Chapter 388-828 WAC

Last Update: 7/8/19

THE DIVISION OF DEVELOPMENTAL DISABILITIES (DDD) ASSESSMENT

WAC Sections

PURPOSE AND SCOPE
388-828-1000What is the purpose and scope of this chapter?
DEFINITIONS
388-828-1020What definitions apply to this chapter?
DIVISION OF DEVELOPMENTAL DISABILITIES ASSESSMENT
388-828-1040What is the DDD assessment?
388-828-1060What is the purpose of the DDA assessment?
388-828-1080Who must administer the DDD assessment?
388-828-1100Who receives the DDD assessment?
388-828-1120Who does not receive the DDD assessment?
388-828-1140What will DDD do if there is no one willing to receive notice on your behalf regarding specific DDD decisions?
388-828-1160Does everyone receive all three modules of the DDD assessment?
388-828-1180How will your assessed unmet need(s) be met if there is no approved funding to provide a DDD paid service?
388-828-1200Who does DDD ask to disclose financial information?
388-828-1220Will DDD require the reported annual gross income to be verified with supporting documentation?
388-828-1300How will your access to, or receipt of, DDD paid services, private duty nursing services, or SSP be affected if income information is not reported?
388-828-1320What happens if you are approved to receive a DDD paid service and you refuse to have a DDD assessment administered?
388-828-1340After administering the DDD assessment, how long does DDD have to complete your DDD assessment?
388-828-1360Are there any exceptions to completing your DDD assessment within thirty days?
388-828-1380What will DDD do if you are unable to identify an ADSA contracted provider?
388-828-1400What is your responsibility when selecting and/or hiring an ADSA contracted individual provider?
388-828-1420What is your responsibility when selecting an ADSA contracted agency provider?
388-828-1440What is the definition of DDD "paid service" in chapter 388-828 WAC?
388-828-1460When will you receive an initial DDD assessment?
388-828-1480Are there any exceptions allowing authorization of a DDD paid service prior to administering a DDD assessment?
388-828-1500When does DDA conduct a reassessment?
388-828-1520Where is the DDA assessment and reassessment administered?
388-828-1540Who participates in your DDA assessment?
388-828-1560Do all questions in the DDD assessment have to be answered?
388-828-1580Why does DDD require all questions on mandatory panels to be answered in the DDD assessment?
388-828-1600What happens if you refuse to answer a question on a mandatory panel in the DDD assessment?
388-828-1620How does DDD determine which panels are mandatory in your DDD assessment?
388-828-1640What are the mandatory panels in your DDD assessment?
SUPPORT ASSESSMENT MODULE
388-828-2000What is the support assessment module?
388-828-2020What is the purpose of the support assessment module?
388-828-2040What components are contained in the support assessment module?
388-828-2060How does your assessment age affect the support assessment module?
388-828-2080How does DDD determine your assessment age?
THE SUPPORT ASSESSMENT FOR CHILDREN
388-828-3000What is the purpose of the support assessment for children?
388-828-3020What is the purpose of the support assessment for children?
388-828-3040What questions are asked in the support assessment for children and how are they scored?
388-828-3060How does DDD determine your total LOC score for ICF/MR level of care if you are age birth through fifteen years old?
388-828-3080How does DDD determine if you meet the eligibility requirements for ICF/MR level of care (LOC) if you are age birth through fifteen years old?
THE SUPPORTS INTENSITY SCALE ASSESSMENT
388-828-4000What is the supports intensity scale (SIS) assessment?
388-828-4020What is the purpose of the supports intensity scale (SIS) assessment?
388-828-4040What scales are contained in the supports intensity scale (SIS) assessment?
388-828-4060What subscales are contained in the support needs scale?
388-828-4080How does the SIS measure your support need(s) in the support needs and supplemental protection and advocacy scales?
388-828-4100How is type of support scored in the SIS assessment?
388-828-4120How is frequency of support scored in the SIS assessment?
388-828-4140How is daily support time scored in the SIS assessment?
388-828-4160How does DDD determine your raw score for each of the activities that are assessed in the support needs and supplemental protection and advocacy scales?
388-828-4165How does DDD determine your total raw score for each subscale in the SIS support needs scale?
388-828-4180Are all questions in the support needs and supplemental protection and advocacy scales scored the same way?
388-828-4200What activities are assessed in the home living activities subscale of the support needs scale?
388-828-4220What activities are assessed in the community living activities subscale of the support needs scale?
388-828-4240What activities are assessed in the lifelong learning activities subscale of the support needs scale?
388-828-4260What activities are assessed in the employment activities subscale of the support needs scale?
388-828-4280What activities are assessed in the health and safety activities subscale of the support needs scale?
388-828-4300What activities are assessed in the social activities subscale of the support needs scale?
388-828-4320What activities are assessed in the supplemental protection and advocacy activities subscale?
388-828-4340How does DDD determine your support score for each of the items identified in the SIS exceptional medical and behavioral support needs scales?
388-828-4360What exceptional medical support activities are evaluated to assess your medical support needs?
388-828-4380What exceptional behavioral support activities are evaluated to assess your behavioral support needs?
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?
388-828-4420How does DDD determine your percentile rank and standard score for each subscale in the SIS support needs scale?
388-828-4440How does DDD determine your SIS support needs index percentile ranking?
DDD PROTECTIVE SUPERVISION ACUITY SCALE
388-828-5000What is the DDD protective supervision acuity scale?
388-828-5020How is information in the protective supervision acuity scale used by DDD?
388-828-5040What questions are asked in the DDD protective supervision acuity scale?
