WSR 21-19-093
PERMANENT RULES
DEPARTMENT OF
SOCIAL AND HEALTH SERVICES
[Filed September 17, 2021, 8:01 a.m., effective October 18, 2021]
Effective Date of Rule: Thirty-one days after filing.
Purpose: The developmental disabilities administration (DDA) amended this chapter to update the DDA assessment rules to reflect the switch from a desktop application to a web-based application. These changes do not affect any algorithms in the assessment that determine eligibility for a service or a client's benefit level.
DDA also amended the definition of "contracted provider" to include CDE-employed individual providers. Additional amendments replace outdated terminology, such as "DDD," "ISP," "ADSA," "ICF/MR," "SSPS," etc., and update and clarify language that was inaccurate or ambiguous.
Citation of Rules Affected by this Order: New WAC 388-828-1345; repealing WAC 388-828-1160, 388-828-1200, 388-828-1220, 388-828-1300, 388-828-1360, 388-828-1380, 388-828-1400, 388-828-1560, 388-828-1620, 388-828-1640 and 388-828-8020; and amending WAC 388-828-1000, 388-828-1020, 388-828-1040, 388-828-1060, 388-828-1080, 388-828-1100, 388-828-1120, 388-828-1140, 388-828-1180, 388-828-1320, 388-828-1340, 388-828-1420, 388-828-1440, 388-828-1460, 388-828-1500, 388-828-1540, 388-828-1580, 388-828-1600, 388-828-2000, 388-828-2020, 388-828-2040, 388-828-2060, 388-828-2080, 388-828-3020, 388-828-3040, 388-828-3060, 388-828-3080, 388-828-4020, 388-828-4400, 388-828-6020, 388-828-7000, 388-828-7020, 388-828-8000, 388-828-8040, 388-828-8060, 388-828-8500, 388-828-8505, 388-828-8510, 388-828-8515, 388-828-8520, 388-828-9000, 388-828-9020, 388-828-9040, 388-828-9060, 388-828-9100, 388-828-9120, 388-828-9140, 388-828-9200, 388-828-9205, 388-828-9210, 388-828-9215, 388-828-9220, 388-828-9225, 388-828-9230, 388-828-9235, 388-828-9240, 388-828-9245, 388-828-9250, 388-828-9255, 388-828-9260, 388-828-9265, 388-828-9270, 388-828-9275, 388-828-9280, 388-828-9325, 388-828-9355, 388-828-9500, 388-828-9520, 388-828-9530, 388-828-9540, 388-828-9550, 388-828-9570, and 388-828-9640.
Adopted under notice filed as WSR 21-12-048 on May 26, 2021.
Changes Other than Editing from Proposed to Adopted Version: DDA will not adopt the proposed changes to the definition of "client." The definition that is currently enacted will remain without amendment.
DDA added "of denial or termination of eligibility for services" to WAC 388-828-1600 to clarify the types of notices DDA sends.
A final cost-benefit analysis is available by contacting Chantelle Diaz, P.O Box 45310, Olympia, WA 98504-5310, fax 360-407-0955, TTY 1-800-833-6388, email Chantelle.Diaz@dshs.wa.gov.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 1, 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 the 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 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 1, Amended 73, Repealed 11.
Date Adopted: September 17, 2021.
Donald L. Clintsman
Acting Secretary
SHS-4866.4
AMENDATORY SECTION(Amending WSR 07-10-029, filed 4/23/07, effective 6/1/07)
WAC 388-828-1000What is the purpose and scope of this chapter?
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.
AMENDATORY SECTION(Amending WSR 16-17-009, filed 8/4/16, effective 9/4/16)
WAC 388-828-1020What definitions apply to this chapter?
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 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.
"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.
AMENDATORY SECTION(Amending WSR 07-10-029, filed 4/23/07, effective 6/1/07)
WAC 388-828-1040What is the ((DDD))DDA assessment?
(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).
AMENDATORY SECTION(Amending WSR 16-17-009, filed 8/4/16, effective 9/4/16)
WAC 388-828-1060What is the purpose of the DDA assessment?
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:
(a) Medicaid personal care services or community first choice services per chapter 388-106 WAC;
(b) Waiver respite care services per chapter 388-845 WAC;
(c) Services in the voluntary placement program (VPP) per chapter 388-826 WAC;
(d) Supported living residential services per chapter 388-101 WAC;
(e) Group home residential services per chapter 388-101 WAC;
(f) Group training home residential services per chapter 388-101 WAC;
(g) Companion home residential services per chapter 388-829C WAC;
(h) Individual and family services per chapter 388-832 WAC;
(i) Individual and family services waiver per chapter 388-845 WAC;
(j) State supplementary program per chapter 388-827 WAC.
(4) Records your service requests))DDA services.
AMENDATORY SECTION(Amending WSR 07-10-029, filed 4/23/07, effective 6/1/07)
WAC 388-828-1080Who must administer the ((DDD))DDA assessment?
Only ((DDD))DDA employees can administer the ((DDD))DDA assessment.
AMENDATORY SECTION(Amending WSR 07-10-029, filed 4/23/07, effective 6/1/07)
WAC 388-828-1100Who receives 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.
AMENDATORY SECTION(Amending WSR 07-10-029, filed 4/23/07, effective 6/1/07)
WAC 388-828-1120Who does not receive the ((DDD))DDA assessment?
((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)).
AMENDATORY SECTION(Amending WSR 07-10-029, filed 4/23/07, effective 6/1/07)
WAC 388-828-1140What will ((DDD))DDA do if there is no one willing to receive notice on your behalf regarding specific ((DDD))DDA decisions?
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.
AMENDATORY SECTION(Amending WSR 07-10-029, filed 4/23/07, effective 6/1/07)
WAC 388-828-1180How will your assessed unmet need(s) be met if there is no approved funding to provide a ((DDD))DDA paid service?
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)).
AMENDATORY SECTION(Amending WSR 07-10-029, filed 4/23/07, effective 6/1/07)
WAC 388-828-1320What happens if you are approved to receive a ((DDD))DDA paid service and you refuse to have a ((DDD))DDA assessment administered?
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.
AMENDATORY SECTION(Amending WSR 07-10-029, filed 4/23/07, effective 6/1/07)
WAC 388-828-1340After administering the ((DDD))DDA assessment, ((how long does DDD have to complete your DDD assessment))when will DDA inform me of the services I am eligible to receive?
(((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.
NEW SECTION
WAC 388-828-1345When will I receive the services for which I have been determined eligible?
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.
AMENDATORY SECTION(Amending WSR 07-10-029, filed 4/23/07, effective 6/1/07)
WAC 388-828-1420What is your responsibility when selecting ((an ADSA contracted agency))a provider?
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.
AMENDATORY SECTION(Amending WSR 07-10-029, filed 4/23/07, effective 6/1/07)
WAC 388-828-1440What is the definition of ((DDD))DDA "paid service" in chapter 388-828 WAC?
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:
(a) Person to person; or
(b) Individual employment; or
(c) Group supported employment; or
(d) Prevocational/specialized industries; or
(e) Community access)); ((or
(f) Individual and family assistance.))
(3) ((A current waiver POC or waiver ISP; or
(4) Residence in a state operated living alternative (SOLA) program; or
(5) Authorization of family support services within the last twelve months per chapter 388-825 WAC; 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:
(a) Dangerous mentally ill offender funds;
(b) Crisis stabilization services;
(c) Specialized psychiatric services; or
(d) Diversion bed services)).
