Title of Rule and Other Identifying Information: The department is proposing to amend WAC 388-828-4200 What activities are assessed in the home living activities subscale of the support needs scale?, 388-828-4220 What activities are assessed in the community living activities subscale of the support needs scale?, 388-828-4240 What activities are assessed in the lifelong learning activities subscale of the support needs scale?, 388-828-4260 What activities are assessed in the employment activities subscale of the support needs scale?, 388-828-4280 What activities are assessed in the health and safety activities subscale of the support needs scale?, 388-828-4300 What activities are assessed in the social activities subscale of the support needs scale?, 388-828-4320 What activities are assessed in the supplemental protection and advocacy activities subscale?, 388-828-4360 What exceptional medical support activities are evaluated to assess your medical support needs?, 388-828-4380 What exceptional behavioral support activities are evaluated to assess your behavioral support needs?, 388-828-4400 How does DDD determine if you meet the eligibility requirements for ICF/MR level of care if you are age sixteen or older?, 388-828-5460 How does DDD determine your ADL support needs score if you are age sixteen or older?, 388-828-5700 How does DDD determine your medical acuity level?, 388-828-5800 How does DDD determine your interpersonal support needs score if you are age sixteen or older?, 388-828-5900 How does DDD determine your mobility acuity level if you are age sixteen or older?, 388-828-8040 How does DDD determine which health and welfare needs must be addressed in your individual support plan if you are age birth through fifteen?, 388-828-8060 How does DDD determine which health and welfare needs must be addressed in your individual support plan if you are age sixteen or older?, 388-828-9560 How does the residential algorithm determine your daily support needs score?, 388-828-9580 How does the residential algorithm determine your mid-frequency support needs score?, 388-828-9650 How does the residential algorithm determine your toileting support needs score?, 388-828-9660 How does the residential algorithm calculate your daily critical support time?, 388-828-9670 How does the residential algorithm calculate your mid-frequency critical support time?, and 388-828-9680 How does the residential algorithm determine your weekly critical support time?

The home living activities subscale measures your personal support needs for the following home living activities:

#	Home living activities	Type of support					Frequency of support					Daily support time					Raw score
A1	((Using the toilet))Operating home appliances/electronics	0	1	2	3	4	0	1	2	3	4	0	1	2	3	4
A2	Bathing and taking care of ((clothes (includes laundering)))personal hygiene and grooming needs	0	1	2	3	4	0	1	2	3	((4))*	0	1	2	3	4
A3	((Preparing food))Using the toilet	0	1	2	3	4	0	1	2	3	((*))4	0	1	2	3	4
A4	((Eating food))Dressing	0	1	2	3	4	0	1	2	3	4	0	1	2	3	4
A5	((Housekeeping and cleaning))Preparing food	0	1	2	3	4	0	1	2	3	((4))*	0	1	2	((*))3	((*))4
A6	((Dressing))Eating food	0	1	2	3	4	0	1	2	3	4	0	1	2	3	4
A7	((Bathing and))Taking care of ((personal hygiene and grooming needs))clothes, including laundering	0	1	2	3	4	0	1	2	3	((*))4	0	1	2	3	4
A8	((Operating home appliances))Housekeeping and cleaning	0	1	2	3	4	0	1	2	3	4	0	1	2	((3))*	((4))*
A9	Using currently prescribed equipment or treatment	0	1	2	3	4	0	1	2	3	4	0	1	2	3	4
Total raw score for home living activities:
* = Score is not an option per AAIDD. Note: Question A9 is a question added by ((DDD))DDA. It is for ((information))informational purposes only and is not used to calculate scores or levels for service determination.

The community living activities subscale measures your personal support needs for the following community living activities:

#	Community living activities	Type of support					Frequency of support					Daily support time					Raw score
B1	Getting from place to place throughout the community (transportation)	0	1	2	3	4	0	1	2	3	*	0	1	2	3	4
B2	Participating in recreation/leisure activities in community ((settings))	0	1	2	3	4	0	1	2	3	*	0	1	2	3	4
B3	((Using public services in the))Participating in preferred community activities (churches, volunteer, etc.)	0	1	2	3	4	0	1	2	3	*	0	1	2	3	4
B4	((Going to visit friends and family))Accessing public buildings and settings	0	1	2	3	4	0	1	2	3	((*))4	0	1	2	3	4
B5	((Participating))Using public services in ((preferred))the community ((activities (church, volunteer, etc.)))	0	1	2	3	4	0	1	2	3	*	0	1	2	3	4
B6	Shopping and purchasing goods and services	0	1	2	3	4	0	1	2	3	4	0	1	2	3	4
B7	Interacting with community members	0	1	2	3	4	0	1	2	3	4	0	1	2	3	4
B8	((Accessing public buildings and settings))Going to visit friends and family	0	1	2	3	4	0	1	2	3	((4))*	0	1	2	3	4
Total raw score for community living activities:
* = Score is not an option per AAIDD.

