PROPOSED RULES
SOCIAL AND HEALTH SERVICES
(Aging and Disability Services Administration)
(Division of Developmental Disabilities)
Original Notice.
Preproposal statement of inquiry was filed as WSR 10-21-094.
Title of Rule and Other Identifying Information: The department is amending chapter 388-828 WAC, The division of developmental disabilities (DDD) assessment, to include the algorithm DDD will use in determining an individual's employment support level.
Hearing Location(s): Office Building 2, Auditorium, DSHS Headquarters, 1115 Washington, Olympia, WA 98504 (public parking at 11th and Jefferson. A map is available at http://www1.dshs.wa.gov/msa/rpau/RPAU-OB-2directions.html
or by calling (360) 664-6094), on April 26, 2011, at 10:00 a.m.
Date of Intended Adoption: Not earlier than April 27, 2011.
Submit Written Comments to: DSHS Rules Coordinator, P.O. Box 45850, Olympia, WA 98504-5850, delivery 1115 Washington Street S.E., Olympia, WA 98504, e-mail DSHSRPAURulesCoordinator@dshs.wa.gov, fax (360) 664-6185, by 5 p.m. on April 26, 2011.
Assistance for Persons with Disabilities: Contact Jennisha Johnson, DSHS rules consultant, by April 5, 2011, TTY (360) 664-6178 or (360) 664-6094 or by e-mail at jennisha.johnson@dshs.wa.gov.
Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The purpose of these proposed rules [is] to provide information to clients, families, providers, stakeholders, and the general public with information regarding the process DDD uses to determine an individual's employment support level. This information is essential in developing a consistent process to govern outcome-based vendor contracts.
Reasons Supporting Proposal: The 2009-11 operating budget (ESHB 1244), sections 103(7) and 205(c) requires DDD to develop and implement the use of a consistent outcome-based vendor contract for employment and day program services. In order to achieve this mandate, DDD must first implement a standardized methodology to promote consistency in determining an individual's employment support needs. DDD is proposing rules to govern the process to determine an individual's employment acuity score and support level, which is based on his/her assessed needs.
Statutory Authority for Adoption: RCW 71A.12.030.
Statute Being Implemented: RCW 71A 12.020(3) [71A.12.020(3)] and 71A 12.040(4) [71A.12.040(4)].
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: Mark Eliason, P.O. Box 45310, Olympia, WA 98504, (360) 725-2517; Implementation: Branda Matson, P.O. Box 45310, Olympia, WA 98504, (360) 725-3205; and Enforcement: Don Clintsman, P.O. Box 45310, Olympia, WA 98504, (360) 725-3426.
No small business economic impact statement has been prepared under chapter 19.85 RCW. DDD has analyzed the proposed rule amendments and has determined that these rules will not "have a disproportionate impact on the state's small businesses" as described in chapter 19.85 RCW. The proposed rule amendments establish a consistent methodology in determining a person's employment acuity score and employment support level.
A cost-benefit analysis is required under RCW 34.05.328. A preliminary cost-benefit analysis may be obtained by contacting Mark Eliason, P.O. Box 45310, Olympia, WA 98504-5310, phone (360) 725-2517, fax (360) 407-0955, e-mail mark.eliason@dshs.wa.gov.
March 15, 2011
Katherine I. Vasquez
Rules Coordinator
4281.1DDD EMPLOYMENT ACUITY SCALE
[]
| If your employment acuity score in WAC 388-828-9210 is: | Your employment support level is: | |
| 0 or less | None | |
| Greater than 0 and less than 1.5 | Low | |
| 1.5 to less than 2.5 | Medium | |
| 2.5 or greater | High | |
[]
(1) Activities of daily living (see WAC 388-828-9215);
(2) Behavioral support (see WAC 388-828-9220);
(3) Interpersonal support (see WAC 388-828-9225);
(4) Environmental support (see WAC 388-828-9230);
(5) Level of monitoring (see WAC 388-828-9240);
(6) Employment support (see WAC 388-828-9245);
(7) Completing tasks with acceptable speed (see WAC 388-828-9255);
(8) Completing tasks with acceptable quality (see WAC 388-828-9260);
(9) Medical support (see WAC 388-828-9265); and
(10) Seizure support (see WAC 388-828-9270).