AMENDATORY SECTION(Amending WSR 07-10-029, filed 4/23/07, effective 6/1/07)
WAC 388-828-1460When will you receive ((an initial DDD))a DDA assessment?
((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.
AMENDATORY SECTION(Amending WSR 16-17-009, filed 8/4/16, effective 9/4/16)
WAC 388-828-1500When does DDA conduct a reassessment?
(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.
AMENDATORY SECTION(Amending WSR 16-17-009, filed 8/4/16, effective 9/4/16)
WAC 388-828-1540Who participates in your DDA assessment?
(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.
AMENDATORY SECTION(Amending WSR 07-10-029, filed 4/23/07, effective 6/1/07)
WAC 388-828-1580Why does ((DDD))DDA require ((all questions on mandatory panels to be answered in the DDD))an assessment?
((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 of 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.
AMENDATORY SECTION(Amending WSR 07-10-029, filed 4/23/07, effective 6/1/07)
WAC 388-828-1600What happens if you refuse to answer a question ((on a mandatory panel)) in 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:
(1) Explain what happens if you refuse to answer a question on a mandatory panel 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 paid services when they reach their authorized end date;
(4) Provide you notice and appeal rights for denied and/or terminated service(s) per WAC 388-825-100 and 388-825-120; and
(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 of denial or termination of eligibility for services as required under chapter 388-825 WAC.
AMENDATORY SECTION(Amending WSR 07-10-029, filed 4/23/07, effective 6/1/07)
WAC 388-828-2000What is the support assessment ((module))?
The support assessment ((module)) is the ((first section of the DDD assessment and is administered to all DDD clients)):
(1) Supports intensity scale for clients sixteen and older; and
(2) Support assessment for children under sixteen.
AMENDATORY SECTION(Amending WSR 07-10-029, filed 4/23/07, effective 6/1/07)
WAC 388-828-2020What is the purpose of the support assessment ((module))?
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
(4) Identify the persons receiving, or approved for, DDD paid services or SSP who will need the additional two assessment modules:
(a) The service level assessment module; and
(b) The individual support plan module)).
AMENDATORY SECTION(Amending WSR 07-10-029, filed 4/23/07, effective 6/1/07)
WAC 388-828-2040What components are contained in the support assessment ((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.
AMENDATORY SECTION(Amending WSR 07-10-029, filed 4/23/07, effective 6/1/07)
WAC 388-828-2060How does your assessment age affect the support assessment ((module))?
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:
Components contained in the Support Assessment ((module)) | Age (0-15) | Age (16+) |
The Support Assessment for Children | Yes | No |
SIS Support Needs and Supplemental Protection and Advocacy Scales | No | Yes |
SIS Exceptional Medical and Behavior Support Needs Scales | Yes | Yes |
((DDD))DDA Protective Supervision Acuity Scale | Yes | Yes |
((DDD))DDA Caregiver Status Acuity Scale | Yes | Yes |
((DDD))DDA Activities of Daily Living Acuity Scale | Yes | Yes |
((DDD))DDA Behavioral Acuity Scale | Yes | Yes |
((DDD))DDA Medical Acuity Scale | Yes | Yes |
((DDD))DDA Interpersonal Support Acuity Scale | Yes | Yes |
((DDD))DDA Mobility Scale | Yes | Yes |
Current Programs and Services component | Yes | Yes |
AMENDATORY SECTION(Amending WSR 07-10-029, filed 4/23/07, effective 6/1/07)
WAC 388-828-2080How does ((DDD))DDA determine 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.
AMENDATORY SECTION(Amending WSR 07-10-029, filed 4/23/07, effective 6/1/07)
WAC 388-828-3020What is the purpose of the support assessment for children?
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.
AMENDATORY SECTION(Amending WSR 07-10-029, filed 4/23/07, effective 6/1/07)
WAC 388-828-3040What questions are asked in the support assessment for children and how are they scored?
((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?
Answers | Definitions | LOC Score | Acuity Score |
Physical Assistance | Needs major support in the form of total physical assistance, intensive training and/or therapy for dressing and grooming. | 1 | 4 |
Training | Needs moderate support in the form of some physical assistance and/or training and/or therapies to dress and groom self. | 0 | 3 |
Reminders/Prompts | Needs reminders or prompts to dress and groom self appropriately. | 0 | 2 |
No support needed or at age level | At age level (may have physical supports) in dressing and grooming. | 0 | 0 |
(2) Toilet self: What support does the child need to toilet self as expected of others in his/her age group?
Answers | Definitions | LOC Score | Acuity Score |
Total physical support | Needs major support in the form of total physical support. Intensive training intervention and/or daily therapy to toilet self. | 1 | 4 |
Partial physical assistance, training | Needs moderate support in the form of some physical assistance, standard training and/or regular therapy. | 0 | 3 |
Reminders/prompts | Needs reminders or prompts. | 0 | 2 |
No support needed or at age level | Toilets self or has physical support in place to toilet self. | 0 | 0 |
(3) Eat at age level: What support does the child need to eat at age level?
Answers | Definitions | LOC Score | Acuity Score |
Total physical support | Needs major support in the form of total physical assistance, intensive training and/or daily therapy. | 1 | 4 |
Partial physical assistance, training | Needs moderate support in the form of some physical assistance, standard training, and/or regular therapy. | 1 | 3 |
Reminders/prompts | Needs help with manners and appearance when eating, in the form of reminders and prompts. | 0 | 2 |
No support needed or at age level | At age level (may have physical supports) in eating. | 0 | 0 |
(4) Move around: What support does the child need to move around in the same ways as other children of same age?
Answers | Definitions | LOC Score | Acuity Score |
Total physical support | Needs major intervention in the form of total physical support to move around, intensive training and/or daily therapy. | 1 | 4 |
Partial physical assistance, training | Needs moderate support such as someone's help to move around or may use or learn to use adaptive device or may require standard training. | 1 | 3 |
Reminders/prompts | Needs mild intervention in the form of training and physical prompting for scooting/crawling/walking behaviors. | 0 | 2 |
No support needed or at age level | No supports needed - child is scooting/crawling/walking at age level | 0 | 0 |
(5) Communicate: What support does the child need to communicate as others of same age?
Answers | Definitions | LOC Score | Acuity Score |
Total physical support | Currently someone else must always determine and communicate child's needs. | 1 | 4 |
Training/therapy | With intensive training or therapy support, child may learn sufficient verbal and/or signing skills to make self easily understandable to others. May include partial physical support. | 1 | 3 |
Adaptive device/interpreter | With physical support (adaptive device, interpreter), child is always able to communicate. | 0 | 2 |
No support needed or at age level | No supports needed and/or at age level. | 0 | 0 |
(6) Learn about and use money: What support does the child need to learn about and use money?
Answers | Definitions | LOC Score | Acuity Score |
Total physical support | Child is not old enough to know about money. | 0 | 4 |
Partial physical assistance, training | Family must devise special opportunities for child to earn/or spend money. | 0 | 3 |
Create opportunities, reminders/prompts | Needs to learn about earning and/or spending money in typical age-level ways. | 0 | 2 |
No support needed or at age level | Needs no support. Independently uses opportunities typical to his/her age group to earn and/or spend money. | 0 | 0 |
(7) Make choices and take responsibility: What support does the child need to make choices and take responsibility?