The lifelong learning activities subscale measures your personal support needs for the following lifelong learning activities:

#	Lifelong learning activities	Type of support					Frequency of support					Daily support time					Raw score
C1	((Interacting with others in learning activities))Learning and using problem-solving strategies	0	1	2	3	4	0	1	2	3	((*))4	0	1	2	3	4
C2	((Participating in training/educational decisions))Learning functional academics (reading signs, counting change, etc.)	0	1	2	3	4	0	1	2	3	((*))4	0	1	2	3	((*))4
C3	Learning ((and using problem-solving strategies))health and physical education skills	0	1	2	3	4	0	1	2	3	4	0	1	2	3	4
C4	((Using technology for))Learning self-determination skills	0	1	2	3	4	0	1	2	3	4	0	1	2	3	4
C5	((Accessing training/educational settings))Learning self-management strategies	0	1	2	3	4	0	1	2	3	((4))*	0	1	2	3	4
C6	((Learning functional academics (reading signs, counting change, etc.)))Participating in training/educational decisions	0	1	2	3	4	0	1	2	3	((4))*	0	1	2	3	((4))*
C7	((Learning health and physical education skills))Accessing training/educational settings	0	1	2	3	4	0	1	2	3	4	0	1	2	3	4
C8	Interacting with others in learning ((self-determination skills))activities	0	1	2	3	4	0	1	2	3	((4))*	0	1	2	3	4
C9	Using technology for learning ((self-management strategies))	0	1	2	3	4	0	1	2	3	((*))4	0	1	2	3	4
Total raw score for lifelong learning activities:
* = Score is not an option per AAIDD.

The employment activities subscale measures your personal support needs for the following employment activities:

#	Employment activities	Type of support					Frequency of support					Daily support time					Raw score
D1	((Accessing/receiving/job/tasks accommodations))Learning and using specific job skills	0	1	2	3	4	0	1	2	3	*	0	1	2	3	4
D2	((Learning and using specific job skills))Accessing/receiving job/task accommodations	0	1	2	3	4	0	1	2	3	*	0	1	2	3	4
D3	Interacting with co-workers	0	1	2	3	4	0	1	2	3	*	0	1	2	3	4
D4	Interacting with supervisors ((and/or))/coaches	0	1	2	3	4	0	1	2	3	*	0	1	2	3	4
D5	Completing work-related tasks with acceptable speed	0	1	2	3	4	0	1	2	3	*	0	1	2	3	4
D6	Completing work-related tasks with acceptable quality	0	1	2	3	4	0	1	2	3	*	0	1	2	3	4
D7	Changing job assignments	0	1	2	3	4	0	1	2	*	*	0	1	2	3	4
D8	Seeking information and assistance from an employer	0	1	2	3	4	0	1	2	3	*	0	1	2	3	4
Total raw score for employment activities:
* = Score is not an option per AAIDD.

The health and safety activities subscale measures your personal support needs for the following health and safety activities:

#	Health and safety activities	Type of support					Frequency of support					Daily support time					Raw score
E1	Taking medications	0	1	2	3	4	0	1	2	3	4	0	1	2	3	4
E2	((Avoiding health))Ambulating and ((safety hazards))moving about	0	1	2	3	4	0	1	2	3	4	0	1	2	3	4
E3	((Obtaining health care services))Avoiding health and safety hazards	0	1	2	3	4	0	1	2	3	4	0	1	2	((*))3	((*))4
E4	((Ambulating and moving about))Obtaining health care services	0	1	2	3	4	0	1	2	3	4	0	1	2	((3))*	((4))*
E5	Learning how to access emergency services	0	1	2	3	4	0	1	2	3	4	0	1	2	3	4
E6	Maintaining a nutritious diet	0	1	2	3	4	0	1	2	3	4	0	1	2	3	4
E7	Maintaining physical health and fitness	0	1	2	3	4	0	1	2	3	4	0	1	2	3	4
E8	Maintaining emotional well-being	0	1	2	3	4	0	1	2	3	4	0	1	2	3	4
Total raw score for health and safety activities:
* = Score is not an option per AAIDD.

The social activities subscale measures your personal support needs for the following social activities:

#	Social activities	Type of support					Frequency of support					Daily support time					Raw score
F1	((Socializing within the household))Using appropriate social skills	0	1	2	3	4	0	1	2	3	((*))4	0	1	2	3	4
F2	Participating in recreation ((and/or))/leisure activities with others	0	1	2	3	4	0	1	2	3	*	0	1	2	3	4
F3	Socializing outside the household	0	1	2	3	4	0	1	2	3	4	0	1	2	3	4
F4	Making and keeping friends	0	1	2	3	4	0	1	2	3	*	0	1	2	3	4
F5	((Communicating with others about personal needs))Engaging in loving and intimate relationships	0	1	2	3	4	0	1	2	3	4	0	1	2	3	4
F6	((Using appropriate social skills))Socializing within the household	0	1	2	3	4	0	1	2	3	((4))*	0	1	2	3	4
F7	((Engaging in loving and intimate relationships))Communicating with others about personal needs	0	1	2	3	4	0	1	2	3	4	0	1	2	3	4
F8	Engaging in volunteer work	0	1	2	3	4	0	1	2	3	4	0	1	2	3	4
Total raw score for social activities:
* = Score is not an option per AAIDD.