Example:
| Acuity scales and questions used in determining employment acuity score: | If employment support scores are: | |
| Activities of daily living | 0.20607 | |
| Behavioral support | 0.08372 | |
| Interpersonal support | 0.47326 | |
| Environmental support | 0.13596 | |
| Level of monitoring | 0.7311 | |
| Employment support | 0.43562 | |
| Completing tasks with acceptable speed | 0.18855 | |
| Completing tasks with acceptable quality | 0.10836 | |
| Medical support | 0.135 | |
| Seizure support | -0.15393 | |
| Your employment acuity score is: | 2.34371 | |
[]
| If your ADL support needs level in WAC 388-828-5480 is: | Then your ADL support needs level score is: |
| None | 0 |
| Low | 1 |
| Medium | 2 |
| High | 3 |
Example: An ADL support needs level score of 3 is multiplied by 0.06869 resulting in an employment acuity scale score for activities of daily living of 0.20607.
[]
| If your behavioral acuity level in WAC 388-828-5640 is: | Then your behavioral acuity level score is: |
| None | 0 |
| Low | 1 |
| Medium | 2 |
| High | 3 |
[]
| If your interpersonal support needs level in WAC 388-828-5820 is: | Then your interpersonal support needs level score is: |
| None | 0 |
| Low | 1 |
| Medium | 2 |
| High | 3 |
[]
| If your environmental support score from WAC 388-828-9235 is: | Then your environmental support level is: | ||
| 0 | 0 | None | |
| 1 or 2 | 1 | Low | |
| 3 or 4 | 2 | Medium | |
| 5 or more | 3 | High | |
Example: An environmental support score of 3 equals an environmental support level of 2. The environmental support level of 2 is then multiplied by 0.06798 resulting in an employment acuity scale score for environmental support of 0.13596.
[]
| Response | Employment Support/Limitations | Score |
| 1 | Behaviors impact workplace | 1 |
| 2 | Employment goals too specific | 1 |
| 3 | Fearful/scared of new situations | 0 |
| 4 | Frequent job changes | 1 |
| 5 | High turnover of natural supports | 1 |
| 6 | Hygiene issues unresolved | 1 |
| 7 | Lacks social skills | 1 |
| 8 | Little work history | 1 |
| 9 | Narrow scope of job requirements | 1 |
| 10 | Needs support arranging childcare | 1 |
| 11 | Others not supportive of employment goals | 1 |
| 12 | Others unable to support employment goals | 1 |
| 13 | Transportation | 1 |
| 14 | Unable to regularly get to work on time | 1 |
| 15 | Uncertain about work | 0 |
| 16 | Uncooperative/lacks motivation | 0 |
| Maximum employment support limitation score is: | 13 | |
[]
Example: If you level of monitoring is "onsite (e.g., on property) your level of monitoring score is 5. Multiplying a "level of monitoring score" of 5 by 0.14622 results in an employment support score for level of monitoring of 0.7311.
[]
Example: A DDD employment support score of 2 is multiplied by 0.21781 resulting in an employment acuity scale score for employment support of 0.43562.
[]
| If your total raw score for the SIS employment activities subscale in WAC 388-828-4260 is: | Then your DDD employment level is: | And your DDD employment support score is: | ||
| 0 | None | 0 | ||
| 1 through 35 | Low | 1 | ||
| 36 through 59 | Medium | 2 | ||
| 60 or more | High | 3 | ||
[]
Example: A "type of support" score of 3 (partial physical assistance) is multiplied by 0.06285 resulting in an employment acuity score for completing tasks with acceptable speed of 0.18855.
[]
Example: A "type of support" score of 2 (verbal/gestural prompting) is multiplied by 0.05418 resulting in an employment acuity score for completing tasks with acceptable quality of 0.10836.
[]
| If your medical support needs level in WAC 388-828-5700 is: | Then your medical support needs level score is: |
| None | 0 |
| Low | 1 |
| Medium | 2 |
| High | 3 |
Example: A medical support needs level score of 2 is multiplied by 0.06750 resulting in an employment acuity scale score for medical support of 0.135.
[]
Example: A seizure support score of 3 is multiplied by -0.05131 resulting in an employment acuity scale score for seizure support of -0.15393.
[]
| If your assessment indicates the following: | Your seizure support level is: | And your seizure support score is: | |
| (1) Does the client have a history of seizures equals "no" | None | 0 | |
| (2) Does the client have a
history of seizures equals
"yes"; and (3) Client does not meet requirements for seizure support level of "medium" or "high" |
Low | 1 | |
| (4) Client has convulsive
seizures (tonic-clonic or
atonic); and (5) Frequency is quarterly, monthly, weekly or multiple times per week; and (6) Seizure duration is 5 minutes or less |
Medium | 2 | |
| (7) Two ore more
emergency room visits/911
calls in past year; or (8) Has convulsive seizures (tonic-clonic or atonic); and (9) Frequency is quarterly, monthly, weekly or multiple times per week; and (10) Seizure duration is greater than 5 minutes or requires medical intervention to stop |
High | 3 | |
[]
[]