Answers | Definitions | LOC Score | Acuity Score |
Total physical support | Needs major support in the form of special and/or technical help to and from family/teachers to create opportunities for making choices and taking responsibility. | 1 | 4 |
Partial physical assistance, training | Needs moderate support in the form of family/teachers creating and explaining a variety of opportunities for making choices and taking responsibility. | 1 | 3 |
Create opportunities, reminders/prompts | Needs some support in the form of explanation of available options for making choices and taking responsibility. | 1 | 2 |
No support needed or at age level | Needs no support. Readily uses a variety of opportunities to indicate choices (activity, food, etc.) and take responsibility for tasks, self, etc. | 0 | 0 |
(8) Explore environment: What support does the child need to explore environment?
Answers | Definitions | LOC Score | Acuity Score |
Total physical support | Needs major support in the form of specialized technical help to and from family/teachers to create ways which support/encourage child to explore and reach out. | 1 | 4 |
Partial physical assistance, training | Needs moderate support in the form of some training/physical help to and from family and teachers to create ways and opportunities for child to explore environment and reach out. | 1 | 3 |
Reminders/prompts | Needs some support in the form of verbal encouragement or presence of someone child trusts to explore environment and reach out. | 0 | 2 |
No support needed or at age level | Needs no support and/or is at age level. Readily explores environment (may have adaptive device) and reaches out in ways typical to child's age group. | 0 | 0 |
(9) Meet therapy health needs: What supports are necessary to get child's therapy health needs met?
Answers | Definitions | LOC Score | Acuity Score |
Daily intervention by professionals | Child requires medical/health intervention or monitoring by professionals at least daily. | 1 | 4 |
Monitoring by health professionals | Child needs regular (weekly, monthly) monitoring by health professionals. | 1 | 3 |
Monitoring by trained others | Child needs daily support and/or monitoring by training others. | 1 | 2 |
Community health system | Needs regular on-going therapy and/or monitoring of health needs through typical community health systems. | 0 | 1 |
No support needed or at age level | No specialized supports or ongoing therapies necessary. | 0 | 0 |
(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?
Answers | Definitions | LOC Score | Acuity Score |
Urgent extensive support | Substantial significant supports to child and parents needed. Child in, or at risk of, out-of-home placement at this time. | 1 | 4 |
Substantial support/referrals needed | Substantial support needed/requested; (e.g., requests for more than two days per month respite, referral to homemakers, homebuilders; request for long term behavior management training, need extensive and/or expensive environmental modification or equipment; request frequent contact with case manager.) | 1 | 3 |
Moderate support | Moderate external support needed/requested; (e.g., requests for regular respite, intensive but short-term behavior management, referral for parent training help, referral to day care services; and/or request for regular contact with case manager.) | 0 | 2 |
Minimal support | Minimal external support needed/requested; (e.g., requests for occasional respite, referrals to parent support group, and/or case manager helps obtain adaptive equipment.) | 0 | 1 |
No support needed or at age level | No external supports are necessary. Family has obtained any necessary adaptive equipment. | 0 | 0 |
(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?
Answers | Definitions | LOC Score | Acuity Score |
Total physical support | Opportunities for contributing to family life totally dependent on others to maintain, interpret child's role to other family members. | 0 | 4 |
Partial physical assistance, training | Requires major support in the form of daily/weekly creation of opportunities to be seen as a contributing member and assume typical family responsibilities. | 0 | 3 |
Reminders/prompts | Requires moderate support in the form of adaptive device, training and/or reminders to be seen as contributing member and assume typical family responsibilities. | 0 | 2 |
No support needed or at age level | Needs no support to form positive family relationship. | 0 | 0 |
(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?
Answers | Definitions | LOC Score | Acuity Score |
Total physical support | Family needs major support (perhaps respite) to continue to provide child total physical support to use typical resources. | 0 | 4 |
Partial physical assistance, training | Moderate support is needed - family must create ways for child to use these resources in ways typical to child's age group. | 0 | 3 |
Reminders/prompts | Minimal support needed - family may wish suggestions or some support on ways to enable child's regular use of typical resources. | 0 | 2 |
No support needed or at age level | Needs no support and/or at age level. Uses these resources regularly. | 0 | 0 |
(13) Play with others: What supports are needed for the child to develop age-level skills in playing with others?
Answers | Definitions | LOC Score | Acuity Score |
Total physical support | Major support needed by others to help child play. Parents may request special adaptive equipment and training to foster child's playing skills. | 0 | 4 |
Partial physical assistance training | Moderate support needed in the form of a verbal and/or some physical intervention to help child play. Parents may be requesting suggestions instruction in ways to help child develop playing skills. | 0 | 3 |
Reminders/prompts | Minimal support needed. | 0 | 2 |
No support needed or at age level | No supports needed and/or at age level. Child's playing skills developing at age level. | 0 | 0 |
(14) Have opportunities to play with typically developing children: What supports does the child need to have opportunities to play with typically developing children?
Answers | Definitions | LOC Score | Acuity Score |
Total physical support | Substantial system support (e.g., system must set up "programs" that allow for interaction with typically developing children and the "programs"). | 0 | 4 |
Partial physical assistance, training | Moderate supports (e.g., parents have to create opportunities for contacts). Parents may ask for instruction in how to facilitate such contacts. System may need to provide structural supports (e.g., transportation, barrier-free public play environments, etc). | 0 | 3 |
Reminders/prompts | Minimal support (e.g., some monitoring). Parents may request help on how to broaden child's range of contacts or to increase the age appropriateness of contacts. | 0 | 2 |
No support needed or at age level | No support needed. | 0 | 0 |
(15) Identify and respond safely to emergencies: What support does the child need to identify and respond safely to emergencies?
Answers | Definitions | LOC Score | Acuity Score |
Total physical support | Needs total physical support to respond to emergencies. | 1 | 4 |
Always needs help to identify and respond | Needs help all of the time to identify emergencies and to respond. | 1 | 3 |
Sometimes needs help to identify and respond | Needs help some of the time to identify emergencies and to respond. | 1 | 2 |
Can identify, needs help to respond | Independently identifies emergencies; needs help from others to respond. | 1 | 1 |
No help needed or at age level | Needs no help from others in emergencies. | 0 | 0 |
(16) Practice age-level safety measures: What support does the child need to practice age-level safety measures?
Answers | Definitions | LOC Score | Acuity Score |
Total physical support | Needs total physical support for safety measures in daily activities and routines. | 1 | 4 |
Partial physical assistance, training | Does not recognize own safety needs and requires help in most safety areas. | 1 | 3 |
Reminders/prompts | Knows importance of safety measures. Needs training and/or physical support in many areas. | 1 | 2 |
No support needed or at age level | Needs no support in providing for own safety. | 0 | 0 |
(17) Effectively relate to other students/peers: What support does the child need to most effectively relate to fellow students and/or peers?
Answers | Definitions | LOC Score | Acuity Score |
Total physical support | Needs physical support by others in the form of interpretation of self to others to interact with peers. | 1 | 4 |
Partial physical assistance, training | Needs physical intervention in the form of modeling to enable child to reach out to peers to give and take support. | 1 | 3 |
Reminders/prompts | Needs much encouragement, supervision and guidance in how to give and ask for support and interact with peers. | 0 | 2 |
No support needed or at age level | Without support, child relates to others as a valued member of work/learning unit. | 0 | 0 |
(18) Have behaviors which promote being included: What support is needed for this child to have behaviors which promote being included?
