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 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

PDFWAC 388-828-8040

How does DDA determine which health and welfare needs must be addressed in your person-centered service plan if you are age birth through fifteen?