388-828-5060How does DDD score each question?
388-828-5080How does DDD determine your adjusted protective supervision acuity score?
388-828-5100How does DDD determine your protective supervision support level?
DDD CAREGIVER STATUS ACUITY SCALE
388-828-5120What is the DDD caregiver status acuity scale?
388-828-5140How is information in the DDD caregiver status acuity scale used by DDD?
388-828-5160When is a collateral contact an informal caregiver?
388-828-5180When is a collateral contact a formal caregiver?
388-828-5200When is a collateral contact a backup caregiver?
388-828-5220Are you allowed to identify more than one person as a backup caregiver?
388-828-5240Who is your primary caregiver?
388-828-5260What questions are asked in the DDD caregiver status acuity scale and how are your caregiver's answers scored?
388-828-5280Which caregiver risk factors determine the caregiver risk level?
388-828-5300How does DDD determine a caregiver risk level?
388-828-5320How does DDD determine the availability of a backup caregiver?
388-828-5340How does DDD determine whether a backup caregiver lives with you?
388-828-5360How does DDD determine the risk level score of your backup caregiver not being able to provide the supports you need when you need them?
DDD ACTIVITIES OF DAILY LIVING (ADL) ACUITY SCALE
388-828-5380What is the DDD activities of daily living (ADL) acuity scale?
388-828-5400What does the activities of daily living (ADL) acuity scale measure?
388-828-5420How does DDD determine your ADL support needs score if you are age birth through fifteen?
388-828-5440How does DDD use your ADL support needs score for the support assessment for children?
388-828-5460How does DDA determine your ADL support needs score if you are age sixteen or older?
388-828-5480How does DDD determine your ADL support needs level for the SIS assessment?
DDD BEHAVIORAL ACUITY SCALE
388-828-5500What is the DDD behavioral acuity scale?
388-828-5520How is information in the DDD behavioral acuity scale used by DDD?
388-828-5540How does DDD determine if you have a prominent behavior?
388-828-5560Do all prominent behaviors get scored?
388-828-5580How does DDD determine the frequency of your most prominent behavior?
388-828-5600How does DDD determine the severity of your most prominent behavior?
388-828-5620How does DDD determine the type of caregiver assistance you receive to help you keep your most prominent behavior under control?
388-828-5640How does DDD determine your behavioral acuity level?
DDD MEDICAL ACUITY SCALE
388-828-5660What is the DDD medical acuity scale?
388-828-5680What is the purpose of the DDD medical acuity scale?
388-828-5700How does DDA determine your medical acuity level?
DDD INTERPERSONAL SUPPORT ACUITY SCALE
388-828-5720What is the DDD interpersonal support acuity scale?
388-828-5740What does the DDD interpersonal support acuity scale determine?
388-828-5760How does DDD determine your interpersonal support needs score if you are age birth through fifteen?
388-828-5780What does the DDD interpersonal support needs score determine if you are age birth through fifteen?
388-828-5800How does DDA determine your interpersonal support needs score if you are age sixteen or older?
388-828-5820How does DDD use your interpersonal support needs score if you are age sixteen or older?
DDD MOBILITY ACUITY SCALE
388-828-5840What is the DDD mobility acuity scale?
388-828-5860What does the DDD mobility acuity scale determine?
388-828-5880How does DDD determine your mobility acuity level if you are age birth through fifteen?
388-828-5900How does DDA determine your mobility acuity level if you are age sixteen or older?
RESPITE ASSESSMENT
388-828-5920What is the respite assessment?
388-828-5940Are there any exceptions when the respite assessment is not used to determine the number of hours for waiver respite services?
388-828-5960What is the purpose of the respite assessment?
388-828-5980How does DDD determine your respite assessment level?
388-828-5985How does DDD determine your unadjusted respite assessment level if DDD has authorized you to receive voluntary placement services per chapter 388-826 WAC?
388-828-5990How does DDD determine your unadjusted respite assessment level if DDD has authorized you to receive companion home services per chapter 388-829C WAC?
388-828-6000How does DDD determine the maximum number of hours you may receive for respite care?
388-828-6005How does DDD determine your voluntary placement services support score per chapter 388-826 WAC?
388-828-6006How does DDD determine the number to use in the adjustment of your voluntary placement services score?
388-828-6007How does DDD determine the number of respite hours you may receive annually if you are receiving voluntary placement services?
388-828-6010How does DDD determine your companion home services support score per chapter 388-829C WAC?
388-828-6011How does DDD determine the number to use in the adjustment of your companion home services support score?
388-828-6012How does DDD determine the number of respite hours you may receive annually if you are receiving companion home services?
PROGRAMS AND SERVICES COMPONENT
388-828-6020What is the purpose of the programs and services component?
SERVICE LEVEL ASSESSMENT MODULE
388-828-7000What is the purpose of the service level assessment module?
388-828-7020What components contained in the service level assessment module determine a service level and/or number of hours?
DDD SEIZURE ACUITY SCALE
388-828-7040What is the DDD seizure acuity scale?
388-828-7060What does the DDD seizure acuity scale measure?
388-828-7080How does DDD determine your seizure acuity level?
INDIVIDUAL SUPPORT PLAN MODULE
388-828-8000What is the purpose of the person-centered service plan/individual support plan (ISP) module?
388-828-8020What components contained in the individual support plan module determine a service level and/or number of hours?
388-828-8040How does DDA determine which health and welfare needs must be addressed in your individual support plan if you are age birth through fifteen?
388-828-8060How does DDA determine which health and welfare needs must be addressed in your individual support plan if you are age sixteen or older?
388-828-8500What is the children's intensive in-home behavioral support (CIIBS) program algorithm?