Answers | Definitions | LOC Score | Acuity Score |
Continuous behavioral interventions | Needs major tolerance and control. Could include being dangerous to self and/or others. | 1 | 4 |
Major behavior modifications | Needs major behavior modifications to be perceived as typical. Child's behaviors are extremely disagreeable to others. | 1 | 3 |
Modeling, reminders, prompts | Needs participation in typical settings with typically developing others to model desirable behaviors. Child's behaviors cause him/her to be easily recognized as different from others. | 0 | 2 |
Minor support | Needs interactions with typically developing others. Child's behaviors are different from others in minor ways and the child may not immediately be perceived as different. | 0 | 1 |
No support needed or at age level | Needs no support. Behaviors are similar to others in general community of same age and culture. | 0 | 0 |
AMENDATORY SECTION(Amending WSR 07-10-029, filed 4/23/07, effective 6/1/07)
WAC 388-828-3060How does ((DDD))DDA determine your total LOC score for ((ICF/MR))ICF/IID level of care if you are age birth through fifteen years old?
((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.
AMENDATORY SECTION(Amending WSR 07-10-029, filed 4/23/07, effective 6/1/07)
WAC 388-828-3080How does ((DDD))DDA determine if you meet the eligibility requirements for ((ICF/MR))ICF/IID level of care (LOC) if you are age birth through fifteen years old?
((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.
AMENDATORY SECTION(Amending WSR 07-10-029, filed 4/23/07, effective 6/1/07)
WAC 388-828-4020What is the purpose of the supports intensity scale (SIS) assessment?
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.
AMENDATORY SECTION(Amending WSR 19-02-020, filed 12/21/18, effective 2/1/19)
WAC 388-828-4400How does DDA determine if you meet the eligibility requirements for ICF/IID level-of-care if you are age sixteen or older?
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:
Question # of SIS support needs scale | Text of question | Your score for "Type of support" is: | And your score for "Frequency of support" is: |
A2 | Bathing and ((take))taking care of personal hygiene and grooming needs | 2 or more | 4 |
3 or more | 2 |
A3 | Using the toilet | 2 or more | 4 |
3 or more | 2 |
A4 | Dressing | 2 or more | 4 |
3 or more | 2 |
A5 | Preparing food | 2 or more | 4 |
3 or more | 2 |
A6 | Eating food | 2 or more | 4 |
3 or more | 2 |
A7 | Taking care of clothes, including laundering | 2 or more | 2 or more |
3 or more | 1 |
A8 | Housekeeping and cleaning | 2 or more | 2 or more |
3 or more | 1 |
B6 | Shopping and purchasing goods and services | 2 or more | 2 or more |
3 or more | 1 |
C1 | Learning and using problem-solving strategies | 2 or more | 3 or more |
3 or more | 2 |
C5 | Learning self-management strategies | 2 or more | 3 or more |
3 or more | 2 |
E1 | Taking medications | 2 or more | 4 |
3 or more | 2 |
E2 | Ambulating and moving about | 2 or more | 4 |
3 or more | 2 |
E3 | Avoiding health and safety hazards | 2 or more | 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 |
F1 | Using appropriate social skills | 2 or more | 3 or more |
3 or more | 2 |
G7 | Managing money and personal finances | 2 or more | 2 or more |
3 or more | 1 |
AMENDATORY SECTION(Amending WSR 07-10-029, filed 4/23/07, effective 6/1/07)
WAC 388-828-6020What is the purpose of the programs and services component?
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)).
AMENDATORY SECTION(Amending WSR 07-10-029, filed 4/23/07, effective 6/1/07)
WAC 388-828-7000What is the purpose of the service level assessment ((module))?
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.
AMENDATORY SECTION(Amending WSR 07-10-029, filed 4/23/07, effective 6/1/07)
WAC 388-828-7020What components contained in the service level assessment ((module)) determine a service level ((and/or))or number of hours?
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.
AMENDATORY SECTION(Amending WSR 16-17-009, filed 8/4/16, effective 9/4/16)
WAC 388-828-8000What is the purpose of the person-centered service plan((/individual support plan (ISP) module))?
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)).
AMENDATORY SECTION(Amending WSR 19-02-020, filed 12/21/18, effective 2/1/19)
WAC 388-828-8040How does DDA determine which health and welfare needs must be addressed in your ((individual support))person-centered service plan if you are age birth through fifteen?
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:
# | Questions in the Support Needs Assessment for Children: | DDA must address in your 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 | DDA must address in your 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 | Hypertension | 1 or more | Medical Supports |
17 | 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: | DDA must address in your PSCP if you have an acuity score of: | Health and Welfare Category |
1 | Prevention of emotional outbursts | 1 or more | Behavioral Supports |
2 | Prevention of assault or injury to others | 1 or more | Behavioral Supports |
3 | Prevention of property destruction (e.g., fire setting, breaking furniture) | 1 or more | Behavioral Supports |
4 | Prevention of stealing | 1 or more | Behavioral Supports |
5 | Prevention of self-injury | 1 or more | Behavioral Supports |
6 | Prevention of suicide attempts | 1 or more | Behavioral Supports |
7 | Prevention of 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 sexual aggression | 1 or more | Behavioral Supports |
10 | Prevention of substance abuse | 1 or more | Behavioral Supports |
11 | Prevention of 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 DDA Caregiver Status Acuity Scale: | DDA must address in your 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 | DDA Caregiver Status |
AMENDATORY SECTION(Amending WSR 19-02-020, filed 12/21/18, effective 2/1/19)
WAC 388-828-8060How does DDA determine which health and welfare needs must be addressed in your ((individual support))person-centered service plan if you are age sixteen or older?
(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:
# | SIS Activity | DDA must address in the PSCP if your Type of Support score is: | Health and Welfare Category |
A1 | Operating home appliances | 3 or more | |
A2 | Bathing and taking care of personal hygiene and grooming needs | 3 or more | |
A3 | Using the toilet | 3 or more | |
A4 | Dressing | 3 or more | |
A5 | Preparing food | 3 or more | Home Living |
A6 | Eating food | 3 or more | |
A7 | Taking care of clothes, including laundering | 3 or more | |
A8 | 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 | 2 or more | |
B4 | Accessing public buildings and settings | 2 or more | Community Living |
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 | Going to visit friends and family | 4 | |
D3 | Interacting with co-workers | 3 or more | Employment |
D4 | Interacting with supervisors and or coaches | 3 or more |
E1 | Taking medications | 2 or more | |
E2 | Ambulating and moving about | 3 or more | |
E3 | Avoiding health and safety hazards | 3 or more | Health ((antd))and Safety |
E4 | Obtaining health care services | 3 or more | |
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 | Socializing within the household | 4 | |
G2 | Making choices and decisions | 2 or more | |
G3 | Protecting self from exploitation | 2 or more | Protection and Advocacy |
G7 | 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, 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.
AMENDATORY SECTION(Amending WSR 10-07-019, filed 3/8/10, effective 4/8/10)
WAC 388-828-8500What is the children's intensive in-home behavioral support (CIIBS) program algorithm?
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.
AMENDATORY SECTION(Amending WSR 10-07-019, filed 3/8/10, effective 4/8/10)
WAC 388-828-8505When does the ((DDD))DDA assessment run the CIIBS algorithm to determine your eligibility for the CIIBS waiver?
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)).
