This chapter establishes rules governing the ((administration of the division of)) developmental disabilities (((DDD)))administration (DDA) assessment ((to persons))of people determined eligible to be clients of the ((division))administration per chapter 71A.16 RCW.

The following definitions apply to this chapter:

"AAIDD" means the American Association on Intellectual and Developmental Disabilities.

"Acuity Scale" refers to an assessment tool that is intended to provide a framework for documenting important assessment elements and for standardizing the key questions that should be asked as part of a professional assessment. The design helps provide consistency from client to client by minimizing subjective bias and assists in promoting objective assessment of a person's support needs.

"Administration" ((or "DDA")) means the developmental disabilities administration of the department of social and health services.

"Adult family home" or "AFH" means a residential home in which a person or persons provide personal care, special care, room and board to more than one but not more than six adults who are not related by blood or marriage to the person or persons providing the services per chapter 388-76 WAC.

"Agency provider" means a business that is licensed, certified, or both, and that is contracted with the department or a county to provide DDA services ((such as personal care, respite care, residential services, therapy, nursing, and employment)).

"Algorithm" means a numerical formula used by the DDA assessment for one or more of the following:

(1) Calculation of assessed information to identify a client's relative level of need; and

(2) ((Determination regarding which assessment modules a client receives as part of his or her DDA assessment; and

(3))) Assignment of a service level to support a client's assessed need.

"Authorization" means DDA approval of funding for a service as identified in the ((individual support))person-centered service plan or evidence of payment for a service.

"CARE" refers to the comprehensive assessment reporting evaluation assessment per chapter 388-106 WAC.

"Client" means a person who:

(1) Has a developmental disability as defined in RCW 71A.10.020(3) who also has been determined eligible to receive services by the administration under chapter 71A.16 RCW; or

(2) Is under age eighteen and is eligible to receive medicaid personal care or community first choice services under chapter 388-106 WAC.

"Collateral contact" means a person or agency that is involved in the client's life such as legal guardian, family member, care provider, or friend.

"Companion home" is a DDA contracted residential service that provides twenty-four hour training, support, and supervision, to one adult living with a paid provider.

"Contracted provider" means an individual provider contracted with the department, individual provider employed by the consumer directed employer, or an individual or agency who is one or more of the following: Licensed, certified, or contracted by the department to provide services to DDA clients.

"DDA" means the developmental disabilities administration of the department of social and health services.

"Department" means the department of social and health services (DSHS).

"Group home" or "GH" means a licensed adult family home or assisted living facility contracted and certified to provide residential services and support to adults with developmental disabilities.

"ICF/IID" means a facility certified as an intermediate care facility for individuals with intellectual disabilities to provide habilitation services to DDA clients.

"ICF/IID level of care" is a standardized assessment of a client's need for ICF/IID level of care per 42 C.F.R. Sec. 440 and 42 C.F.R. Sec. 483. In addition, ICF/IID level of care refers to one of the standards used by DDA to determine whether a client meets minimum eligibility criteria for one of the DDA HCBS waivers or the community first choice program.

"Legal guardian" means a person/agency, appointed by a court, who is authorized to make some or all decisions for a person determined by the court to be incapacitated. In the absence of court intervention, parents remain the legal guardians for their child until the child reaches the age of eighteen.

"LOC score" means a level of care score for answers to questions in the support needs assessment for children that are used in determining if a client meets eligibility requirements for ICF/IID level of care.

(("Modules" refers to three sections of the DDA assessment. They are: The support assessment, the service level assessment, and the person-centered service plan/individual support plan (ISP).))

"Panel" refers to the visual user-interface in the DDA assessment computer application where assessment questions are typically organized by topic and you and your respondents' answers are recorded.

"Person-centered service plan((/individual support plan))(PCSP)" ((or "ISP")) is a document that identifies your goals and assessed health and welfare needs. Your person-centered service plan((/individual support plan)) also indicates the paid services and natural supports that will assist you to achieve your goals and address your ((addressed))assessed needs.

(("Plan of care" or "POC" refers to the paper-based assessment and service plan for clients receiving services on one of the DDA HCBS waivers prior to June 1, 2007.))

"Raw score" means the numerical value when adding a person's "frequency of support," "daily support time," and "type of support" scores for each activity in the support needs and supplemental protection and advocacy scales of the supports intensity scale (SIS) assessment.

