WSR 11-13-039

PERMANENT RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Aging and Disability Services Administration)

(Division of Developmental Disabilities)

[ Filed June 8, 2011, 2:42 p.m. , effective July 9, 2011 ]


Effective Date of Rule: Thirty-one days after filing.

Purpose: The purpose of these proposed rules 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.

Statutory Authority for Adoption: RCW 71A.12.030, 71A.12.020(3), and 71A.12.040(4).

Other Authority: The 2009-11 operating budget (ESHB 1244, sections 103(7) and 205(c)).

Adopted under notice filed as WSR 11-07-080 on March 22, 2011.

A final cost-benefit analysis is available by contacting Mark Eliason, P.O. Box 45310, Olympia, WA 98504, phone (360) 725-2517, fax (360) 407-0955, e-mail mark.eliason@dshs.wa.gov.

Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

Number of Sections Adopted on the Agency's Own Initiative: New 17, Amended 0, Repealed 0.

Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 17, Amended 0, Repealed 0.

Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 0, Repealed 0.

Date Adopted: June 8, 2011.

Susan N. Dreyfus

Secretary

4281.1DDD EMPLOYMENT ACUITY SCALE
NEW SECTION
WAC 388-828-9200   What is the DDD employment acuity scale?   The DDD employment acuity scale is an algorithm that determines your employment acuity score and employment support level.

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NEW SECTION
WAC 388-828-9205   How does DDD determine your employment support level?   DDD determines your employment support level using the following table:


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

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NEW SECTION
WAC 388-828-9210   How does DDD determine your employment acuity score?   DDD determines your employment acuity support score by combining your employment support scores for:

(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
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

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NEW SECTION
WAC 388-828-9215   How does DDD determine your employment acuity scale score for activities of daily living?   DDD determines your employment acuity score for activities of daily living by multiplying your ADL support needs level score by 0.06869.


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.

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NEW SECTION
WAC 388-828-9220   How does DDD determine your employment acuity scale score for behavioral support?   DDD determines your employment acuity scale score for behavioral support by multiplying your behavioral acuity level score (see WAC 388-828-5640) by 0.04186.


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

Example: A behavioral acuity level score of 2 is multiplied by 0.04186 resulting in an employment acuity scale score for behavioral support of 0.08372.

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NEW SECTION
WAC 388-828-9225   How does DDD determine your employment acuity scale score for interpersonal support?   DDD determines your employment acuity scale score for interpersonal support by multiplying your interpersonal support needs level score (see WAC 388-828-5820) by 0.23663.


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

Example: An interpersonal support needs level score of 2 is multiplied by 0.23663 resulting in an employment acuity scale score for interpersonal support of 0.47326.

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NEW SECTION
WAC 388-828-9230   How does DDD determine your employment acuity scale score for environmental support?   DDD determines your employment acuity scale score for environmental support by multiplying your environmental support level by 0.06798.


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.

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NEW SECTION
WAC 388-828-9235   How does DDD determine your environmental support score?   DDD determines your environmental support score by adding the sum of your assessment responses to employment support limitations in the following table:


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 have selected responses 1, 3, 8, 13, and 15, the sum of your scores for employment support limitations would be 3, resulting in an environmental support score of 3 for WAC 388-828-9230.

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NEW SECTION
WAC 388-828-9240   How does DDD determine your employment support score for level of monitoring?   DDD determines your employment support score for level of monitoring by multiplying your level of monitoring score in WAC 388-828-5060(1) by 0.14622.

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.

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NEW SECTION
WAC 388-828-9245   How does DDD determine your employment acuity scale score for employment support?   DDD determines your employment acuity score for employment support by multiplying your DDD employment support score in WAC 388-828-9250 by 0.21781.

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.

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NEW SECTION
WAC 388-828-9250   How does DDD determine your DDD employment support score?   DDD determines your DDD employment support score using the following table:


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

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NEW SECTION
WAC 388-828-9255   How does DDD determine your employment acuity score for completing tasks with acceptable speed?   DDD determines your employment acuity score for completing tasks with acceptable speed by using your "type of support" score for question "D5" in WAC 388-828-4260 and multiplying it by 0.06285.

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.

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NEW SECTION
WAC 388-828-9260   How does DDD determine your employment acuity score for completing tasks with acceptable quality?   DDD determines your employment acuity score for completing tasks with acceptable quality by using your "type of support" score for question "D6" in WAC 388-828-4260 and multiplying it by 0.05418.

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.

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NEW SECTION
WAC 388-828-9265   How does DDD determine your employment acuity scale score for medical support?   DDD determines your employment acuity scale score for medical support by multiplying your medical support needs level score (see WAC 388-828-5700) by 0.06750.

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.

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NEW SECTION
WAC 388-828-9270   How does DDD determine your employment acuity scale score for seizure support?   DDD determines your employment acuity scale score for seizure support by multiplying your seizure support score in WAC 388-828-9275 by negative 0.05131.

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.

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NEW SECTION
WAC 388-828-9275   How does DDD determine your seizure support score?   DDD determines your seizure support score using the following table:


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

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NEW SECTION
WAC 388-828-9280   Why does DDD multiply your seizure support score by a negative factor?   DDD multiplies your seizure support score by a negative factor because the DDD employment acuity scale tends to over-predict employment support needs for persons with seizures. This is because seizures can often be controlled with medication and the relationship between a person's seizure acuity and employment support needs may have already been partially taken into account by other variables in the algorithm, such as the medical acuity scale.

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Washington State Code Reviser's Office