388-828-8505When does the DDD assessment run the CIIBS algorithm to determine your eligibility for the CIIBS waiver?
388-828-8510What elements does the CIIBS algorithm use to calculate your out-of-home placement risk score?
388-828-8515How does DDD determine your CIIBS out-of-home placement risk score?
388-828-8520How does DDD determine if I am eligible for the CIIBS waiver?
INDIVIDUAL AND FAMILY SERVICES ASSESSMENT
388-828-9000What is the individual and family services assessment?
388-828-9020What is the purpose of the individual and family services assessment?
388-828-9040How does DDD determine your individual and family services level?
388-828-9060How does DDD determine your individual and family services support rating?
388-828-9100How does DDD determine the number to use in the adjustment of your individual and family services support rating?
388-828-9120How does DDD determine your individual and family services score?
388-828-9140How does DDD determine the amount of your individual and family service award?
DDD EMPLOYMENT ACUITY SCALE
388-828-9200What is the DDD employment acuity scale?
388-828-9205How does DDD determine your employment support level?
388-828-9210How does DDD determine your employment acuity score?
388-828-9215How does DDD determine your employment acuity scale score for activities of daily living?
388-828-9220How does DDD determine your employment acuity scale score for behavioral support?
388-828-9225How does DDD determine your employment acuity scale score for interpersonal support?
388-828-9230How does DDD determine your employment acuity scale score for environmental support?
388-828-9235How does DDD determine your environmental support score?
388-828-9240How does DDD determine your employment support score for level of monitoring?
388-828-9245How does DDD determine your employment acuity scale score for employment support?
388-828-9250How does DDD determine your DDD employment support score?
388-828-9255How does DDD determine your employment acuity score for completing tasks with acceptable speed?
388-828-9260How does DDD determine your employment acuity score for completing tasks with acceptable quality?
388-828-9265How does DDD determine your employment acuity scale score for medical support?
388-828-9270How does DDD determine your employment acuity scale score for seizure support?
388-828-9275How does DDD determine your seizure support score?
388-828-9280Why does DDD multiply your seizure support score by a negative factor?
388-828-9300What is the community access acuity scale?
388-828-9310How does DDA determine the number of community inclusion services hours you may receive each month?
DDD EMPLOYMENT ACUITY SCALE
388-828-9325How does DDD determine the number of hours you may receive for employment support services?
388-828-9330How does DDA determine your employment status?
388-828-9335How does DDA determine your employment service level?
388-828-9340How does your employment service type affect how your employment service hours are used?
388-828-9345Can you receive fewer than the number of hours allocated to you in your employment service level?
388-828-9350Are there conditions when DDA will authorize additional hours to your monthly employment service hours?
388-828-9355How many add-on hours are you eligible to receive?
388-828-9360What is short-term employment support?
RESIDENTIAL ALGORITHM
388-828-9500What is the residential algorithm?
388-828-9510When is the residential algorithm administered?
388-828-9520Where does the residential algorithm obtain your support needs information?
388-828-9530How does the residential algorithm identify your residential support needs score?
388-828-9540What residential service levels of support does DDD use?
388-828-9550How does the residential algorithm determine if you are enrolled in the community protection program?
388-828-9560How does the residential algorithm determine your daily support needs score?
388-828-9570How does DDD define mid-frequency support?
388-828-9580How does the residential algorithm determine your mid-frequency support needs score?
388-828-9590How does the residential algorithm determine your behavior support needs score?
388-828-9600How does the residential algorithm determine your medical support needs score?
388-828-9610How does the residential algorithm determine your seizure support needs score?
388-828-9620How does the residential algorithm determine your protective supervision support needs score?
388-828-9630How does the residential algorithm determine your ability to seek help score?
388-828-9640How does the residential algorithm determine your nighttime support needs score?
388-828-9650How does the residential algorithm determine your toileting support needs score?
388-828-9660How does the residential algorithm calculate your daily critical support time?
388-828-9670How does the residential algorithm calculate your mid-frequency critical support time?
388-828-9680How does the residential algorithm determine your weekly critical support time?
388-828-9690How does the residential algorithm calculate your total critical support time (CST)?
388-828-9700How does the residential algorithm use your assessed support needs scores to determine your residential service level of support?
DISPOSITION OF SECTIONS FORMERLY CODIFIED IN THIS TITLE
388-828-10000What is the residential algorithm? [Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW. WSR 08-12-037, § 388-828-10000, filed 5/30/08, effective 7/1/08.] Decodified by WSR 08-15-091, filed 7/17/08, effective 7/17/08. Recodified as § 388-828-9500.
388-828-10020When is the residential algorithm administered? [Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW. WSR 08-12-037, § 388-828-10020, filed 5/30/08, effective 7/1/08.] Decodified by WSR 08-15-091, filed 7/17/08, effective 7/17/08. Recodified as § 388-828-9510.
388-828-10040Where does the residential algorithm obtain your support needs information? [Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW. WSR 08-12-037, § 388-828-10040, filed 5/30/08, effective 7/1/08.] Decodified by WSR 08-15-091, filed 7/17/08, effective 7/17/08. Recodified as § 388-828-9520.
388-828-10060How does the residential algorithm identify your residential support needs score? [Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW. WSR 08-12-037, § 388-828-10060, filed 5/30/08, effective 7/1/08.] Decodified by WSR 08-15-091, filed 7/17/08, effective 7/17/08. Recodified as § 388-828-9530.