The supplemental protection and advocacy activities subscale measures your personal support needs for the following protection and advocacy activities:

#	Protection and advocacy activities	Type of support					Frequency of support					Daily support time					Raw score
G1	Advocating for self	0	1	2	3	4	0	1	2	3	*	0	1	2	3	4
G2	((Managing money))Making choices and ((personal finances))decisions	0	1	2	3	4	0	1	2	3	4	0	1	2	3	4
G3	Protecting self from exploitation	0	1	2	3	4	0	1	2	3	4	0	1	2	3	4
G4	Exercising legal/civic responsibilities	0	1	2	3	4	0	1	2	3	4	0	1	2	3	4
G5	Belonging to and participating in self-advocacy/support organizations	0	1	2	3	4	0	1	2	3	4	0	1	2	3	4
G6	Obtaining legal services	0	1	2	3	4	0	1	2	3	4	0	1	2	3	4
G7	((Making choices))Managing money and ((decisions))personal finances	0	1	2	3	4	0	1	2	3	4	0	1	2	3	4
G8	Advocating for others	0	1	2	3	4	0	1	2	3	*	0	1	2	3	4
Total raw score for protection and advocacy activities:
* = Score is not an option for AAIDD.

The SIS exceptional medical support needs scale measures your personal support needs for the following medical support need(s) activities:

#	Medical supports needed	No support needed	Some support needed	Extensive support needed
1.	Inhalation or oxygen therapy	0	1	2
2.	Postural drainage	0	1	2
3.	Chest PT	0	1	2
4.	Suctioning	0	1	2
5.	Oral stimulation or jaw positioning	0	1	2
6.	Tube feeding (e.g., nasogastric)	0	1	2
7.	Parenteral feeding (e.g., IV)	0	1	2
8.	Turning or positioning	0	1	2
9.	Dressing of open wound(s)	0	1	2
10.	Protection from infectious diseases due to immune system impairment	0	1	2
11.	Seizure management	0	1	2
12.	Dialysis	0	1	2
13.	Ostomy care	0	1	2
14.	Lifting and/or transferring	0	1	2
15.	Therapy services	0	1	2
16.	((Diabetes Management*))Hypertension	0	1	2
17.	((Other(s) - Specify:))Allergies	0	1	2
18.	Diabetes	0	1	2
19.	Other(s) - specify	0	1	2
Subtotal scores of 1s and 2s:
Add subtotals scores for 1s and 2s for total exceptional medical support needs score:
((* #16 is a question added by DDD. It is used as part of the DDD medical acuity scale and is not used to calculate SIS percentiles.))

The SIS exceptional behavioral support needs scale measures your personal support needs for the following behaviors:

#	Behavioral supports needed	No support needed	Some support Needed	Extensive support needed
1.	Prevention of ((assaults or injuries to others))emotional outbursts	0	1	2
2.	Prevention of ((property destruction (e.g., fire setting, breaking furniture)))assault or injury to others	0	1	2
3.	Prevention of ((stealing))property destruction (e.g. fire setting, breaking furniture)	0	1	2
4.	Prevention of ((self-injury))stealing	0	1	2
5.	Prevention of ((PICA (ingestion of inedible substances)))self-injury	0	1	2
6.	Prevention of suicide attempts	0	1	2
7.	Prevention of ((sexual aggression))PICA (ingestion of inedible substances)	0	1	2
8.	Prevention of nonaggressive but inappropriate behavior (e.g., exposes self in public, exhibitionism, inappropriate touching or gesturing)	0	1	2
9.	Prevention of ((tantrums or emotional outbursts))sexual aggression	0	1	2
10.	Prevention of ((wandering))substance abuse	0	1	2
11.	Prevention of ((substance abuse))wandering	0	1	2
12.	Maintenance of mental health treatments	0	1	2
13.	Managing attention-seeking behavior*	0	1	2
14.	Managing uncooperative behavior*	0	1	2
15.	Managing agitated/over reactive behavior*	0	1	2
16.	Managing obsessive/repetitive behavior*	0	1	2
17.	Prevention of other serious behavior problem(s) - Specify:	0	1	2
Subtotal scores of 1s and 2s:
Add subtotals scores for 1s and 2s for total exceptional behavioral support needs scores:
* #13-16 are questions added by ((DDD))DDA. They are used as part of the ((DDD))DDA behavior acuity scale and are not used to calculate SIS percentiles.

If you are age sixteen or older, ((DDD))DDA determines you to be eligible for ((ICF/MR))ICF/IID level-of-care from your SIS scores. Eligibility for ((ICF/MR))ICF/IID level-of-care requires that your scores meet at least one of the following:

(1) You have a percentile rank ((that is)) over nine percent for three or more of the six subscales in the SIS support needs scale;

(2) You have a percentile rank ((that is)) over twenty-five percent for two or more of the six subscales in the SIS support needs scale;

(3) You have a percentile rank ((that is)) over fifty percent in at least one of the six subscales in the SIS support needs scale;

(4) You have a support score of one or two for any of the questions listed in the SIS exceptional medical support needs scale;

(5) You have a support score of one or two for at least one of the following items in the SIS exceptional behavior support needs scale:

(a) Prevention of assaults or injuries to others;

(b) Prevention of property destruction (e.g., fire setting, breaking furniture);

(d) Prevention of PICA (ingestion of inedible substances);

(e) Prevention of suicide attempts;

(f) Prevention of sexual aggression; or

(g) Prevention of wandering.