AMENDATORY SECTION(Amending WSR 10-07-019, filed 3/8/10, effective 4/8/10)
WAC 388-828-8510What elements does the CIIBS algorithm use to calculate your out-of-home placement risk score?
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).
AMENDATORY SECTION(Amending WSR 10-07-019, filed 3/8/10, effective 4/8/10)
WAC 388-828-8515How does ((DDD))DDA determine your CIIBS out-of-home placement risk score?
Your CIIBS out-of-home placement risk score is calculated using the following table:
Section and WAC reference | If you meet the following criteria: | Then adjust your score by: | Score if you meet criteria |
| Clients meeting eligibility criteria in WAC 388-828-8505 | | Beginning Score = 0 |
((DDD))DDA Determination WAC 388-823-0500 | Eligible condition of autism in the ((DDD))DDA determination. | Adding 40 points | = |
ADL Acuity Level WAC 388-828-5480 | Your ADL support needs level = high, medium or low | Subtracting 54 points | = |
Behavior Acuity Scale WAC 388-828-5500 through 388-828-5640 | Your most prominent behavior = assault/injury and Severity of your most prominent behavior = "potentially dangerous" or "life threatening" | Adding 14 points | = |
Protective Supervision Acuity Scale WAC 388-828-5060 | Your answer to the following question: "What level of monitoring does the client typically require during awake hours?" = "Line of sight/earshot" | Adding 13 points | = |
((DDD))DDA Caregiver Status Acuity WAC 388-828-5300 | Your caregiver risk level = high or immediate | Adding 136 points | = |
Backup Caregiver Status WAC 388-828-5320 | Your answer to the following question: "Under what conditions are other caregiver(s) available?" = "No other caregiver available" | Adding 33 points | = |
Mobility Acuity Scale WAC 388-828-5900 | Your mobility acuity level = high, medium or low | Subtracting 15 points | = |
| | Sum of all of scores above is your CIIBS out-of-home placement risk score | = |
AMENDATORY SECTION(Amending WSR 10-07-019, filed 3/8/10, effective 4/8/10)
WAC 388-828-8520How does ((DDD))DDA determine if I am eligible for the CIIBS waiver?
((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:
If your CIIBS out-of-home placement risk score is: | Then your CIIBS eligibility is: |
96 or greater | Yes - Severe |
17 through 95 | Yes - High |
Less than 17 | No - (not eligible) |
AMENDATORY SECTION(Amending WSR 08-16-121, filed 8/5/08, effective 9/5/08)
WAC 388-828-9000What is the individual and family services assessment?
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.
AMENDATORY SECTION(Amending WSR 08-16-121, filed 8/5/08, effective 9/5/08)
WAC 388-828-9020What is the purpose of the individual and family services assessment?
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).
AMENDATORY SECTION(Amending WSR 09-21-033, filed 10/13/09, effective 11/13/09)
WAC 388-828-9040How does ((DDD))DDA determine your individual and family services level?
(1) ((DDD))DDA determines your individual and family services level using the following table:
If your protective supervision support level is: | And your primary caregiver risk level is: | And your backup caregiver risk score is: | And your behavioral acuity level is: | Then your unadjusted individual and family services level is: |
0 | None | 1 | None | 1 |
0 | None | 1 | Low | 1 |
0 | None | 1 | Medium | 1 |
0 | None | 1 | High | 2 |
0 | None | 2 or 3 | None | 1 |
0 | None | 2 or 3 | Low | 1 |
0 | None | 2 or 3 | Medium | 2 |
0 | None | 2 or 3 | High | 2 |
0 | Low | 1 | None | 1 |
0 | Low | 1 | Low | 1 |
0 | Low | 1 | Medium | 1 |
0 | Low | 1 | High | 2 |
0 | Low | 2 or 3 | None | 1 |
0 | Low | 2 or 3 | Low | 1 |
0 | Low | 2 or 3 | Medium | 2 |
0 | Low | 2 or 3 | High | 2 |
0 | Medium | 1 | None | 1 |
0 | Medium | 1 | Low | 1 |
0 | Medium | 1 | Medium | 1 |
0 | Medium | 1 | High | 2 |
0 | Medium | 2 or 3 | None | 1 |
0 | Medium | 2 or 3 | Low | 1 |
0 | Medium | 2 or 3 | Medium | 2 |
0 | Medium | 2 or 3 | High | 2 |
0 | High | 1 | None | 1 |
0 | High | 1 | Low | 1 |
0 | High | 1 | Medium | 2 |
0 | High | 1 | High | 2 |
0 | High | 2 or 3 | None | 2 |
0 | High | 2 or 3 | Low | 2 |
0 | High | 2 or 3 | Medium | 2 |
0 | High | 2 or 3 | High | 3 |
0 | Immediate | 1 | None | 1 |
0 | Immediate | 1 | Low | 1 |
0 | Immediate | 1 | Medium | 2 |
0 | Immediate | 1 | High | 2 |
0 | Immediate | 2 or 3 | None | 2 |
0 | Immediate | 2 or 3 | Low | 2 |
0 | Immediate | 2 or 3 | Medium | 2 |
0 | Immediate | 2 or 3 | High | 3 |
1 | None | 1 | None | 1 |
1 | None | 1 | Low | 1 |
1 | None | 1 | Medium | 1 |
1 | None | 1 | High | 2 |
1 | None | 2 or 3 | None | 1 |
1 | None | 2 or 3 | Low | 1 |
1 | None | 2 or 3 | Medium | 2 |
1 | None | 2 or 3 | High | 3 |
1 | Low | 1 | None | 1 |
1 | Low | 1 | Low | 1 |
1 | Low | 1 | Medium | 1 |
1 | Low | 1 | High | 2 |
1 | Low | 2 or 3 | None | 1 |
1 | Low | 2 or 3 | Low | 1 |
1 | Low | 2 or 3 | Medium | 2 |
1 | Low | 2 or 3 | High | 3 |
1 | Medium | 1 | None | 1 |
1 | Medium | 1 | Low | 1 |
1 | Medium | 1 | Medium | 2 |
1 | Medium | 1 | High | 3 |
1 | Medium | 2 or 3 | None | 1 |
1 | Medium | 2 or 3 | Low | 2 |
1 | Medium | 2 or 3 | Medium | 2 |
1 | Medium | 2 or 3 | High | 3 |
1 | High | 1 | None | 2 |
1 | High | 1 | Low | 2 |
1 | High | 1 | Medium | 2 |
1 | High | 1 | High | 3 |
1 | High | 2 or 3 | None | 2 |
1 | High | 2 or 3 | Low | 2 |
1 | High | 2 or 3 | Medium | 3 |