"Residential habilitation center" or "RHC" is a state-operated facility certified to provide ICF/IID ((and/or))or nursing facility level of care for persons with developmental disabilities per chapter 71A.20 RCW.

"Respondent" means the adult client ((and/or))or another person familiar with the client who participates in the client's DDA assessment by answering questions and providing information. Respondents may include DDA contracted providers.

"SIS" means the supports intensity scale developed by the American Association of Intellectual and Developmental Disabilities (AAIDD). ((The SIS is in the support assessment module of the DDA assessment.))

"Service provider" refers to a department contracted agency or person who provides services to DDA clients. Also refers to state operated living alternative programs (SOLA).

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

"State supplementary payment" or "SSP" is the state paid cash assistance program for certain DDA eligible Social Security income clients per chapter 388-827 WAC.

"Supported living" or "SL" refers to residential services provided by DDA certified residential agencies to clients living in homes that are owned, rented, or leased by the clients or their legal representatives.

(("Waiver personal care" means physical or verbal assistance with activities of daily living (ADL) and instrumental activities of daily living (IADL) due to your functional limitations per chapter 388-106 WAC to individuals who are authorized to receive services available in the basic plus waiver per chapter 388-845 WAC.))

"Waiver respite care" means short-term intermittent relief for persons normally providing care to individuals who are authorized to receive services available in the individual and family services (IFS), children's intensive in-home behavioral support (CIIBS), basic plus, and core waivers per chapter 388-845 WAC.

"You((/Your))" and "your" means the client.

(1) The ((DDD))DDA assessment is an assessment tool designed to measure the support needs of persons with developmental disabilities.

(2) The ((DDD))DDA assessment ((has three modules))consists of:

(a) The support assessment (see WAC 388-828-2000 to 388-828-6020);

(b) The service level assessment (see WAC 388-828-7000 to 388-828-7080); and

(c) The ((individual support plan (ISP)))person-centered service plan (PCSP) (see WAC 388-828-8000 to 388-828-8060).

(3) The ((DDD))DDA assessment is part of the ((aging and disability services administration's (ADSA))) comprehensive assessment reporting evaluation system (CARE).

The purpose of the DDA assessment is to provide a comprehensive assessment process that:

(1) Collects a common set of assessment information for reporting purposes to the legislature and the department.

(2) Promotes consistency in evaluating client support needs for purposes of planning, budgeting, and resource management.

(3) Identifies a level of service ((and/or))or number of hours that is used to support the assessed needs of clients who have been authorized ((by DDA)) to receive ((one or more of the following:

(4) Records your service requests))DDA services.

Only ((DDD))DDA employees can administer the ((DDD))DDA assessment.

((DDD))DDA must administer a ((DDD))DDA assessment when you meet any of the following conditions:

(1) You are currently approved by ((DDD))DDA to receive a ((DDD))DDA paid service evidenced by meeting one of the conditions in WAC 388-828-1440;

(2) You request enrollment in one of the ((DDD))DDA HCBS waivers per chapter 388-845 WAC;

(3) You ((are age three or older))have been determined to be DDA eligible and request a ((DDD))DDA assessment;

(4) You have been determined eligible for categorically needy medical coverage per WAC 388-475-0100 and requested one of the following medicaid state plan services:

(a) You are under age eighteen and have requested an assessment for community first choice or medicaid personal care services ((per))under chapter 388-106 WAC; or

(b) You have been approved to receive private duty nursing services for clients seventeen years of age and younger per WAC 388-551-3000.

(5) You are receiving SSP in lieu of a ((DDD))DDA paid service per chapter 388-827 WAC;

(6) You request admission to ((a))an RHC per Title 42 C.F.R. 440, Title 42 C.F.R. 483, and Title 71A RCW;

(7) You reside in ((a))an RHC or community ((ICF/MR))ICF/IID and you are involved in discharge planning for community placement; or

(8) You do not meet any of the conditions listed in WAC 388-828-1120.