(6) You have a support score of two for any of the questions listed in the SIS exceptional behavior support needs scale; or

(7) You meet or exceed any of the qualifying scores for one or more of the following SIS questions:

Question # of SIS support needs scale	Text of question	Your score for "Type of support" is:	And your score for "Frequency of support" is:
((A1))A2	((Using the toilet))Bathing and take care of personal hygiene and grooming needs	2 or more	4
		3 or more	2
((A2))A3	((Taking care of clothes))Using the toilet	2 or more	((2 or more))4
		3 or more	((1))2
((A3))A4	((Preparing food))Dressing	2 or more	4
		3 or more	2
((A4))A5	((Eating))Preparing food	2 or more	4
		3 or more	2
((A5))A6	((Housekeeping and cleaning))Eating food	2 or more	((2 or more))4
		3 or more	((1))2
((A6))A7	((Dressing))Taking care of clothes, including laundering	2 or more	((4))2 or more
		3 or more	((2))1
((A7))A8	((Bathing and taking care of personal hygiene))Housekeeping and ((grooming needs))cleaning	2 or more	((4))2 or more
		3 or more	((2))1
((C3))B6	((Learning))Shopping and ((using problem-solving strategies))purchasing goods and services	2 or more	((3))2 or more
		3 or more	((2))1
((C9))C1	Learning ((self-management))and using problem-solving strategies	2 or more	3 or more
		3 or more	2
((B6))C5	((Shopping and purchasing goods and services))Learning self-management strategies	2 or more	((2))3 or more
		3 or more	((1))2
E1	Taking medications	2 or more	4
		3 or more	2
E2	((Avoiding health))Ambulating and ((safety hazards))moving about	2 or more	((3 or more))4
		3 or more	2
((E4))E3	((Ambulating))Avoiding health and ((moving about))safety hazards	2 or more	((4))3 or more
		3 or more	2
E6	Maintaining a nutritious diet	2 or more	2 or more
		3 or more	1
E8	Maintaining emotional well-being	2 or more	3 or more
		3 or more	2
((F6))F1	Using appropriate social skills	2 or more	3 or more
		3 or more	2
((G2))G7	Managing money and personal finances	2 or more	2 or more
		3 or more	1

(1) If you are age sixteen or older, your ADL support needs score is the total adjusted "Type of support" scores from the following SIS questions:

ADL questions from the SIS assessment in WAC 388-828-4200 and 388-828-4280
Question #	Text of ADL questions:
A2	Bathing and taking care of personal hygiene and grooming needs
((A1))A3	Using the toilet
A4	((Eating food))Dressing
A6	((Dressing))Eating food
((A7	Bathing and taking care of personal hygiene and grooming needs))
E1	Taking medications
((E4))E2	Ambulating and moving about

(2) If your "Frequency of support" score for a SIS ADL question is zero or one, adjust your "Type of support" score for that question to zero.

(3) If your "Frequency of support" score for a SIS ADL support question is two, three, or four, no adjustment is needed to your "Type of support" score.

Example:

SIS ADL Questions	Text of SIS ADL Questions	If your "Frequency of Support" score is:	And your "Type of Support" score is:	Then your adjusted "Type of Support" score is:
A2	Bathing and taking care of personal hygiene and grooming needs	1	2	0
((A1))A3	Using the toilet	3	3	3
A4	((Eating food))Dressing	((1))3	((2))3	((0))3
A6	((Dressing))Eating food	((3))1	((3))2	((3))0
((A7	Bathing and taking care of personal hygiene and grooming needs	1	2	0))
E1	Taking medications	3	2	2
((E4))E2	Ambulating and moving about	0	0	0
Your SIS ADL support needs score:				8

((DDD))DDA uses your SIS support scores to questions in the exceptional medical support needs scale per WAC 388-828-4360 and the following table to determine your medical acuity level:

If you meet the following criteria:	Then your medical acuity level is:	Value
(1) If you have a score of 2 on questions 1, 4, and 7;	High	3
(2) If you have a score of 2 on any two of the following questions: 2, 3, 5, 6, 8, 9, 10, 11, 12, 13, 14, 16, ((or)) 17, 18, or 19;	High	3
(3) If your total exceptional medical support needs score is 8 or higher;	High	3
(4) If you have a score of 2 on any of the following questions: 2, 3, 5, 6, 8, 9, 10, 11, 12, 13, 14, 16, ((or)) 17, 18, or 19 and do not meet the criteria for a high medical acuity level;	Medium	2
(5) If your total exceptional medical support needs score is 6 or 7 and you do not meet the criteria for a high medical acuity level;	Medium	2
(6) If your total exceptional medical support needs score is 5 or less, but greater than zero, and you do not have a score of 2 on any questions excluding number 15;	Low	1
(7) If your total exceptional medical support needs score equals zero.	None	0

If you are age birth through fifteen and are receiving ((DDD))DDA HCBS waiver services or reside in a state only residential setting, ((DDD))DDA uses the following tables to determine the health and welfare needs that must be addressed in your individual support plan:

(1) Activities from the support needs assessment for children:

#	Questions in the Support Needs Assessment for Children:	((DDD))DDA must address in your ((ISP))PSCP if you have an acuity score of:	Health and Welfare Category
1	Dress and groom self	2 or more	Home Living
2	Toilet self	2 or more	Home Living
3	Eat at age level	3 or more	Home Living
4	Move around	3 or more	Home Living
5	Communicate	2 or more	Home Living
7	Make choices and take responsibility	2 or more	Protection and Advocacy
8	Explore environment	3 or more	Community Living
9	Meet therapy health needs	1 or more	Medical Supports
10	Help family continue to meet child's needs	1 or more	Protection and Advocacy
15	Identify and respond safely to emergencies	1 or more	Health and Safety
16	Practice age-level safety measures	2 or more	Protection and Advocacy
17	Effectively relate to other students/peers	3 or more	Employment
18	Have behaviors which promote being included	3 or more	Behavior Supports