388-828-10080What residential service levels of support does DDD use? [Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW. WSR 08-12-037, § 388-828-10080, filed 5/30/08, effective 7/1/08.] Decodified by WSR 08-15-091, filed 7/17/08, effective 7/17/08. Recodified as § 388-828-9540.
388-828-10100How does the residential algorithm determine if you are enrolled in the community protection program? [Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW. WSR 08-12-037, § 388-828-10100, filed 5/30/08, effective 7/1/08.] Decodified by WSR 08-15-091, filed 7/17/08, effective 7/17/08. Recodified as § 388-828-9550.
388-828-10120How does the residential algorithm determine your daily support needs score? [Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW. WSR 08-12-037, § 388-828-10120, filed 5/30/08, effective 7/1/08.] Decodified by WSR 08-15-091, filed 7/17/08, effective 7/17/08. Recodified as § 388-828-9560.
388-828-10130How does DDD define mid-frequency support? [Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW. WSR 08-12-037, § 388-828-10130, filed 5/30/08, effective 7/1/08.] Decodified by WSR 08-15-091, filed 7/17/08, effective 7/17/08. Recodified as § 388-828-9570.
388-828-10140How does the residential algorithm determine your mid-frequency support needs score? [Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW. WSR 08-12-037, § 388-828-10140, filed 5/30/08, effective 7/1/08.] Decodified by WSR 08-15-091, filed 7/17/08, effective 7/17/08. Recodified as § 388-828-9580.
388-828-10160How does the residential algorithm determine your behavior support needs score? [Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW. WSR 08-12-037, § 388-828-10160, filed 5/30/08, effective 7/1/08.] Decodified by WSR 08-15-091, filed 7/17/08, effective 7/17/08. Recodified as § 388-828-9590.
388-828-10180How does the residential algorithm determine your medical support needs score? [Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW. WSR 08-12-037, § 388-828-10180, filed 5/30/08, effective 7/1/08.] Decodified by WSR 08-15-091, filed 7/17/08, effective 7/17/08. Recodified as § 388-828-9600.
388-828-10200How does the residential algorithm determine your seizure support needs score? [Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW. WSR 08-12-037, § 388-828-10200, filed 5/30/08, effective 7/1/08.] Decodified by WSR 08-15-091, filed 7/17/08, effective 7/17/08. Recodified as § 388-828-9610.
388-828-10220How does the residential algorithm determine your protective supervision support needs score? [Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW. WSR 08-12-037, § 388-828-10220, filed 5/30/08, effective 7/1/08.] Decodified by WSR 08-15-091, filed 7/17/08, effective 7/17/08. Recodified as § 388-828-9620.
388-828-10240How does the residential algorithm determine your ability to seek help score? [Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW. WSR 08-12-037, § 388-828-10240, filed 5/30/08, effective 7/1/08.] Decodified by WSR 08-15-091, filed 7/17/08, effective 7/17/08. Recodified as § 388-828-9630.
388-828-10260How does the residential algorithm determine your nighttime support needs score? [Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW. WSR 08-12-037, § 388-828-10260, filed 5/30/08, effective 7/1/08.] Decodified by WSR 08-15-091, filed 7/17/08, effective 7/17/08. Recodified as § 388-828-9640.
388-828-10280How does the residential algorithm determine your toileting support needs score? [Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW. WSR 08-12-037, § 388-828-10280, filed 5/30/08, effective 7/1/08.] Decodified by WSR 08-15-091, filed 7/17/08, effective 7/17/08. Recodified as § 388-828-9650.
388-828-10300How does the residential algorithm calculate your daily critical support time? [Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW. WSR 08-12-037, § 388-828-10300, filed 5/30/08, effective 7/1/08.] Decodified by WSR 08-15-091, filed 7/17/08, effective 7/17/08. Recodified as § 388-828-9660.
388-828-10320How does the residential algorithm calculate your mid-frequency critical support time? [Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW. WSR 08-12-037, § 388-828-10320, filed 5/30/08, effective 7/1/08.] Decodified by WSR 08-15-091, filed 7/17/08, effective 7/17/08. Recodified as § 388-828-9670.
388-828-10340How does the residential algorithm determine your weekly critical support time? [Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW. WSR 08-12-037, § 388-828-10340, filed 5/30/08, effective 7/1/08.] Decodified by WSR 08-15-091, filed 7/17/08, effective 7/17/08. Recodified as § 388-828-9680.
388-828-10360How does the residential algorithm calculate your total critical support time (CST)? [Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW. WSR 08-12-037, § 388-828-10360, filed 5/30/08, effective 7/1/08.] Decodified by WSR 08-15-091, filed 7/17/08, effective 7/17/08. Recodified as § 388-828-9690.
388-828-10380How does the residential algorithm use your assessed support needs scores to determine your residential service level of support? [Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW. WSR 08-12-037, § 388-828-10380, filed 5/30/08, effective 7/1/08.] Decodified by WSR 08-15-091, filed 7/17/08, effective 7/17/08. Recodified as § 388-828-9700.
388-828-1240What does DDD do when family income and household dependent information are not provided? [Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-1240, filed 4/23/07, effective 6/1/07.] Repealed by WSR 08-12-037, filed 5/30/08, effective 7/1/08. Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW.
388-828-1260What action will DDD take if your family does not report income and dependent information? [Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-1260, filed 4/23/07, effective 6/1/07.] Repealed by WSR 08-12-037, filed 5/30/08, effective 7/1/08. Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW.
388-828-1280How will your access to, or receipt of, DDD HCBS waiver services be affected if your family does not report family income and dependent information? [Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-1280, filed 4/23/07, effective 6/1/07.] Repealed by WSR 08-12-037, filed 5/30/08, effective 7/1/08. Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW.