((DDD))DDA will not administer the ((DDD))DDA assessment when you meet any of the following conditions:

(1) You have not identified a person willing to receive notice or correspondence on your behalf regarding specific ((DDD))DDA decisions as required per RCW 71A.10.060 and ((DDD))DDA does not believe you are capable of understanding department decisions that may affect your care (see WAC 388-828-1140); ((or))

(2) A respondent cannot be identified to participate in your ((DDD))DDA assessment (see WAC 388-828-1540(c));

(3) You reside in ((a))an RHC and are not currently involved in discharge planning for community placement; or

(4) You reside in a community ((ICF/MR))ICF/IID and are not authorized by ((DDD))DDA to receive employment/community services paid through the counties((; or

(5) You are under the age of three and do not meet any of the conditions in WAC 388-828-1100)).

If there is no one available to receive notice or correspondence on your behalf regarding specific ((DDD))DDA decisions, ((DDD))DDA will do all of the following:

(1) Consult with the assistant attorney general to determine if:

(a) You are able to represent yourself; or

(b) You require a legal representative/guardian.

(2) Continue current services until the issue is resolved per section (1) above.

If you complete the ((DDD))DDA assessment and are assessed to have an unmet need and there is no approved funding to support that need, ((DDD))DDA will offer you referral information for ((ICF/MR))ICF/IID services per Title 71A RCW, chapter 388-825 WAC, and chapter 388-837 WAC. In addition, ((DDD))DDA may:

(1) Provide information and referral for ((non-DDD))non-DDA community based supports; and

(2) Add your name to the waiver database, if you have requested enrollment in a ((DDD))DDA HCBS waiver per chapter 388-845 WAC((; and

(3) Authorize short-term emergency services as an exception to rule (ETR) per WAC 388-440-0001)).

If you are approved to receive a ((DDD))DDA paid service and refuse to have a ((DDD))DDA assessment administered, ((DDD))DDA is unable to authorize new or current ((DDD))DDA paid services and will do all of the following:

(1) Explain what happens if you refuse to allow ((DDD))DDA to administer the ((DDD))DDA assessment to you, your respondents, and the person you have identified to receive notice on your behalf per RCW 71A.10.060.

(2) Consult with the assistant attorney general when you have not identified a person to receive notice on your behalf per RCW 71A.10.060 to determine if:

(a) You are able to represent yourself; or

(b) You require a legal representative/guardian.

(3) Terminate existing ((DDD))DDA paid services when they reach their authorized end date.

(4) Provide you notice and appeal rights for a denied ((and/or))or terminated ((service(s) per))service under WAC 388-825-100 and 388-825-120.

(5) Provide you with information on how to contact ((DDD))DDA in case you later decide you want a ((DDD))DDA assessment administered.

(((1) DDD))DDA will ((complete your DDD assessment as soon as possible after it is administered.

(2) DDD will complete your DDD assessment no later))inform you of the services you are eligible to receive no more than thirty days ((from the date it was created in CARE))after DDA administers your assessment.

You will begin receiving a service for which you have been determined eligible after:

(1) Your DDA assessment is complete;

(2) You are found financially and functionally eligible for services;

(3) You have given consent for services and approved your plan of care;

(4) You have chosen a qualified provider; and

(5) DDA has authorized the qualified provider to provide services.

You or your legal representative/guardian has the responsibility of choosing ((an agency))a provider. ((DDD or the county))DDA will provide you information on contracted and qualified ((agency)) providers. If you are receiving services through a county, the county will provide you with information on contracted providers.

For the purpose of this chapter, a ((DDD))DDA paid service is defined as an authorization of a program and/or service as evidenced by one or more of the following:

(1) An open ((social service payment system (SSPS)))ProviderOne authorization within the past ninety days used for payment of a service or SSP; ((or))

(2) A current county service authorization ((for one of the following services:

(e) Community access)); ((or

(f) Individual and family assistance.))

(3) ((A current waiver POC or waiver ISP; or

(6))) Documentation of ((DDD))DDA approval of your absence from ((DDD))DDA paid services for more than ninety days with available funding for your planned return to services; ((or

(7)))(4) Evidence of approval for funding of a ((DDD))DDA service or enrollment in a ((DDD))DDA HCBS waiver; or

(((8)))(5) Authorization and payment of services using form A-19 state of Washington invoice voucher ((for receipt of:

(d) Diversion bed services)).