(2) Medical supports from the SIS exceptional medical support needs scale

#	Questions in the Exceptional Medical Support Needs Scale	((DDD))DDA must address in your ((ISP))PSCP if you have an acuity score of:	Health and Welfare Category
1	Inhalation or oxygen therapy	1 or more	Medical Supports
2	Postural drainage	1 or more	Medical Supports
3	Chest PT	1 or more	Medical Supports
4	Suctioning	1 or more	Medical Supports
5	Oral Stimulation or Jaw Repositioning	1 or more	Medical Supports
6	Tube feeding (e.g., nasogastric)	1 or more	Medical Supports
7	Parenteral feeding (e.g., IV)	1 or more	Medical Supports
8	Turning or positioning	1 or more	Medical Supports
9	Dressing of open wound(s)	1 or more	Medical Supports
10	Protection from infectious diseases due to immune system impairment	1 or more	Medical Supports
11	Seizure management	1 or more	Medical Supports
12	Dialysis	1 or more	Medical Supports
13	Ostomy care	1 or more	Medical Supports
14	Lifting and/or transferring	1 or more	Medical Supports
15	Therapy services	1 or more	Medical Supports
16	((Diabetes management))Hypertension	1 or more	Medical Supports
17	((Other(s)))Allergies	1 or more	Medical supports
18	Diabetes	1 or more	Medical supports
19	Other(s)-Specify	1 or more	Medical Supports

(3) Behavioral supports from the SIS exceptional behavior support needs scale

#	Questions in the Exceptional Behavior Support Needs Scale:	((DDD))DDA must address in your ((ISP))PSCP if you have an acuity score of:	Health and Welfare Category
1	Prevention of ((assaults or injuries to others))emotional outbursts	1 or more	Behavioral Supports
2	Prevention of ((property destruction (e.g., fire setting, breaking furniture)))assault or injury to others	1 or more	Behavioral Supports
3	Prevention of ((stealing))property destruction (e.g., fire setting, breaking furniture)	1 or more	Behavioral Supports
4	Prevention of ((self-injury))stealing	1 or more	Behavioral Supports
5	Prevention of ((pica (ingestion of inedible substances)))self-injury	1 or more	Behavioral Supports
6	Prevention of suicide attempts	1 or more	Behavioral Supports
7	Prevention of ((sexual aggression))pica (ingestion of inedible substances)	1 or more	Behavioral Supports
8	Prevention of nonaggressive but inappropriate behavior (e.g., exposes self in public, exhibitionism, inappropriate touching or gesturing)	1 or more	Behavioral Supports
9	Prevention of ((tantrums or emotional outbursts))sexual aggression	1 or more	Behavioral Supports
10	Prevention of ((wandering))substance abuse	1 or more	Behavioral Supports
11	Prevention of ((substance abuse))wandering	1 or more	Behavioral Supports
12	Maintenance of mental health treatments	1 or more	Behavioral Supports
13	Managing attention-seeking behavior	1 or more	Behavioral Supports
14	Managing uncooperative behavior	1 or more	Behavioral Supports
15	Managing agitated/over-reactive behavior	1 or more	Behavioral Supports
16	Managing obsessive/repetitive behavior	1 or more	Behavioral Supports
17	Prevention of other serious behavior problem(s)-Specify	1 or more	Behavioral Supports

(4) Caregiver from the SIS exceptional behavior support needs scale

#	Question in the ((DDD))DDA Caregiver Status Acuity Scale:	((DDD))DDA must address in your ((ISP))PSCP if you have a score:	Health and Welfare Category
6	How long do you think you expect to continue providing care?	1 to 6 months or less than 1 month	((DDD))DDA Caregiver Status

(1) If you are age sixteen or older and receiving ((DDD))DDA HCBS waiver services or reside in a state-only residential setting, ((DDD))DDA uses the following table to determine the health and welfare needs that must be addressed in your individual support plan:

#	SIS Activity	((DDD))DDA must address in the ((ISP))PSCP if your Type of Support score is:	Health and Welfare Category
A1	((Using the toilet))Operating home appliances	3 or more
A2	Bathing and taking care of ((clothes (includes laundering)))personal hygiene and grooming needs	3 or more
A3	((Preparing food))Using the toilet	3 or more
A4	((Eating food))Dressing	3 or more
A5	((Housekeeping and cleaning))Preparing food	3 or more	Home Living
A6	((Dressing))Eating food	3 or more
A7	((Bathing and))Taking care of ((personal hygiene and grooming needs))clothes, including laundering	3 or more
A8	((Operating home appliances))Housekeeping and cleaning	3 or more
A9	Using currently prescribed equipment or treatment	3 or more
B1	Getting from place to place throughout the community (transportation)	2 or more
B2	Participating in recreation/leisure activities in the community ((settings))	2 or more
((B3	Using public services in the community	2 or more))	Community Living
B4	((Going to visit friends and family))Accessing public buildings and settings	((4))2 or more
B5	Using public services in the community	2 or more
B6	Shopping and purchasing goods and services	2 or more
B7	Interacting with community members	4
B8	((Accessing public buildings and settings))Going to visit friends and family	((2 or more))4
D3	Interacting with co-workers	3 or more
D4	Interacting with supervisors and or coaches	3 or more	Employment
E1	Taking medications	2 or more
E2	((Avoiding health and safety hazards))Ambulating and moving about	3 or more
E3	((Obtaining health care services))Avoiding health and safety hazards	3 or more
E4	((Ambulating and moving about))Obtaining health care services	3 or more	Health and Safety
E6	Maintaining a nutritious diet	3 or more
E7	Maintaining physical health and fitness	3 or more
F2	Participating in recreation/leisure activities with others	2 or more
F4	Making and keeping friends	4	Social Activities
F6	((Using appropriate social skills))Socializing within the household	4
G2	((Managing money and personal finances))Making choices and decisions	2 or more
G3	Protecting self from exploitation	2 or more	Protection and Advocacy
G7	((Making choices and decisions))Managing money and personal finances	2 or more