1 | High | 2 or 3 | High | 4 |
1 | Immediate | 1 | None | 2 |
1 | Immediate | 1 | Low | 2 |
1 | Immediate | 1 | Medium | 2 |
1 | Immediate | 1 | High | 3 |
1 | Immediate | 2 or 3 | None | 2 |
1 | Immediate | 2 or 3 | Low | 2 |
1 | Immediate | 2 or 3 | Medium | 3 |
1 | Immediate | 2 or 3 | High | 4 |
2 or 3 | None | 1 | None | 1 |
2 or 3 | None | 1 | Low | 1 |
2 or 3 | None | 1 | Medium | 2 |
2 or 3 | None | 1 | High | 3 |
2 or 3 | None | 2 or 3 | None | 2 |
2 or 3 | None | 2 or 3 | Low | 2 |
2 or 3 | None | 2 or 3 | Medium | 2 |
2 or 3 | None | 2 or 3 | High | 4 |
2 or 3 | Low | 1 | None | 1 |
2 or 3 | Low | 1 | Low | 1 |
2 or 3 | Low | 1 | Medium | 2 |
2 or 3 | Low | 1 | High | 3 |
2 or 3 | Low | 2 or 3 | None | 2 |
2 or 3 | Low | 2 or 3 | Low | 2 |
2 or 3 | Low | 2 or 3 | Medium | 2 |
2 or 3 | Low | 2 or 3 | High | 4 |
2 or 3 | Medium | 1 | None | 2 |
2 or 3 | Medium | 1 | Low | 2 |
2 or 3 | Medium | 1 | Medium | 2 |
2 or 3 | Medium | 1 | High | 3 |
2 or 3 | Medium | 2 or 3 | None | 2 |
2 or 3 | Medium | 2 or 3 | Low | 2 |
2 or 3 | Medium | 2 or 3 | Medium | 3 |
2 or 3 | Medium | 2 or 3 | High | 4 |
2 or 3 | High | 1 | None | 2 |
2 or 3 | High | 1 | Low | 2 |
2 or 3 | High | 1 | Medium | 2 |
2 or 3 | High | 1 | High | 3 |
2 or 3 | High | 2 or 3 | None | 2 |
2 or 3 | High | 2 or 3 | Low | 2 |
2 or 3 | High | 2 or 3 | Medium | 3 |
2 or 3 | High | 2 or 3 | High | 4 |
2 or 3 | Immediate | 1 | None | 2 |
2 or 3 | Immediate | 1 | Low | 2 |
2 or 3 | Immediate | 1 | Medium | 2 |
2 or 3 | Immediate | 1 | High | 3 |
2 or 3 | Immediate | 2 or 3 | None | 2 |
2 or 3 | Immediate | 2 or 3 | Low | 2 |
2 or 3 | Immediate | 2 or 3 | Medium | 3 |
2 or 3 | Immediate | 2 or 3 | High | 4 |
4 | None | 1 | None | 2 |
4 | None | 1 | Low | 2 |
4 | None | 1 | Medium | 2 |
4 | None | 1 | High | 3 |
4 | None | 2 or 3 | None | 2 |
4 | None | 2 or 3 | Low | 2 |
4 | None | 2 or 3 | Medium | 3 |
4 | None | 2 or 3 | High | 4 |
4 | Low | 1 | None | 2 |
4 | Low | 1 | Low | 2 |
4 | Low | 1 | Medium | 2 |
4 | Low | 1 | High | 3 |
4 | Low | 2 or 3 | None | 2 |
4 | Low | 2 or 3 | Low | 2 |
4 | Low | 2 or 3 | Medium | 3 |
4 | Low | 2 or 3 | High | 4 |
4 | Medium | 1 | None | 2 |
4 | Medium | 1 | Low | 2 |
4 | Medium | 1 | Medium | 3 |
4 | Medium | 1 | High | 3 |
4 | Medium | 2 or 3 | None | 2 |
4 | Medium | 2 or 3 | Low | 3 |
4 | Medium | 2 or 3 | Medium | 3 |
4 | Medium | 2 or 3 | High | 4 |
4 | High | 1 | None | 2 |
4 | High | 1 | Low | 2 |
4 | High | 1 | Medium | 3 |
4 | High | 1 | High | 3 |
4 | High | 2 or 3 | None | 2 |
4 | High | 2 or 3 | Low | 3 |
4 | High | 2 or 3 | Medium | 4 |
4 | High | 2 or 3 | High | 4 |
4 | Immediate | 1 | None | 2 |
4 | Immediate | 1 | Low | 2 |
4 | Immediate | 1 | Medium | 3 |
4 | Immediate | 1 | High | 3 |
4 | Immediate | 2 or 3 | None | 2 |
4 | Immediate | 2 or 3 | Low | 3 |
4 | Immediate | 2 or 3 | Medium | 4 |
4 | Immediate | 2 or 3 | High | 4 |
5 | None | 1 | None | 2 |
5 | None | 1 | Low | 2 |
5 | None | 1 | Medium | 3 |
5 | None | 1 | High | 4 |
5 | None | 2 or 3 | None | 3 |
5 | None | 2 or 3 | Low | 3 |
5 | None | 2 or 3 | Medium | 4 |
5 | None | 2 or 3 | High | 5 |
5 | Low | 1 | None | 2 |
5 | Low | 1 | Low | 2 |
5 | Low | 1 | Medium | 3 |
5 | Low | 1 | High | 4 |
5 | Low | 2 or 3 | None | 3 |
5 | Low | 2 or 3 | Low | 3 |
5 | Low | 2 or 3 | Medium | 4 |
5 | Low | 2 or 3 | High | 5 |
5 | Medium | 1 | None | 2 |
5 | Medium | 1 | Low | 2 |
5 | Medium | 1 | Medium | 3 |
5 | Medium | 1 | High | 4 |
5 | Medium | 2 or 3 | None | 3 |
5 | Medium | 2 or 3 | Low | 3 |
5 | Medium | 2 or 3 | Medium | 4 |
5 | Medium | 2 or 3 | High | 5 |
5 | High | 1 | None | 2 |
5 | High | 1 | Low | 2 |
5 | High | 1 | Medium | 3 |
5 | High | 1 | High | 4 |
5 | High | 2 or 3 | None | 3 |
5 | High | 2 or 3 | Low | 3 |
5 | High | 2 or 3 | Medium | 4 |
5 | High | 2 or 3 | High | 5 |
5 | Immediate | 1 | None | 2 |
5 | Immediate | 1 | Low | 2 |
5 | Immediate | 1 | Medium | 3 |
5 | Immediate | 1 | High | 4 |
5 | Immediate | 2 or 3 | None | 3 |
5 | Immediate | 2 or 3 | Low | 3 |
5 | Immediate | 2 or 3 | Medium | 4 |
5 | Immediate | 2 or 3 | High | 5 |
6 | None | 1 | None | 2 |
6 | None | 1 | Low | 3 |
6 | None | 1 | Medium | 3 |
6 | None | 1 | High | 4 |
6 | None | 2 or 3 | None | 3 |
6 | None | 2 or 3 | Low | 3 |
6 | None | 2 or 3 | Medium | 4 |
6 | None | 2 or 3 | High | 5 |
6 | Low | 1 | None | 2 |
6 | Low | 1 | Low | 3 |
6 | Low | 1 | Medium | 3 |
6 | Low | 1 | High | 4 |
6 | Low | 2 or 3 | None | 3 |
6 | Low | 2 or 3 | Low | 3 |
6 | Low | 2 or 3 | Medium | 4 |
6 | Low | 2 or 3 | High | 5 |
6 | Medium | 1 | None | 3 |
6 | Medium | 1 | Low | 3 |
6 | Medium | 1 | Medium | 3 |
6 | Medium | 1 | High | 4 |
6 | Medium | 2 or 3 | None | 3 |
6 | Medium | 2 or 3 | Low | 4 |
6 | Medium | 2 or 3 | Medium | 4 |
6 | Medium | 2 or 3 | High | 5 |
6 | High | 1 | None | 3 |
6 | High | 1 | Low | 3 |
6 | High | 1 | Medium | 4 |
6 | High | 1 | High | 4 |
6 | High | 2 or 3 | None | 4 |
6 | High | 2 or 3 | Low | 4 |
6 | High | 2 or 3 | Medium | 5 |
6 | High | 2 or 3 | High | 5 |
6 | Immediate | 1 | None | 3 |
6 | Immediate | 1 | Low | 3 |
6 | Immediate | 1 | Medium | 4 |
6 | Immediate | 1 | High | 4 |
6 | Immediate | 2 or 3 | None | 4 |
6 | Immediate | 2 or 3 | Low | 4 |
6 | Immediate | 2 or 3 | Medium | 5 |
6 | Immediate | 2 or 3 | High | 5 |
(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.