((DDD intends to assess all clients per WAC 388-828-1100 by June 30, 2008. DDD))DDA must administer ((an initial DDD))a DDA assessment when:

(1) You are receiving a ((DDD))DDA paid service and your annual reassessment is due for continuation of the ((DDD))DDA paid service; ((or))

(2) You are receiving a ((DDD))DDA paid service and a reassessment is needed due to a significant change that may affect your support needs; ((or))

(3) You are receiving SSP in lieu of a ((DDD))DDA paid service and your eligibility for SSP needs to be redetermined per WAC 388-827-0120;

(4) You are approved for funding of a ((DDD))DDA paid service and an assessment must be performed prior to the authorization of services; ((or))

(5) You make a request to have a ((DDD))DDA assessment administered and meet the criteria in WAC 388-828-1100; or

(6) You are contacted by ((DDD))DDA and offered an opportunity to have a ((DDD))DDA assessment.

(1) DDA must conduct a reassessment:

(a) On an annual basis if you are receiving a paid service ((or SSP));

(b) When a significant change is reported that may affect your need for support; ((or))

(c) Before the next ((ISP))person-centered service plan date of your current assessment; or

(d) At your request.

(2) DDA will provide you with notice in advance of your next ((ISP))person-centered service plan date so you may schedule the assessment at a time that is convenient to you.

(1) You choose the people who participate in your assessment and person-centered service plan((/individual support plan)) meeting.

(2) DDA requires that at a minimum: You, one of your respondents, and a DDA employee participate in your DDA assessment interview. In addition:

(a) If you are under the age of eighteen, your parent(s) or legal guardian(s) must participate in your DDA assessment interview.

(b) If you are age eighteen or older, your court appointed legal representative/guardian must be consulted if he/she does not attend your DDA assessment interview.

(c) If you are age eighteen and older and have no legal representative/guardian, DDA will assist you to identify a respondent.

(d) DDA may consult with other people who were not present at your DDA assessment interview, if needed, to obtain complete and accurate information.

((DDD))DDA requires ((that all questions on mandatory panels be answered))an assessment because:

(1) ((The legislature has directed DDD to assess all eligible))DDA assesses clients with a common, standardized assessment process that measures the support needs of individuals with developmental disabilities.

(2) The ((DDD))DDA assessment algorithms ((in the support assessment module)) are designed to:

(a) Determine acuity scores and acuity levels for a variety client needs; and

(b) Provide a valid measure of each client's support needs relative to the support needs of other clients who have received the ((DDD))DDA assessment.

If you refuse to answer a DDA assessment question ((on a mandatory panel in the DDD assessment, DDD))that is necessary to determine your service level and DDA is unable to complete your ((DDD))DDA assessment ((and will do all of the following:

(5) Provide you with information on how to contact DDD in case you later decide you want a DDD assessment administered)), DDA will send you or your legal representative notice as required under chapter 388-825 WAC.

The support assessment ((module)) is the ((first section of the DDD assessment and is administered to all DDD clients)):

(2) Support assessment for children under sixteen.

The purpose of the support assessment ((module)) is to:

(1) Collect a common set of assessment information that is scored for all persons who are eligible to receive a ((DDD))DDA assessment per WAC 388-828-1100;

(2) Promote a consistent process to evaluate client support needs; and

(3) Determine whether a person meets the ((ICF/MR))ICF/IID level of care standard for potential waiver eligibility((; and

(b) The individual support plan module)).

The support assessment ((module)) contains the following components:

(1) The support assessment for children;

(2) The supports intensity scale (SIS) assessment;

(3) ((DDD))DDA protective supervision acuity scale;

(4) ((DDD))DDA caregiver status acuity scale;

(5) ((DDD))DDA activities of daily living (ADL) acuity scale;

(6) ((DDD))DDA behavioral acuity scale;

(7) ((DDD))DDA medical acuity scale;

(8) ((DDD))DDA interpersonal support acuity scale;

(9) ((DDD))DDA mobility acuity scale;

(10) ((DDD))DDA respite assessment; and

(11) Programs and services component.

Age guidelines are incorporated into the support assessment ((module)) to exclude age appropriate supports unrelated to a disability. The following table illustrates which components ((DDD))DDA includes in your support assessment ((module)) based on your assessment age:

If you are within thirty calendar days of your next birthday, ((DDD))DDA determines your assessment age to be that of your next birthday.