(2) If you have a support score of one or more for any of the questions in the SIS exceptional medical support needs scale, ((DDD))DDA must address your support need using the medical supports category.

(3) If you have a support score of one or more for any of the questions in the SIS exceptional behavior support needs scale, ((DDD))DDA must address your support need using the behavior supports category.

The residential algorithm determines that you have daily support needs if you meet or exceed all of the qualifying scores for one or more of the following activities from the SIS:

Qualifying Scores from Supports Intensity Scale (per WAC 388-828-4200 through 388-828-4320)
SIS Activity	If your score for type of support is:	And your score for frequency of support is:	And your daily support time is:
((A1: Using the toilet))A2: Bathing and taking care of personal hygiene and grooming needs	2 or more	3 or more	1 or more
((A4: Eating food))A3: Using the toilet	2 or more	3 or more	1 or more
((A6))A4: Dressing	2 or more	3 or more	1 or more
((A7: Bathing, personal hygiene, grooming))A6: Eating food	2 or more	3 or more	1 or more
A9: Using currently prescribed equipment or ((treatments))treatment	2 or more	3 or more	1 or more
E1: Taking medication	2 or more	3 or more	1 or more
E2: ((Avoiding health and safety hazards))Ambulating and moving about	((1))3 or more	3 or more	1 or more
((E4: Ambulating and moving about))E3: Avoiding health and safety hazards	((3))1 or more	3 or more	1 or more
Or
Any combination of 3 of the SIS activities listed above (((A1))A2, A3, A4, A6, ((A7,)) A9, E1, E2, ((E4))E3)	1 or more	3 or more	1 or more

The residential algorithm determines that you have mid-frequency support needs if you meet one of the following three conditions:

(1) You meet or exceed all of the qualifying scores for one or more of the following activities from the SIS assessment:

Qualifying Scores from Supports Intensity Scale (per WAC 388-828-4200 through 388-828-4320)
SIS Activity	If your type of support score is:	And your frequency of support score is:	And your daily support time score is:
((A3))A5: Preparing food	2 or more	2 or more	2 or more
((A5))A8: Housekeeping and cleaning	3 or more	3 or more	2 or more
B2: Participating in recreational/leisure activities in community settings	3 or more	2 or more	2 or more
B7: Interacting with community members	3 or more	2 or more	2 or more
G3: Protecting self from exploitation	2 or more	2 or more	2 or more

(2) Or you meet or exceed all of the qualifying scores for four or more of the following activities from the SIS assessment:

Qualifying Scores from Supports Intensity Scale (per WAC 388-828-4200 through 388-828-4320)
SIS Activity	If your type of support score is:	And your frequency of support score is:	And your daily support time score is:	Score if you meet or exceed criteria
((A1: Using the toilet))A2: Bathing and taking care of personal hygiene and grooming needs	1 or more	2 or more	1 or more
A3: ((Preparing food))Using the toilet	1 or more	2 or more	1 or more
A4: ((Eating food))Dressing	1 or more	2 or more	1 or more
A5: ((Housekeeping and cleaning))Preparing food	1 or more	2 or more	1 or more
A6: ((Dressing))Eating food	1 or more	2 or more	1 or more
((A7: Bathing, personal hygiene and grooming))A8: Housekeeping and cleaning	1 or more	2 or more	1 or more
A9: Using currently prescribed equipment and medications	1 or more	2 or more	1 or more
B2: Participating in recreational/leisure activities in community settings	1 or more	2 or more	1 or more
B7: Interacting with community members	1 or more	2 or more	1 or more
E1: Taking medications	1 or more	2 or more	1 or more
E2: ((Avoiding health and safety hazards))Ambulating and moving about	1 or more	2 or more	1 or more
((E4: Ambulating and moving about))E3: Avoiding health and safety hazards	1 or more	2 or more	1 or more
G3: Protecting self from exploitation	1 or more	2 or more	1 or more
Total of all questions where criteria is met or exceed =				Sum of scores entered

(3) Or you meet the qualifying scores for the following SIS activities and your total weekly critical support time score exceeds ten hours:

Qualifying Scores from Supports Intensity Scale (per WAC 388-828-4200 through 388-828-4320)
SIS Activity	If your type of support score is:	And your frequency of support score is:	And your daily support time score is:	Your weekly critical support time is:	Enter one time for each qualifying SIS activity
((A2))A7: Taking care of clothes (((includes)), including laundering(()))	1 or more	2 or more	0	0
			1	.25
			2	1
			3	3
			4	5
((B3))B5: Using public services in the community	1 or more	2 or more	0	0
			1	.25
			2	1
			3	3
			4	5
B6: Shopping and purchasing ((foods))goods and services	1 or more	2 or more	0	0
			1	.25
			2	1
			3	3
			4	5
F2: ((Participation))Participating in ((recreational))recreation/leisure activities with others	1 or more	2 or more	0	0
			1	.25
			2	1
			3	3
			4	5
F8: Engaging in volunteer work	1 or more	2 or more	0	0
			1	.25
			2	1
			3	3
			4	5
((G2))G7: Managing money and personal finances	1 or more	2 or more	0	0
			1	.25
			2	1
			3	3
			4	5
Mid-frequency support needs weekly critical support time total =					Sum of times entered

The residential algorithm uses the following chart to calculate your daily critical support time score:

Qualifying Scores from Supports Intensity Scale (per WAC 388-828-4200 through 388-828-4320)
SIS Activity:	If your type of support is:	And your frequency of support score is:	And your daily support time score is:	Then your critical task hours =	Enter one time for each SIS activity
((A1: Using the toilet))A2: Bathing and taking care of personal hygiene and grooming needs	1 or more	0	0 or more	0
		1	0 or more	0
		2	0 or more	0
		3	0	0
			1	.25
			2	1
			3	3
			4	5
		4	0	0
			1	.25
			2	1
			3	3
			4	5
((A4: Eating food))A3: Using the toilet	1 or more	0	0 or more	0
		1	0 or more	0
		2	0 or more	0
		3	0	0
			1	.25
			2	1
			3	3
			4	5
		4	0	0
			1	.25
			2	1
			3	3
			4	5
((A6))A4: Dressing	1 or more	0	0 or more	0
		1	0 or more	0
		2	0 or more	0
		3	0	0
			1	.25
			2	1
			3	3
			4	5
		4	0	0
			1	.25
			2	1
			3	3
			4	5
((A7: Bathing and taking care of personal hygiene and grooming needs))A6: Eating food	1 or more	0	0 or more	0
		1	0 or more	0
		2	0 or more	0
		3	0	0
			1	.25
			2	1
			3	3
			4	5
		4	0	0
			1	.25
			2	1
			3	3
			4	5
A9: Using currently prescribed equipment or treatment	1 or more	0	0 or more	0
		1	0 or more	0
		2	0 or more	0
		3	0	0
			1	.25
			2	1
			3	3
			4	5
		4	0	0
			1	.25
			2	1
			3	3
			4	5
E1: Taking medications	1 or more	0	0 or more	0
		1	0 or more	0
		2	0 or more	0
		3	0	0
			1	.25
			2	1
			3	3
			4	5
		4	0	0
			1	.25
			2	1
			3	3
			4	5
E2: ((Avoiding health and safety hazards))Ambulating and moving about	1 or more	0	0 or more	0
		1	0 or more	0
		2	0 or more	0
		3	0	0
			1	.25
			2	1
			3	3
			4	5
		4	0	0
			1	.25
			2	1
			3	3
			4	5
((E4: Ambulating and moving about))E3: Avoiding health and safety hazards	1 or more	0	0 or more	0
		1	0 or more	0
		2	0 or more	0
		3	0	0
			1	.25
			2	1
			3	3
			4	5
		4	0	0
			1	.25
			2	1
			3	3
			4	5
Daily critical support time score =					Sum of all times entered.

The residential algorithm uses the following chart to calculate your mid-frequency critical support time score:

Qualifying Scores from Supports Intensity Scale (per WAC 388-828-4200 through 388-828-4320)
SIS Activity	If your type of support is:	And your frequency of support score is:	And your daily support time score is:	Then your critical task hours =	Enter one time for each SIS activity
((A1: Using the toilet))A2: Bathing and taking care of personal hygiene and grooming needs*	1 or more	0	0 or more	0
		1	0 or more	0
		2	0	0
			1	.25
			2	1
			3	3
			4	5
		3	0 or more	0
		4	0 or more	0
A3: ((Preparing food))Using the toilet	1 or more	0	0 or more	0
		1	0 or more	0
		2	0	0
			1	.25
			2	1
			3	3
			4	5
		3	0	0
			1	.25
			2	1
			3	3
			4	5
		4	0	0
			1	.25
			2	1
			3	3
			4	5
A4: ((Eating food))Dressing*	1 or more	0	0 or more	0
A4: ((Eating food))Dressing*	1 or more	1	0 or more	0
		2	0	0
			1	.25
			2	1
			3	3
			4	5
		3	0 or more	0
		4	0 or more	0
A5: ((Housekeeping and cleaning))Preparing food	1 or more	0	0 or more	0
A5: ((Housekeeping and cleaning))Preparing food	1 or more	1	0 or more	0
		2	0	0
			1	.25
			2	1
			3	3
			4	5
		3	0	0
			1	.25
			2	1
			3	3
			4	5
		4	0	0
			1	.25
			2	1
			3	3
			4	5
A6: ((Dressing))Eating food*	1 or more	0	0 or more	0
A6: ((Dressing))Eating food*	1 or more	1	0 or more	0
		2	0	0
			1	.25
			2	1
			3	3
			4	5
		3	0 or more	0
		4	0 or more	0
((A7: Bathing and taking care of personal hygiene and grooming needs*))A8: Housekeeping and cleaning	1 or more	0	0 or more	0
		1	0 or more	0
		2	0	0
			1	.25
			2	1
			3	3
			4	5
		3	0 or more	0
		4	0 or more	0
A9: Using currently prescribed equipment or treatment*	1 or more	0	0 or more	0
		1	0 or more	0
		2	0	0
			1	.25
			2	1
			3	3
			4	5
		3	0 or more	0
		4	0 or more	0
B2: Participating in recreation/leisure activities in community ((settings))	1 or more	0	0 or more	0
		1	0 or more	0
		2	0	0
			1	.25
			2	1
			3	3
			4	5
		3	0	0
			1	.25
			2	1
			3	3
			4	5
		4	0	0
			1	.25
			2	1
			3	3
			4	5
B7: Interacting with community members	1 or more	0	0 or more	0
		1	0 or more	0
		2	0	0
			1	.25
			2	1
			3	3
			4	5
		3	0	0
			1	.25
			2	1
			3	3
			4	5
		4	0	0
			1	.25
			2	1
			3	3
			4	5
E1: Taking medications*	1 or more	0	0 or more	0
E1: Taking medications*	1 or more	1	0 or more	0
		2	0	0
			1	.25
			2	1
			3	3
			4	5
		3	0 or more	0
		4	0 or more	0
E2: ((Avoiding health and safety hazards))Ambulating and moving about*	1 or more	0	0 or more	0
		1	0 or more	0
		2	0	0
			1	.25
			2	1
			3	3
			4	5
		3	0 or more	0
		4	0 or more	0
((E4: Ambulating and moving about))E3: Avoiding health and safety hazards*	1 or more	0	0 or more	0
	1 or more	1	0 or more	0
		2	0	0
			1	.25
			2	1
			3	3
			4	5
		3	0 or more	0
		4	0 or more	0
G3: Protecting self from exploitation	1 or more	0	0 or more	0
		1	0 or more	0
		2	0	0
			1	.25
			2	1
			3	3
			4	5
		3	0	0
			1	.25
			2	1
			3	3
			4	5
		4	0	0
			1	.25
			2	1
			3	3
			4	5
	Mid-frequency critical support time score =				Sum of all times entered
	*Daily support activities that have less than daily support needs are added into the mid-frequency critical support time score.

The residential algorithm uses the following chart to calculate your weekly critical support time score:

Qualifying Scores from Supports Intensity Scale (per WAC 388-828-4200 through 388-828-4320)
SIS Activity	If your type of support is:	And your frequency of support score is:	And your daily support time score is:	Then your critical task hours =	Enter one time for each SIS activity
((A2))A7: Taking care of clothes (including laundering)	1 or more	0	0 or more	0
		1	0 or more	0
		2	0	0
			1	.25
			2	1
			3	3
			4	5
		3	0	0
			1	.25
			2	1
			3	3
			4	5
		4	0	0
			1	.25
			2	1
			3	3
			4	5
((B3))B5: Using public services in the community	1 or more	0	0 or more	0
		1	0 or more	0
		2	0	0
			1	.25
			2	1
			3	3
			4	5
		3	0	0
			1	.25
			2	1
			3	3
			4	5
		4	0	0
			1	.25
			2	1
			3	3
			4	5
B6: Shopping and purchasing goods and services	1 or more	0	0 or more	0
		1	0 or more	0
		2	0	0
			1	.25
			2	1
			3	3
			4	5
		3	0	0
			1	.25
			2	1
			3	3
			4	5
		4	0	0
			1	.25
			2	1
			3	3
			4	5
F2: Participating in recreation ((and/or))/leisure activities with others	1 or more	0	0 or more	0
		1	0 or more	0
		2	0	0
			1	.25
			2	1
			3	3
			4	5
		3	0	0
			1	.25
			2	1
			3	3
			4	5
		4	0	0
			1	.25
			2	1
			3	3
			4	5
F8: Engaging in volunteer work	1 or more	0	0 or more	0
		1	0 or more	0
		2	0	0
			1	.25
			2	1
			3	3
			4	5
		3	0	0
			1	.25
			2	1
			3	3
			4	5
		4	0	0
			1	.25
			2	1
			3	3
			4	5
((G2))G7: Managing money and personal finances	1 or more	0	0 or more	0
		1	0 or more	0
		2	0	0
			1	.25
			2	1
			3	3
			4	5
		3	0	0
			1	.25
			2	1
			3	3
			4	5
		4	0	0
			1	.25
			2	1
			3	3
			4	5
	Weekly critical support time score =				Sum of all times entered

If you score for "Frequency of Support" is:	And your score for "Type of Support" is:	Then your Mobility Acuity Level is:	Value
3 or 4	4	High	3
3 or 4	3	Medium	2
If your raw score for question ((E4 or))E2 is 5 or more and you do not meet the criteria for a high or medium mobility acuity level		Low	1
If your raw score for question ((E4))E2 is 4 or less		None	0

Interpersonal support needs questions from the SIS assessment
Question #	Text of interpersonal support needs questions:
B7	Interacting with community members
((C1))C8	Interacting with others in learning activities
D3	Interacting with co-workers
D4	Interacting with supervisors/coaches
D8	Seeking information and assistance from an employer
F1	((Socializing within the household))Using appropriate social skills
F3	Socializing outside the household
((F5))F6	((Communicating with others about personal needs))Socializing within the household
((F6))F7	((Using appropriate social skills))Communicating with others about personal needs