388-828-1000
What is the purpose and scope of this chapter?

This chapter establishes rules governing the administration of the division of developmental disabilities (DDD) assessment to persons determined eligible to be clients of the division per chapter 71A.16 RCW.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-1000, filed 4/23/07, effective 6/1/07.]



388-828-1020
What 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;
(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 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 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.
"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" 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 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 nursing facility level of care for persons with developmental disabilities per chapter 71A.20 RCW.
"Respondent" means the adult client and/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" means the client.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-828-1020, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-1020, filed 4/23/07, effective 6/1/07.]



388-828-1040
What is the DDD assessment?

(1) The DDD assessment is an assessment tool designed to measure the support needs of persons with developmental disabilities.
(2) The DDD assessment has three modules:
(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) (see WAC 388-828-8000 to 388-828-8060).
(3) The DDD assessment is part of the aging and disability services administration's (ADSA) comprehensive assessment reporting evaluation system (CARE).
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-1040, filed 4/23/07, effective 6/1/07.]



388-828-1060
What 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 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.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-828-1060, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW. WSR 08-12-037, § 388-828-1060, filed 5/30/08, effective 7/1/08; WSR 07-10-029, § 388-828-1060, filed 4/23/07, effective 6/1/07.]



388-828-1080
Who must administer the DDD assessment?

Only DDD employees can administer the DDD assessment.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-1080, filed 4/23/07, effective 6/1/07.]



388-828-1100
Who receives the DDD assessment?

DDD must administer a DDD assessment when you meet any of the following conditions:
(1) You are currently approved by DDD to receive a DDD paid service evidenced by meeting one of the conditions in WAC 388-828-1440;
(2) You request enrollment in one of the DDD HCBS waivers per chapter 388-845 WAC;
(3) You are age three or older and request a DDD 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 have requested an assessment for medicaid personal care services per 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 paid service per chapter 388-827 WAC;
(6) You request admission to a RHC per Title 42 C.F.R. 440, Title 42 C.F.R. 483, and Title 71A RCW;
(7) You reside in a RHC or community ICF/MR and you are involved in discharge planning for community placement;
(8) You do not meet any of the conditions listed in WAC 388-828-1120.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-1100, filed 4/23/07, effective 6/1/07.]



388-828-1120
Who does not receive the DDD assessment?

DDD will not administer the DDD 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 decisions as required per RCW 71A.10.060 and DDD 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 assessment (see WAC 388-828-1540(c));
(3) You reside in a RHC and are not currently involved in discharge planning for community placement;
(4) You reside in a community ICF/MR and are not authorized by DDD 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.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-1120, filed 4/23/07, effective 6/1/07.]



388-828-1140
What will DDD do if there is no one willing to receive notice on your behalf regarding specific DDD decisions?

If there is no one available to receive notice or correspondence on your behalf regarding specific DDD decisions, DDD 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.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-1140, filed 4/23/07, effective 6/1/07.]



388-828-1160
Does everyone receive all three modules of the DDD assessment?

(1) The support assessment module is administered to all clients who receive a DDD assessment.
(2) Only clients receiving a DDD paid service, SSP in lieu of a DDD paid service, or who are approved for a DDD paid service will receive the service level assessment and individual support plan modules since these modules are required:
(a) Prior to the authorization/reauthorization of a DDD paid service or SSP; and
(b) To determine a service level and/or number of hours for a service; and
(c) To authorize the DDD approved paid service(s) per WAC 388-828-8000.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-1160, filed 4/23/07, effective 6/1/07.]



388-828-1180
How will your assessed unmet need(s) be met if there is no approved funding to provide a DDD paid service?

If you complete the DDD assessment and are assessed to have an unmet need and there is no approved funding to support that need, DDD will offer you referral information for ICF/MR services per Title 71A RCW, chapter 388-825 WAC, and chapter 388-837 WAC. In addition, DDD may:
(1) Provide information and referral for non-DDD community based supports; and
(2) Add your name to the waiver database, if you have requested enrollment in a DDD 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.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-1180, filed 4/23/07, effective 6/1/07.]



388-828-1200
Who does DDD ask to disclose financial information?