The purpose of the support assessment for children ages fifteen or younger is to determine:

(1) Your ((ICF/MR))ICF/IID level of care score for ((DDD))DDA HCBS waiver eligibility;

(2) The health and welfare needs that must be addressed in your individual support plan if you are enrolled in a ((DDD))DDA HCBS waiver; and

(3) Your support need levels for:

(a) The ((DDD))DDA activities of daily living acuity scale;

(b) The ((DDD))DDA interpersonal support acuity scale; and

(c) The ((DDD))DDA mobility acuity scale.

((DDD))DDA scores the answers to each of the following questions in the support assessment for children based on the respondent information:

(1) Dress and groom self: What support does the child need to dress and groom self as expected of others of same age?

(2) Toilet self: What support does the child need to toilet self as expected of others in his/her age group?

(3) Eat at age level: What support does the child need to eat at age level?

(4) Move around: What support does the child need to move around in the same ways as other children of same age?

(5) Communicate: What support does the child need to communicate as others of same age?

(6) Learn about and use money: What support does the child need to learn about and use money?

(7) Make choices and take responsibility: What support does the child need to make choices and take responsibility?

(8) Explore environment: What support does the child need to explore environment?

(9) Meet therapy health needs: What supports are necessary to get child's therapy health needs met?

(10) Help family continue to meet child's needs: What support services should the system provide to help family continue to meet child's needs?

(11) Have relationships with family members: What support does the child need to make the kind of relationships with family members expected of nondisabled children of the same age?

(12) Explore and use typical community resources: What support does the child need to explore and use typical community resources such as stores, parks, and playgrounds?

(13) Play with others: What supports are needed for the child to develop age-level skills in playing with others?

(14) Have opportunities to play with typically developing children: What supports does the child need to have opportunities to play with typically developing children?

(15) Identify and respond safely to emergencies: What support does the child need to identify and respond safely to emergencies?

(16) Practice age-level safety measures: What support does the child need to practice age-level safety measures?

(17) Effectively relate to other students/peers: What support does the child need to most effectively relate to fellow students and/or peers?

(18) Have behaviors which promote being included: What support is needed for this child to have behaviors which promote being included?

((DDD))DDA determines your total LOC score for ((ICF/MR))ICF/IID level of care by adding all of your LOC scores on questions one through eighteen in the support assessment for children.

((DDD))DDA determines you are eligible for ((ICF/MR))ICF/IID level of care when:

(1) You are age birth through five years old and the total of your LOC scores is five or more; or

(2) You are age six through fifteen years old and the total of your LOC scores is seven or more.

The purpose of the supports intensity scale assessment in the ((DDD))DDA assessment is to determine all of the following:

(1) Your ((ICF/MR))ICF/IID level of care score for ((DDD))DDA HCBS waiver eligibility;

(2) The health and welfare needs that must be addressed in your individual support plan if you are enrolled in a ((DDD))DDA HCBS waiver;

(3) Your ((DDD))DDA behavioral and medical acuity levels regardless of your age; and

(4) Your support need acuity levels specific to the:

(a) ((DDD))DDA activities of daily living acuity scale;

(b) ((DDD))DDA interpersonal support acuity scale; and

(c) ((DDD))DDA mobility acuity scale.

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

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

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

(3) You have a percentile rank 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);

(c) Prevention of self-injury;

(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:

The purpose of the programs and services component is to document:

(1) ((DDD))DDA services you are currently receiving;

(2) ((DDD))DDA services you have been approved to receive; and

(3) ((If))Whether you currently meet the ((ICF/MR))ICF/IID level of care requirements for ((continued DDD))CFC or for DDA HCBS waiver eligibility ((or for potential DDD HCBS waiver services if resources become available)).

The purpose of the service level assessment ((module)) is to determine a service level and the number of hours you are eligible to receive for medicaid ((or waiver)) personal care services ((per))or community first choice under chapter 388-106 WAC.

The service level assessment ((module)) contains two components that are used to determine a service level ((and/or))or number of hours for the following:

(1) The CARE assessment for medicaid ((or waiver)) personal care services((,))or community first choice as defined in chapter 388-106 WAC; and

(2) The ((DDD))DDA seizure acuity scale as defined in WAC 388-828-7040 through 388-828-7080.

