PERMANENT RULES
SOCIAL AND HEALTH SERVICES
Effective Date of Rule: Thirty-one days after filing.
Purpose: The purpose of these rules is to amend chapter 388-828 WAC, The DDD assessment, to include information governing the algorithm DDD uses to determine if a person meets the eligibility requirements for the CIIBS waiver program. Once adopted, these rules will replace emergency rules filed as WSR 10-05-084 on February 15, 2010.
Citation of Existing Rules Affected by this Order: Amending WAC 388-828-1620.
Statutory Authority for Adoption: RCW 71A.12.010 and 71A.12.030.
Other Authority: Title 71A RCW.
Adopted under notice filed as WSR 10-03-108 on January 20, 2010.
A final cost-benefit analysis is available by contacting Mark Eliason, 640 Woodland Square Loop S.E., Lacey, WA 98504, phone (360) 725-2517, fax (360) 407-0955, e-mail eliasmr@dshs.wa.gov.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.
Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 5, Amended 1, Repealed 0.
Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 5, Amended 1, Repealed 0.
Date Adopted: March 8, 2010.
Susan N. Dreyfus
Secretary
4033.3
| If you are approved by DDD to receive: | Your client group is: |
| (1) DDD (( (2) State-only residential services per chapter 388-825 WAC; or (3) ICF/MR services per 42 CFR 440 and 42 CFR 483. |
Waiver and State-Only Residential |
| (4) Medicaid personal care (MPC) per chapter 388-106 WAC; or (5) DDD HCBS Basic, Basic Plus, CIIBS or Core waiver services per chapter 388-845 WAC and personal care services per chapter 388-106 WAC; or (6) Medically intensive health care program services per chapter 388-551 WAC; or (7) Adult day health services per chapter 388-106 WAC; or (8) Private duty nursing services per chapter 388-106 WAC; or (9) Community options program entry system (COPES) services per chapter 388-106 WAC; or (10) Medically needy residential waiver services per chapter 388-106 WAC; or (11) Medicaid nursing facility care services per chapter 388-106 WAC. |
Other Medicaid Paid Services |
| (12) County employment services per chapter 388-850 WAC. (13) Other DDD paid services per chapter 388-825 WAC, such as: (a) Family support services; or (b) Professional services. (14) Nonwaiver voluntary placement program services per chapter 388-826 WAC; (15) SSP only per chapter 388-827 WAC; |
State-Only Paid Services |
| (16) You are not approved to receive any DDD paid services. | No Paid Services |
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. 07-10-029, § 388-828-1620, filed 4/23/07, effective 6/1/07.]
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(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;
(4) Your ICF/MR score is eligible per WAC 388-828-4400; and
(5) You are not enrolled in the CIIBS waiver.
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(1) The DDD protective supervision acuity scale (WAC 388-828-5000 to 388-828-5100);
(2) The DDD caregiver status acuity scale (WAC 388-828-5120 to 388-828-5360);
(3) The DDD behavioral acuity scale (WAC 388-828-5500 to 388-828-5640);
(4) The DDD activities of daily living (ADL) acuity scale (WAC 388-828-5380 to 388-828-5480);
(5) The DDD mobility acuity scale (WAC 388-828-5380 to 388-828-5480); and
(6) Eligible condition of "autism" as indicated in the DDD determination (WAC 388-823-0500).
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| 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 Determination | Eligible condition of autism in the DDD determination. | Adding 40 points | = |
| ADL Acuity Level | 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 | 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 Caregiver Status Acuity | Your caregiver risk level = high or immediate |
Adding 136 points | = |
| Backup Caregiver Status | Your answer to the following question:
"Under what conditions are other
caregiver(s) available?" = "No other caregiver available" |
Adding 33 points | = |
| Mobility Acuity Scale | 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 | = |
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| 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) |
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