When administering the DDD assessment, DDD is required to ask for annual gross income information from:
(1) Your family, if:
(a) You are age seventeen or younger; and
(b) Your family has not made a request for your admission to a residential habilitation center (RHC); or
(2) You, if:
(a) You are age eighteen or older; and
(b) You are receiving state-only funded services.
[Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW. WSR 08-12-037, § 388-828-1200, filed 5/30/08, effective 7/1/08; WSR 07-10-029, § 388-828-1200, filed 4/23/07, effective 6/1/07.]



388-828-1220
Will DDD require the reported annual gross income to be verified with supporting documentation?

DDD accepts a verbal report of annual gross income and does not require supporting documentation to verify the reported information.
[Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW. WSR 08-12-037, § 388-828-1220, filed 5/30/08, effective 7/1/08; WSR 07-10-029, § 388-828-1220, filed 4/23/07, effective 6/1/07.]



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?

Your access to, or receipt of, DDD paid services per WAC 388-828-1440, Private duty nursing services for children seventeen years of age and younger per WAC 388-551-3000, or SSP per chapter 388-827 WAC is not affected if income information is not reported.
[Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW. WSR 08-12-037, § 388-828-1300, filed 5/30/08, effective 7/1/08; WSR 07-10-029, § 388-828-1300, filed 4/23/07, effective 6/1/07.]



388-828-1320
What happens if you are approved to receive a DDD paid service and you refuse to have a DDD assessment administered?

If you are approved to receive a DDD paid service and refuse to have a DDD assessment administered, DDD is unable to authorize new or current DDD paid services and will do all of the following:
(1) Explain what happens if you refuse to allow DDD to administer the DDD 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 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.
(5) Provide you with information on how to contact DDD in case you later decide you want a DDD assessment administered.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-1320, filed 4/23/07, effective 6/1/07.]



388-828-1340
After administering the DDD assessment, how long does DDD have to complete your DDD assessment?

(1) DDD will complete your DDD assessment as soon as possible after it is administered.
(2) DDD will complete your DDD assessment no later than thirty days from the date it was created in CARE.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-1340, filed 4/23/07, effective 6/1/07.]



388-828-1360
Are there any exceptions to completing your DDD assessment within thirty days?

DDD will not complete your DDD assessment when:
(1) You are approved to receive a DDD paid service; and
(2) You or your legal guardian has not identified an ADSA contracted provider.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-1360, filed 4/23/07, effective 6/1/07.]



388-828-1380
What will DDD do if you are unable to identify an ADSA contracted provider?

If you are unable to identify an ADSA contracted provider, DDD will provide you or your legal guardian with contact information for ADSA contracted agency providers.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-1380, filed 4/23/07, effective 6/1/07.]



388-828-1400
What is your responsibility when selecting and/or hiring an ADSA contracted individual provider?

You or your legal representative/guardian has the primary responsibility for identifying, hiring, supervising, and/or terminating an ADSA contracted individual provider.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-1400, filed 4/23/07, effective 6/1/07.]



388-828-1420
What is your responsibility when selecting an ADSA contracted agency provider?

You or your legal representative/guardian has the responsibility of choosing an agency provider. DDD or the county will provide you information on contracted and qualified agency providers.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-1420, filed 4/23/07, effective 6/1/07.]



388-828-1440
What is the definition of DDD "paid service" in chapter 388-828 WAC?

For the purpose of this chapter, a DDD 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) 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 approval of your absence from DDD paid services for more than ninety days with available funding for your planned return to services; or
(7) Evidence of approval for funding of a DDD service or enrollment in a DDD HCBS waiver; or
(8) 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.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-1440, filed 4/23/07, effective 6/1/07.]



388-828-1460
When will you receive an initial DDD assessment?

DDD intends to assess all clients per WAC 388-828-1100 by June 30, 2008. DDD must administer an initial DDD assessment when:
(1) You are receiving a DDD paid service and your annual reassessment is due for continuation of the DDD paid service; or
(2) You are receiving a DDD 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 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 paid service and an assessment must be performed prior to the authorization of services; or
(5) You make a request to have a DDD assessment administered and meet the criteria in WAC 388-828-1100; or
(6) You are contacted by DDD and offered an opportunity to have a DDD assessment.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-1460, filed 4/23/07, effective 6/1/07.]



388-828-1480
Are there any exceptions allowing authorization of a DDD paid service prior to administering a DDD assessment?

During the year prior to July 2009, due to staff resources, DDD may authorize or reauthorize the following services before a DDD assessment is administered:
(1) Funding from the legislature that provides resources for services to be available by a certain date; or
(2) Emergency services as determined by DDD as critical to the client's health and safety.
[Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW. WSR 08-12-037, § 388-828-1480, filed 5/30/08, effective 7/1/08; WSR 07-10-029, § 388-828-1480, filed 4/23/07, effective 6/1/07.]



388-828-1500
When 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 date of your current assessment.
(2) DDA will provide you with notice in advance of your next ISP date so you may schedule the assessment at a time that is convenient to you.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-828-1500, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-1500, filed 4/23/07, effective 6/1/07.]



388-828-1520
Where is the DDA assessment and reassessment administered?