AMENDATORY SECTION(Amending WSR 15-22-039, filed 10/28/15, effective 11/28/15)
WAC 388-828-9060How does ((DDD))DDA determine your individual and family services support rating?
Your individual and family services support rating is determined by using the following table:
If your unadjusted individual and family services level is: | Then your individual and family services support rating is: |
1 | 0 |
2 | 240 |
3 | 336 |
4 | 432 |
5 | 528 |
AMENDATORY SECTION(Amending WSR 15-22-039, filed 10/28/15, effective 11/28/15)
WAC 388-828-9100How does ((DDD))DDA determine the number to use in the adjustment of your individual and family services support rating?
((DDD))DDA determines the amount of the adjustment for your individual and family services support rating using the following table:
If your individual and family services level is 1, 2, 3, 4, or 5. | And your ADL support needs level for the SIS per WAC 388-828-5480 |
None | Low | Medium | High |
And your medical acuity level per WAC 388-828-5700 | None | 57 | 57 | 76 | 85 |
Low | 57 | 57 | 76 | 85 |
Medium | 57 | 88 | 122 | 145 |
High | 57 | 145 | 245 | 287 |
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.
AMENDATORY SECTION(Amending WSR 15-22-039, filed 10/28/15, effective 11/28/15)
WAC 388-828-9120How does ((DDD))DDA determine your individual and family services score?
((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.
AMENDATORY SECTION(Amending WSR 14-07-028, filed 3/10/14, effective 4/10/14)
WAC 388-828-9140How does ((DDD))DDA determine the amount of your individual and family service award?
((DDD))DDA uses the following table to determine the amount of your individual and family services award:
If your individual and family services score is: | The award level will be | The amount of your award is up to: |
0 to 60 | Not eligible | No Award |
61 to 240 | Level 1 | $1,200 |
241 to 336 | Level 2 | $1,800 |
337 to 527 | Level 3 | $2,400 |
528 or more | Level 4 | $3,600 |
AMENDATORY SECTION(Amending WSR 11-13-039, filed 6/8/11, effective 7/9/11)
WAC 388-828-9200What is the ((DDD))DDA employment acuity scale?
The ((DDD))DDA employment acuity scale is an algorithm that determines your employment acuity score and employment support level.
AMENDATORY SECTION(Amending WSR 11-13-039, filed 6/8/11, effective 7/9/11)
WAC 388-828-9205How does ((DDD))DDA determine your employment support level?
((DDD))DDA 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 |
AMENDATORY SECTION(Amending WSR 11-13-039, filed 6/8/11, effective 7/9/11)
WAC 388-828-9210How does ((DDD))DDA determine your employment acuity score?
((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:
Acuity scales and questions used in determining employment acuity score: | If employment support scores are: |
Activities of daily living | 0.20607 |
Behavioral support | 0.08372 |
Interpersonal support | 0.47326 |
Environmental support | 0.13596 |
Level of monitoring | 0.7311 |
Employment support | 0.43562 |
Completing tasks with acceptable speed | 0.18855 |
Completing tasks with acceptable quality | 0.10836 |
Medical support | 0.135 |
Seizure support | -0.15393 |
Your employment acuity score is: | 2.34371 |
AMENDATORY SECTION(Amending WSR 11-13-039, filed 6/8/11, effective 7/9/11)
WAC 388-828-9215How does ((DDD))DDA determine your employment acuity scale score for activities of daily living?
((DDD))DDA 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.
AMENDATORY SECTION(Amending WSR 11-13-039, filed 6/8/11, effective 7/9/11)
WAC 388-828-9220How does ((DDD))DDA determine your employment acuity scale score for behavioral support?
((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.
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.
AMENDATORY SECTION(Amending WSR 11-13-039, filed 6/8/11, effective 7/9/11)
WAC 388-828-9225How does ((DDD))DDA determine your employment acuity scale score for interpersonal support?
((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.
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.
AMENDATORY SECTION(Amending WSR 11-13-039, filed 6/8/11, effective 7/9/11)
WAC 388-828-9230How does ((DDD))DDA determine your employment acuity scale score for environmental support?
((DDD))DDA 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.
AMENDATORY SECTION(Amending WSR 11-13-039, filed 6/8/11, effective 7/9/11)
WAC 388-828-9235How does ((DDD))DDA determine your environmental support score?
((DDD))DDA 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.
AMENDATORY SECTION(Amending WSR 11-13-039, filed 6/8/11, effective 7/9/11)
WAC 388-828-9240How does ((DDD))DDA determine your employment support score for level of monitoring?
((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))your 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.
AMENDATORY SECTION(Amending WSR 11-13-039, filed 6/8/11, effective 7/9/11)
WAC 388-828-9245How does ((DDD))DDA determine your employment acuity scale score for employment support?
((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.
AMENDATORY SECTION(Amending WSR 11-13-039, filed 6/8/11, effective 7/9/11)
WAC 388-828-9250How does ((DDD))DDA determine your ((DDD))DDA employment support score?
((DDD))DDA determines your ((DDD))DDA 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))DDA employment level is: | And your ((DDD))DDA employment support score is: |
0 | None | 0 |
1 through 35 | Low | 1 |
36 through 59 | Medium | 2 |
60 or more | High | 3 |
AMENDATORY SECTION(Amending WSR 11-13-039, filed 6/8/11, effective 7/9/11)
WAC 388-828-9255How does ((DDD))DDA determine your employment acuity score for completing tasks with acceptable speed?
((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.
AMENDATORY SECTION(Amending WSR 11-13-039, filed 6/8/11, effective 7/9/11)
WAC 388-828-9260How does ((DDD))DDA determine your employment acuity score for completing tasks with acceptable quality?
((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.
AMENDATORY SECTION(Amending WSR 11-13-039, filed 6/8/11, effective 7/9/11)
WAC 388-828-9265How does ((DDD))DDA determine your employment acuity scale score for medical support?
((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.
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.
AMENDATORY SECTION(Amending WSR 11-13-039, filed 6/8/11, effective 7/9/11)
WAC 388-828-9270How does ((DDD))DDA determine your employment acuity scale score for seizure support?
((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.
AMENDATORY SECTION(Amending WSR 11-13-039, filed 6/8/11, effective 7/9/11)
WAC 388-828-9275How does ((DDD))DDA determine your seizure support score?
((DDD))DDA 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))or 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 |
AMENDATORY SECTION(Amending WSR 11-13-039, filed 6/8/11, effective 7/9/11)
WAC 388-828-9280Why does ((DDD))DDA multiply your seizure support score by a negative factor?
((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.
AMENDATORY SECTION(Amending WSR 13-01-076, filed 12/18/12, effective 1/18/13)
WAC 388-828-9325How does ((DDD))DDA determine the number of hours you may receive for employment support services?
((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.
