. If you are under age of eighteen or have a legal guardian, the primary respondent(s) will be your parent(s) or legal guardian.

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NEW SECTION
WAC 388-824-0060   How does DDD conduct an initial mini-assessment?   (1) DDD staff must complete the mini-assessment through a face-to-face interview with you.

(2) The mini-assessment may occur at any site agreed to by you, your respondent(s) and DDD.

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NEW SECTION
WAC 388-824-0065   When does DDD conduct a reassessment?   A reassessment may occur when:

(1) A significant change is reported regarding your relative level of need; and

(2) You and/or your respondent have requested assistance in supporting your reported unmet need to your case resource manager; and

(3) You meet the criteria defined in WAC 388-824-0040 and WAC 388-824-0050; or

(4) A supervisor and/or your case resource manager determine that a reassessment is necessary.

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NEW SECTION
WAC 388-824-0070   Does DDD require you to disclose financial information?   (1) If you are under the age of eighteen and live with your natural, step, or adoptive parent(s), your case resource manager must ask for information regarding:

(a) Your family's annual gross income; and

(b) The number of dependents in your family's household.

(2) Your case resource manager must ask for this information before completing your mini-assessment.

(3) If your respondent(s) agree to disclose your family's annual gross income and the number of your family's dependents, your case resource manager must record this information in the CARE tool.

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NEW SECTION
WAC 388-824-0080   Is the respondent required to provide verification of my family's annual gross income?   Your respondent(s) are not required to provide verification or evidence of your family's annual gross income and/or number of family dependents.

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NEW SECTION
WAC 388-824-0090   Does reporting your family's annual gross income and number of family dependents affect your eligibility for paid services?   Reporting your family's annual gross income and number of family dependents does not affect your eligibility for paid services except when the legislature establishes, by law, standards for a specific service.

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NEW SECTION
WAC 388-824-0100   What does DDD do if the respondent does not provide the requested family income and dependent information?   If the respondent does not provide information regarding your family's annual gross income and number of family dependents, the case resource manager must:

(1) Document that the your respondent(s) have declined to provide information regarding your family's annual gross income information and/or number of family dependents.

(2) Ask your respondent(s) if they would like information regarding a referral for ICF/MR services per Title 71A RCW, chapter 388-825 WAC and chapter 388-837 WAC.

(3) Offer you and/or your respondent(s) an opportunity to complete the mini-assessment.

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NEW SECTION
WAC 388-824-0120   What is the difference between a mini-assessment for adults and a mini-assessment for children?   The differences between a mini-assessment for adults and children are:

(1) The requirement to request your family income information and number of family dependents per chapter 388-824-0070; and

(2) The presentation of different wordings of questions which may activate or inactivate whole questions based on your age.

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NEW SECTION
WAC 388-824-0140   How does the mini-assessment use information that is scored during the mini-assessment interview?   The mini-assessment uses information reported by you and/or your respondent(s) to evaluate your relative level of need using an algorithm in the software application.

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NEW SECTION
WAC 388-824-0170   What occurs when you are assigned to the "high level of need" group?   When you are assigned to the "high level of need" group, your case resource manager must do one or more of the following:

(1) Refer you to the Full Assessment Referral Database for a full assessment.

(2) Assist you to resolve a crisis, if indicated by the mini-assessment, before initiating a full assessment.

(3) Offer you necessary information and referral services to address a reported and/or assessed need.

(4) Provide you and your respondent(s) with information on how to contact your case resource manager should a change in your needs occur.

(5) Refer you for further case management review if the mini-assessment indicates:

(a) You have an unmet need in the community protection domain; or

(b) You may be at risk for placement in a more restrictive setting.

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NEW SECTION
WAC 388-824-0190   What occurs when you are assigned to the "moderate level of need" group?   When you are assigned to the "moderate level of need" group, your case resource manager must do one or more of the following:

(1) Refer you to the Full Assessment Referral Database for a full assessment.

(2) Offer you necessary information and referral services to address a reported and/or assessed need.

(3) Refer you for further case management review if the mini-assessment identifies you to be at risk for placement in a more restrictive residential setting.

(4) Provide you and your respondent(s) with information on how to contact your case resource manager should a change in your needs occur.

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NEW SECTION
WAC 388-824-0210   What occurs when you are assigned to the "low level of need" group?   When you are assigned to the "low level of need" group, your case resource manager must do one or more of the following:

(1) Refer you to the Full Assessment Referral Database.

(2) Offer you necessary information and referral services to address a reported and/or assessed need.

(3) Provide you and your respondent(s) with information on how to contact your case resource manager should a change in your needs occur.

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NEW SECTION
WAC 388-824-0220   When will I be reassigned to another level of need group?   You may be reassigned to another level of need group only if you continue to meet the criteria defined in WAC 388-824-0065 and receive a reassessment that indicates assignment to another level of need group.

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NEW SECTION
WAC 388-824-0230   Does the mini-assessment result in paid services?   The mini-assessment does not result in you receiving paid services except when the legislature establishes, by law, standards for specific service.

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NEW SECTION
WAC 388-824-0240   How do you know the results of your mini-assessment?   After the mini-assessment is performed, your case resource manager must discuss the results with you and/or your respondent(s). You and your designated respondent(s) will be notified in writing regarding:

(1) Your assigned level of need group; and

(2) Information on how to contact your case resource manager should a change in your needs occur.

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NEW SECTION
WAC 388-824-0260   What is the full assessment referral database?   The full assessment referral database is a report that assists supervisors and case resource managers to make decisions about whom to refer for a full assessment. It contains the following information:

(1) Your name, date of birth, and phone number.

(2) The date your mini-assessment was performed.

(3) Information about whether the mini-assessment indicated that you may be in crisis.

(4) Information regarding your relative level of need to include:

(a) Your assigned level of need group; and

(b) Your mini-assessment score.

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NEW SECTION
WAC 388-824-0280   What information does DDD use in deciding whom to refer for a full assessment?   DDD refers you from the full assessment referral database for a full assessment on the basis of:

(1) Your mini-assessment score;

(2) Your identified level of unmet need;

(3) DDD's capacity for completing full assessments; and

(4) Available funding to provide an approved service to meet the identified level of unmet need.

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NEW SECTION
WAC 388-824-0290   When does DDD remove my name from the full assessment referral database?   DDD removes your name from the full assessment referral database after:

(1) You have received a full assessment;

(2) DDD determines that you no longer meet the criteria for a mini-assessment per WAC 388-824-0050; or

(3) DDD determines that you are receiving a paid service and/or no longer eligible to be a client of the division of developmental disabilities per chapter 388-823 WAC.

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NEW SECTION
WAC 388-824-0310   When DDD adjusts the mini-assessment algorithm, when does the adjustment become effective?   When DDD adjusts the mini-assessment algorithm, the adjustment becomes effective at your initial or next mini-assessment or reassessment following the date of the algorithm adjustment.

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NEW SECTION
WAC 388-824-0320   Are there appeal rights to the mini-assessment?   (1) You and/or your designated representative(s) have the right to a hearing when:

(a) You disagree with the information entered into the mini-assessment; or

(b) DDD denies you and/or your designated representative's request to have a reassessment performed.

(2) You do not have the right to appeal the mini-assessment algorithm.

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NEW SECTION
WAC 388-824-0330   If you request a hearing to review the results of your mini-assessment, which mini-assessment does the administrative law judge review in the hearing?   If you request a hearing to review the results of your mini-assessment, the administrative law judge must review your most recent mini-assessment.

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Washington State Code Reviser's Office