The purpose of the person-centered service plan((/individual support plan module)) is to create a written plan that includes:

(1) Your goals and desired outcomes;

(2) The services and supports, both paid and unpaid, that will assist you to achieve your identified goals;

(3) Your acuity scores generated from the support assessment;

(4) Referral information;

(5) The SSP, if any, you are approved to receive in lieu of a DDA paid service; ((and))

(6) DDA paid services you are authorized to receive((:)); and

(((a)))(7) If you are enrolled in a DDA waiver, ((the ISP must address all the))your PCSP must address all of your assessed health and welfare needs ((identified in your ICF/IID level of care assessment and the supports used to meet your assessed needs; or

(b) If you are not enrolled in a DDA waiver, DDA is only required to address the DDA paid services you are approved to receive)).

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

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

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

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

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

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

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

The children's intensive in-home behavioral support (CIIBS) program algorithm is a formula in the ((DDD))DDA assessment that calculates your out-of-home placement risk score to determine your eligibility for the CIIBS waiver per chapter 388-845 WAC.

The ((DDD))DDA assessment runs the CIIBS algorithm to determine your eligibility for the CIIBS waiver when your support assessment is moved to current and:

(1) You are the assessed age of eight or older and under age eighteen;

(2) Your behavior acuity level is high per WAC 388-828-5640;

(3) Your caregiver's risk score is medium, high or immediate per WAC 388-828-5300; and

(4) Your ((ICF/MR))ICF/IID score is eligible per WAC 388-828-4400((; and

(5) You are not enrolled in the CIIBS waiver)).

The CIIBS algorithm uses the following elements to determine your out-of-home placement risk score:

(1) The ((DDD))DDA protective supervision acuity scale (WAC 388-828-5000 to 388-828-5100);

(2) The ((DDD))DDA caregiver status acuity scale (WAC 388-828-5120 to 388-828-5360);

(3) The ((DDD))DDA behavioral acuity scale (WAC 388-828-5500 to 388-828-5640);

(4) The ((DDD))DDA activities of daily living (ADL) acuity scale (WAC 388-828-5380 to 388-828-5480);

(5) The ((DDD))DDA mobility acuity scale (WAC 388-828-5380 to 388-828-5480); and

(6) Eligible condition of "autism" as indicated in the ((DDD))DDA determination (WAC 388-823-0500).

Your CIIBS out-of-home placement risk score is calculated using the following table:

((DDD))DDA uses the following table to determine if you are eligible for the CIIBS waiver based on your CIIBS out-of-home placement risk score per WAC 388-828-8510:

The individual and family services assessment is an algorithm in the ((DDD))DDA assessment that determines an award amount that you may receive if ((DDD))DDA has authorized you to receive individual and family services per chapter 388-832 WAC.

The purpose of the individual and family services assessment is to determine your individual and family services level and score using your assessed support levels from:

(1) The ((DDD))DDA protective supervision acuity scale (See WAC 388-828-5000 to 388-828-5100);

(2) The ((DDD))DDA caregiver status acuity scale (See WAC 388-828-5120 to 388-828-5360);

(3) The ((DDD))DDA behavioral acuity scale; (See WAC 388-828-5500 to 388-828-5640);

(4) The ((DDD))DDA medical acuity scale; (See WAC 388-828-5660 to 388-828-5700); and

(5) The ((DDD))DDA activities of daily living (ADL) acuity scale (See WAC 388-828-5380 to 388-828-5480).

(1) ((DDD))DDA determines your individual and family services level using the following table:

(2) ((DDD))DDA adds one level to your individual and family services level when your individual and family services level is determined to be:

(a) Level one, two, three, or four; and

(b) You have a score of four for question two "Other caregiving for persons who are disabled, seriously ill, or under five" in the ((DDD))DDA caregiver status acuity scale. See WAC 388-828-5260.

Your individual and family services support rating is determined by using the following table:

((DDD))DDA determines the amount of the adjustment for your individual and family services support rating using the following table:

Example: If your individual and family service level is 3 and your ADL support needs level is "low" and your medical acuity level is "medium," the amount of your adjustment is 88.

((DDD))DDA adds your individual and family services support rating from WAC 388-828-9060 to the adjustment amount in WAC 388-828-9100 to determine your individual and family services score.

Example: If your individual and family services support rating is 336 and the amount of your adjustment is 122, your individual and family services score is 458.

((DDD))DDA uses the following table to determine the amount of your individual and family services award:

The ((DDD))DDA employment acuity scale is an algorithm that determines your employment acuity score and employment support level.