(1) DDA assessments and reassessments are administered at a location that is convenient to you, such as your home or place of residence.
(2) If you receive or plan to receive a DDA-paid service in your home or place of residence and the DDA assessment is not administered in your home or place of residence, DDA will conduct a follow-up home visit to ensure your person-centered service plan/individual support plan can be implemented in your living environment.
(3) If you receive or plan to receive a DDA-paid service in your home or place of residence, DDA must ask permission to view your living quarters during the DDA assessment or follow-up home visit.
[Statutory Authority: RCW 71A.12.030 and 71A.12.310. WSR 17-12-012, § 388-828-1520, filed 5/26/17, effective 6/26/17. Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-828-1520, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-1520, filed 4/23/07, effective 6/1/07.]



388-828-1540
Who 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.
[Statutory Authority: 2014 c 139, 2014 c 166, 2015 3rd sp.s. c 4, RCW 71A.12.030, and 71A.12.120. WSR 16-17-009, § 388-828-1540, filed 8/4/16, effective 9/4/16. Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW. WSR 08-12-037, § 388-828-1540, filed 5/30/08, effective 7/1/08; WSR 07-10-029, § 388-828-1540, filed 4/23/07, effective 6/1/07.]



388-828-1560
Do all questions in the DDD assessment have to be answered?

All questions in the DDD assessment that are on a mandatory panel must be answered.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-1560, filed 4/23/07, effective 6/1/07.]



388-828-1580
Why does DDD require all questions on mandatory panels to be answered in the DDD assessment?

DDD requires that all questions on mandatory panels be answered because:
(1) The legislature has directed DDD to assess all eligible clients with a common, standardized assessment process that measures the support needs of individuals with developmental disabilities.
(2) The DDD assessment algorithms in the support assessment module are designed to:
(a) Determine acuity scores and acuity levels for a variety client needs; and
(b) Provide a valid measure of each client's support needs relative to the support needs of other clients who have received the DDD assessment.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-1580, filed 4/23/07, effective 6/1/07.]



388-828-1600
What happens if you refuse to answer a question on a mandatory panel in the DDD assessment?

If you refuse to answer a question on a mandatory panel in the DDD assessment, DDD is unable to complete your DDD 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.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-1600, filed 4/23/07, effective 6/1/07.]



388-828-1620
How does DDD determine which panels are mandatory in your DDD assessment?

DDD determines which panels are mandatory in your DDD assessment by assigning you to a client group using the following table:
If you are approved by DDD to receive:
Your client group is:
(1) DDD HCBS waiver services per chapter 388-845 WAC; or
(2) State-only residential services per chapter 388-825 WAC; or
(3) ICF/MR services per 42 C.F.R. 440 and 42 C.F.R. 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.12.010, 71A.12.030, and Title 71A RCW. WSR 10-07-019, § 388-828-1620, filed 3/8/10, effective 4/8/10. Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-1620, filed 4/23/07, effective 6/1/07.]



388-828-1640
What are the mandatory panels in your DDD assessment?

After DDD has determined your client group, DDD determines the mandatory panels in your DDD assessment using the following tables. An "X" indicates that the panel is mandatory; an "O" indicates the panel is optional. If it is blank, the panel is not used.
(1) DDD "Assessment main" and client details information
 
Client Group
DDD Assessment Panel Name
No Paid Services
Waiver and State Only Residential
Other Medicaid Paid Services
State Only Paid Services
Assessment Main
X
X
X
X
Demographics
X
X
X
X
Overview
X
X
X
X
Addresses
X
X
X
X
Collateral Contacts
X
X
X
X
Financials
X
X
X
X
(2) Supports intensity scale assessment
 
Client Group
DDD Assessment Panel Name
No Paid Services
Waiver and State Only Residential
Other Medicaid Paid Services
State-Only Paid Services
Home Living
X
X
X
X
Community Living
X
X
X
X
Lifelong Learning
X
X
X
X
Employment
X
X
X
X
Health & Safety
X
X
X
X
Social Activities
X
X
X
X
Protection & Advocacy
X
X
X
X
(3) Support assessment for children
 
Client Group
DDD Assessment Panel Name
No Paid Services
Waiver and State Only Residential
Other Medicaid Paid Services
State-Only Paid Services
Activities of Daily Living
X
X
X
X
IADLs (Instrumental Activities of Daily Living)
X
X
X
X
Family Supports
X
X
X
X
Peer Relationships
X
X
X
X
Safety & Interactions
X
X
X
X
(4) Common support assessment panels
DDD Assessment Panel Name
No Paid Services
Waiver and State Only Residential
Other Medicaid Paid Services
State-Only Paid Services
Medical Supports
X
X
X
X
Behavioral Supports
X
X
X
X
Protective Supervision
X
X
X
X
DDD Caregiver Status*
X
X
X
X
Programs and Services
X
X
X
X
*Information on the DDD Caregiver Status panel is not mandatory for clients receiving paid services in an AFH, BH, SL, GH, SOLA, or RHC.
(5) Service level assessment panels
DDD Assessment Panel Name
No Paid Services
Waiver and State Only Residential
Other Medicaid Paid Services
State-Only Paid Services
Environment
 
X
X
O
Medical Main
 
O
X
O
Medications
 
X
X
X
Diagnosis
 
X
X
X
Seizures
 
X
X
X
Medication Management
 
X
X
X
Treatments/programs
 
X
X
X
ADH (Adult Day Health)
 
