WSR 12-13-068

PERMANENT RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Aging and Disability Services Administration)

[ Filed June 18, 2012, 1:18 p.m. , effective July 19, 2012 ]


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

Purpose: The department revised its assessment process for allocating personal care hours to disabled children as a result of the Washington state supreme court decision in the Samantha A. v. DSHS.

Citation of Existing Rules Affected by this Order: Amending WAC 388-106-0125.

Statutory Authority for Adoption: RCW 74.08.090, 74.09.520.

Adopted under notice filed as WSR 11-24-095 on December 7, 2011.

Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.

Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.

Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.

Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 0, Amended 1, Repealed 0.

Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 0, Amended 1, Repealed 0.

Date Adopted: June 13, 2012.

Katherine I. Vasquez

Rules Coordinator

4262.5
AMENDATORY SECTION(Amending WSR 10-11-050, filed 5/12/10, effective 6/12/10)

WAC 388-106-0125   ((If I am age twenty-one or older,)) How does CARE use criteria to place me in a classification group for in-home care?   CARE uses the criteria of cognitive performance score as determined under WAC 388-106-0090, clinical complexity as determined under WAC 388-106-0095, mood/behavior and behavior point score as determined under WAC 388-106-0100, ADLS as determined under WAC 388-106-0105, and exceptional care as determined under WAC 388-106-0110 to place you into one of the following seventeen in-home groups. CARE classification is determined first by meeting criteria to be placed into a group, then you are further classified based on ADL score or behavior point score into a classification sub-group following a classification path of highest possible base hours to lowest qualifying base hours. Each classification group is assigned a number of base hours as described below based upon the level of funding provided by the legislature for personal care services, and based upon the relative level of functional disability of persons in each classification group as compared to persons in other classification groups.

(1) If you meet the criteria for exceptional care, then CARE will place you in Group E. CARE then further classifies you into:

(a) Group E High with ((416)) 393 base hours if you have an ADL score of 26-28; or

(b) Group E Medium with ((346)) 327 base hours if you have an ADL score of 22-25.

(2) If you meet the criteria for clinical complexity and have cognitive performance score of 4-6 or you have cognitive performance score of 5-6, then you are classified in Group D regardless of your mood and behavior qualification or behavior points. CARE then further classifies you into:

(a) Group D High with ((277)) 260 base hours if you have an ADL score of 25-28; or

(b) Group D Medium-High with ((234)) 215 base hours if you have an ADL score of 18-24; or

(c) Group D Medium with ((185)) 168 base hours if you have an ADL score of 13-17; or

(d) Group D Low with ((138)) 120 base hours if you have an ADL score of 2-12.

(3) If you meet the criteria for clinical complexity and have a CPS score of less than 4, then you are classified in Group C regardless of your mood and behavior qualification or behavior points. CARE then further classifies you into:

(a) Group C High with ((194)) 176 base hours if you have an ADL score of 25-28; or

(b) Group C Medium-High with ((174)) 158 base hours if you have an ADL score of 18-24; or

(c) Group C Medium with ((132)) 115 base hours if you have an ADL score of 9-17; or

(d) Group C Low with ((87)) 73 base hours if you have an ADL score of 2-8.

(4) If you meet the criteria for mood and behavior qualification and do not meet the classification for C, D, or E groups, then you are classified into Group B. CARE further classifies you into:

(a) Group B High with ((147)) 129 base hours if you have an ADL score of 15-28; or

(b) Group B Medium with ((82)) 69 base hours if you have an ADL score of 5-14; or

(c) Group B Low with ((47)) 39 base hours if you have an ADL score of 0-4; or

(5) If you meet the criteria for behavior points and have a CPS score of greater than 2 and your ADL score is greater than 1, and do not meet the classification for C, D, or E groups, then you are classified in Group B. CARE further classifies you into:

(a) Group B High with ((147)) 129 base hours if you have a behavior point score 12 or greater; or

(b) Group B Medium-High with ((101)) 84 base hours if you have a behavior point score greater than 6; or

(c) Group B Medium with ((82)) 69 base hours if you have a behavior point score greater than 4; or

(d) Group B Low with ((47)) 39 base hours if you have a behavior point score greater than 1.

(6) If you are not clinically complex and your CPS score is less than 5 and you do not qualify under either mood and behavior criteria, then you are classified in Group A. CARE further classifies you into:

(a) Group A High with ((71)) 59 base hours if you have an ADL score of 10-28; or

(b) Group A Medium with ((56)) 47 base hours if you have an ADL score of 5-9; or

(c) Group A Low with ((26)) 22 base hours if you have an ADL score of 0-4.

[Statutory Authority: RCW 74.08.090, 74.09.520, 2009 c 564 206(5). 10-11-050, 388-106-0125, filed 5/12/10, effective 6/12/10. Statutory Authority: RCW 74.08.090, 74.09.520, and 2007 c 522. 08-10-022, 388-106-0125, filed 4/25/08, effective 5/26/08. Statutory Authority: RCW 74.08.090, 74.09.520. 05-11-082, 388-106-0125, filed 5/17/05, effective 6/17/05.]

Reviser's note: The typographical 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.

Washington State Code Reviser's Office