((DDD))DDA determines your employment support level using the following table:

((DDD))DDA 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:

((DDD))DDA determines your employment acuity score for activities of daily living by multiplying your ADL support needs level score by 0.06869.

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.

((DDD))DDA determines your employment acuity scale score for behavioral support by multiplying your behavioral acuity level score (see WAC 388-828-5640) by 0.04186.

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.

((DDD))DDA 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.

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.

((DDD))DDA determines your employment acuity scale score for environmental support by multiplying your environmental support level by 0.06798.

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.

((DDD))DDA determines your environmental support score by adding the sum of your assessment responses to employment support limitations in the following table:

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.

((DDD))DDA 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.

((DDD))DDA determines your employment acuity score for employment support by multiplying your DDD ((employment))DDA support score in WAC 388-828-9250 by 0.21781.

Example: A ((DDD))DDA employment support score of 2 is multiplied by 0.21781 resulting in an employment acuity scale score for employment support of 0.43562.

((DDD))DDA determines your ((DDD))DDA employment support score using the following table:

((DDD))DDA 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.

((DDD))DDA 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.

((DDD))DDA 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.

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.

((DDD))DDA 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.

((DDD))DDA determines your seizure support score using the following table:

((DDD))DDA multiplies your seizure support score by a negative factor because the ((DDD))DDA 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.

((DDD))DDA determines the number of hours you may receive for employment services using information from the following:

(1) Your employment support level determined as described in WAC 388-828-9205;

(2) Your employment status determined as described in WAC 388-828-9330;

(3) Your employment service level and employment service hours determined as described in WAC 388-828-9335;

(4) Your employment service type;

(5) You meet one of the conditions identified as described in WAC 388-828-9345 and require add-on hours identified in WAC 388-828-9350.

((DDD))DDA uses the following table to determine the maximum number of add-on hours you are eligible to receive.

The residential algorithm is a formula in the ((DDD))DDA assessment that determines the level of residential services and supports you may expect to receive based on your assessed support needs.

The residential algorithm obtains your support needs information from the following components of your current ((DDD))DDA assessment:

(1) The supports intensity scale assessment (SIS) per WAC 388-828-4000 through 388-828-4320;

(2) The ((DDD))DDA protective supervision acuity scale per WAC 388-828-5000 through 388-828-5100;

(3) The ((DDD))DDA behavioral acuity scale per WAC 388-828-5500 through 388-828-5640;

(4) The ((DDD))DDA medical acuity scale per WAC 388-828-5660 through 388-828-5700;

(5) The program and services panel per WAC 388-828-6020;

(6) The ((DDD))DDA seizure acuity scale per WAC 388-828-7040 through 388-828-7080; and

(7) The ((DDD))DDA sleep panel per WAC 388-828-9640.

The residential algorithm uses the support needs information from your current ((DDD))DDA assessment to identify the following residential support needs scores:

(1) Community protection program enrollment as defined in WAC 388-828-9590;

(2) Daily support needs score as defined in WAC 388-828-9560;

(3) Mid-frequency support needs score as defined in WAC 388-828-9580;

(4) Behavior support needs score as defined in WAC 388-828-9590;

(5) Medical support needs score as defined in WAC 388-828-9600;

(6) Seizure support needs score as defined in WAC 388-828-9610;

(7) Protective supervision support needs score as defined in WAC 388-828-9620;

(8) Ability to seek help score as defined in WAC 388-828-9630;

(9) Nighttime support needs score as defined in WAC 388-828-9640;

(10) Toileting support needs score as defined in WAC 388-828-9650; and

(11) Total critical support time as defined in WAC 388-828-9660 through 388-828-9690.

((DDD))DDA uses the following residential service levels of support which correspond with your assessed support needs (see WAC 388-828-9530):

The residential algorithm determines that you are enrolled in the community protection program if your current ((DDD))DDA assessment (see WAC 388-828-6020) shows that you are:

(1) On the community protection waiver; or

(2) Considered for the community protection waiver.

((DDD))DDA defines mid-frequency support as support for selected SIS activities that most people perform every two to four days.

The residential algorithm scores the answers to each of the five following questions from the ((DDD))DDA sleep panel in the service level assessment to determine your nighttime support needs:

(1)

(2)

(3)

(4)

(5)