AMENDATORY SECTION(Amending WSR 13-01-076, filed 12/18/12, effective 1/18/13)
WAC 388-828-9355How many add-on hours are you eligible to receive?
((DDD))DDA uses the following table to determine the maximum number of add-on hours you are eligible to receive.
If you meet one of the conditions in WAC 388-828-9350 and your employment level is: | You are eligible to receive up to the following amount of add-on hours: |
A | 0 |
B | 0 |
C | 5 |
D | 7 |
E | 5 |
F | 7 |
G | 12 |
H | 14 |
AMENDATORY SECTION(Amending WSR 08-15-091, filed 7/17/08, effective 7/17/08)
WAC 388-828-9500What is the residential algorithm?
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.
AMENDATORY SECTION(Amending WSR 09-06-047, filed 2/25/09, effective 3/28/09)
WAC 388-828-9520Where does the residential algorithm obtain your support needs information?
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.
AMENDATORY SECTION(Amending WSR 09-06-047, filed 2/25/09, effective 3/28/09)
WAC 388-828-9530How does the residential algorithm identify your residential support needs score?
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.
AMENDATORY SECTION(Amending WSR 09-06-047, filed 2/25/09, effective 3/28/09)
WAC 388-828-9540What residential service levels of support does ((DDD))DDA use?
((DDD))DDA uses the following residential service levels of support which correspond with your assessed support needs (see WAC 388-828-9530):
Support Need Level | Typical Support Need Characteristics from the ((DDD))DDA Assessment | Expected Level of Support* |
Weekly or less Support Level 1 | Client requires supervision, training, or physical assistance in areas that typically occur weekly or less often, such as shopping, paying bills, or medical appointments. Client is generally independent in support areas that typically occur daily or every couple of days. | Clients assessed to need this level receive support on a weekly basis or less frequently. |
Multiple times per week Support Level 2 | Client is able to maintain health and safety for a full day or more at a time AND needs supervision, training, or physical assistance with tasks that typically occur every few days, such as light housekeeping, menu planning, or guidance and support with relationships. Client is generally independent in support areas that must occur daily. | Clients assessed to need this level receive support multiple times per week. |
Intermittent daily -Low Support Level 3A | Client is able to maintain health and safety for short periods of time (i.e., hours, but not days) OR needs supervision, training, or physical assistance with activities that typically occur daily, such as bathing, dressing, or taking medications. | Clients assessed to need this level receive daily support. |
Intermittent daily -Moderate Support Level 3B | Client requires supervision, training, or physical assistance with multiple tasks that typically occur daily OR requires frequent checks for health and safety or due to disruptions in routines. | Clients assessed to need this level receive daily support and may receive checks during nighttime hours as needed. |
Close proximity Support Level 4 | Client requires support with a large number of activities that typically occur daily OR is able to maintain health and safety for very short periods of time (i.e., less than 2 hours, if at all) AND requires occasional health and safety checks or support during overnight hours. | Clients assessed to need this level receive supports in close proximity 24 hours per day. Support hours may be shared with neighboring households. |
Continuous day and continuous night Support Level 5 | Client is generally unable to maintain health and safety OR requires support with a large number of activities that occur daily or almost every day AND requires nighttime staff typically within the household. | Clients assessed to need this level receive support 24 hours per day. |
Community Protection Support Level 6 | Client is enrolled in the community protection program. | Clients assessed to need this level of support will receive 24 hour per day supervision per community protection program policy. |
*Emergency access to residential staff is available to all clients, 24-hours per day, regardless of the residential service level of support the assessment indicates. |
AMENDATORY SECTION(Amending WSR 08-15-091, filed 7/17/08, effective 7/17/08)
WAC 388-828-9550How does the residential algorithm determine if you are enrolled in the community protection program?
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.
AMENDATORY SECTION(Amending WSR 08-15-091, filed 7/17/08, effective 7/17/08)
WAC 388-828-9570How does ((DDD))DDA define mid-frequency support?
((DDD))DDA defines mid-frequency support as support for selected SIS activities that most people perform every two to four days.
AMENDATORY SECTION(Amending WSR 08-15-091, filed 7/17/08, effective 7/17/08)
WAC 388-828-9640How does the residential algorithm determine your nighttime support needs score?
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)
((DDD))DDA Sleep Panel Question | If ((you))your answer to the question is: | Then your support needs score for this question is: |
Nighttime Assistance*needed? Frequency | 0 = None or less than monthly | Less than daily |
1 = At least once a month but not once a week | Less than daily |
2 = At least once a week but not once a day | Less than daily |
3 = At least once a day but not once an hour | Daily or more frequently |
4 = Hourly or more frequently | Daily or more frequently |
* Nighttime assistance needed means that the person wakes in the night and requires assistance with toileting, mobility, medical issues, behaviors, guidance through sleepwalking, or other support requiring intervention. |
(2)
((DDD))DDA Sleep Panel Question | If your answer to this question is: | Then your support needs score for this question is: |
Nighttime assistance needed? Daily support time | 0 = None | Less than (<) 30 minutes |
1 = Less than 30 minutes | Less than (<) 30 minutes |
2 = 30 minutes to less than 2 hours | 30 minutes or more |
| 3 = 2 hours to less than 4 hours | 30 minutes or more |
| 4 = 4 hours or more | 30 minutes or more |
(3)
((DDD))DDA Sleep Panel Question | If your answer to this question is: | Then your support needs score for this question is: |
Can toilet self at night? | Yes | Yes |
No | No |
(4)
((DDD))DDA Sleep Panel Question | If your answer to this question is: | Then your support needs score for this question is: |
Wakes to toilet most nights? | Yes | Yes |
No | No |
(5)
((DDD))DDA Sleep Panel Question | If your answer to this question is: | Then your support needs score for this question is: |
Nighttime behavioral/anxiety issues? | None | Defined as: No behavioral or anxiety issues at night. | No |
| Minor | Defined as: You experience low to medium behavioral or anxiety issues when left alone at night, but can manage the behaviors/anxiety with minimal or no intervention. | No |
| Moderate | Defined as: You experience intense behavioral or anxiety issues when left alone at night, but you are managing to cope, even if only minimally, by yourself or with remote or occasional onsite help as needed. | No |
| Severe | Defined as: You experience intense behavioral or anxiety issues on most nights if left alone and require a support person within your home during all overnight hours in order to maintain yours and/or other's health and safety. | Yes |
REPEALER
The following sections of the Washington Administrative Code are repealed:
WAC 388-828-1160 | Does everyone receive all three modules of the DDD assessment? |
WAC 388-828-1200 | Who does DDD ask to disclose financial information? |
WAC 388-828-1220 | Will DDD require the reported annual gross income to be verified with supporting documentation? |
WAC 388-828-1300 | How will your access to, or receipt of, DDD paid services, private duty nursing services, or SSP be affected if income information is not reported? |
WAC 388-828-1360 | Are there any exceptions to completing your DDD assessment within thirty days? |
WAC 388-828-1380 | What will DDD do if you are unable to identify an ADSA contracted provider? |
WAC 388-828-1400 | What is your responsibility when selecting and/or hiring an ADSA contracted individual provider? |
WAC 388-828-1560 | Do all questions in the DDD assessment have to be answered? |
WAC 388-828-1620 | How does DDD determine which panels are mandatory in your DDD assessment? |
WAC 388-828-1640 | What are the mandatory panels in your DDD assessment? |
WAC 388-828-8020 | What components contained in the individual support plan module determine a service level and/or number of hours? |