O
O
O
Pain
 
X
X
X
Indicators-Main
 
O
X
O
Allergies
 
X
X
X
Indicators/Hospital
 
X
X
X
Foot
 
X
X
O
Skin
 
X
X
O
Skin Observation
 
O
O
O
Vitals/Preventative
 
X
X
O
Comments
 
O
O
O
Communication-Main
 
O
X
O
Speech/Hearing
 
O
X
O
Psych/Social
 
O
X
O
MMSE (Mini-Mental Status Exam)
 
O
X
O
Memory
 
O
X
O
Behavior
 
O
X
O
Depression
 
O
X
O
Suicide
 
O
O
O
Sleep
 
O
O
O
Relationships & Interests
 
O
O
O
Decision Making
 
O
X
O
Goals
 
X
O
O
Legal Issues
 
O
O
O
Alcohol
 
O
O
O
Substance Abuse
 
O
O
O
Tobacco
 
O
X
O
Mobility Main
 
O
X
O
Locomotion In Room
 
O
X
O
Locomotion Outside Room
 
O
X
O
Walk in Room
 
O
X
O
Bed Mobility
 
O
X
O
Transfers
 
O
X
O
Falls
 
O
O
O
Toileting-Main
 
O
X
O
Bladder/Bowel
 
O
X
O
Toilet Use
 
O
X
O
Eating-Main
 
O
X
O
Nutritional/Oral
 
O
X
O
Eating
 
O
X
O
Meal Preparation
 
O
X
O
Hygiene-Main
 
O
X
O
Bathing
 
O
X
O
Dressing
 
O
X
O
Personal Hygiene
 
O
X
O
Household Tasks
 
O
X
O
Transportation
 
O
X
O
Essential Shopping
 
O
X
O
Wood Supply
 
O
X
O
Housework
 
O
X
O
Finances
 
O
O
O
Pet Care
 
O
O
O
Functional Status
 
O
O
O
Employment Support*
 
X*
X*
X*
Mental Health
 
X
X
X
DDD Sleep*
 
X*
O
O
*Indicates that:
(a) The "Employment Support" panel is mandatory only for clients age twenty-one and older who are on or being considered for one of the county services listed in WAC 388-828-1440(2).
(b) The "DDD Sleep" panel is mandatory only for clients who are age eighteen or older and who are receiving:
(i) DDD HCBS Core or Community Protection waiver services; or
(ii) State-Only residential services.
[Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW. WSR 08-12-037, § 388-828-1640, filed 5/30/08, effective 7/1/08; WSR 07-10-029, § 388-828-1640, filed 4/23/07, effective 6/1/07.]



388-828-2000
What is the support assessment module?

The support assessment module is the first section of the DDD assessment and is administered to all DDD clients.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-2000, filed 4/23/07, effective 6/1/07.]



388-828-2020
What 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 assessment per WAC 388-828-1100;
(2) Promote a consistent process to evaluate client support needs;
(3) Determine whether a person meets the ICF/MR 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.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-2020, filed 4/23/07, effective 6/1/07.]



388-828-2040
What 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 protective supervision acuity scale;
(4) DDD caregiver status acuity scale;
(5) DDD activities of daily living (ADL) acuity scale;
(6) DDD behavioral acuity scale;
(7) DDD medical acuity scale;
(8) DDD interpersonal support acuity scale;
(9) DDD mobility acuity scale;
(10) DDD respite assessment; and
(11) Programs and services component.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-2040, filed 4/23/07, effective 6/1/07.]



388-828-2060
How 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 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 Protective Supervision Acuity Scale
Yes
Yes
DDD Caregiver Status Acuity Scale
Yes
Yes
DDD Activities of Daily Living Acuity Scale
Yes
Yes
DDD Behavioral Acuity Scale
Yes
Yes
DDD Medical Acuity Scale
Yes
Yes
DDD Interpersonal Support Acuity Scale
Yes
Yes
DDD Mobility Scale
Yes
Yes
Current Programs and Services component
Yes
Yes
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-2060, filed 4/23/07, effective 6/1/07.]



388-828-2080
How does DDD determine your assessment age?

If you are within thirty calendar days of your next birthday, DDD determines your assessment age to be that of your next birthday.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-2080, filed 4/23/07, effective 6/1/07.]



388-828-3000
What is the purpose of the support assessment for children?

The support assessment for children measures the support needs of children from birth to age fifteen.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-3000, filed 4/23/07, effective 6/1/07.]



388-828-3020
What 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 level of care score for DDD 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 HCBS waiver; and
(3) Your support need levels for:
(a) The DDD activities of daily living acuity scale;
(b) The DDD interpersonal support acuity scale; and
(c) The DDD mobility acuity scale.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-3020, filed 4/23/07, effective 6/1/07.]



388-828-3040
What questions are asked in the support assessment for children and how are they scored?

DDD 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
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-3040, filed 4/23/07, effective 6/1/07.]



388-828-3060
How does DDD determine your total LOC score for ICF/MR level of care if you are age birth through fifteen years old?

DDD determines your total LOC score for ICF/MR level of care by adding all of your LOC scores on questions one through eighteen in the support assessment for children.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-3060, filed 4/23/07, effective 6/1/07.]



388-828-3080
How does DDD determine if you meet the eligibility requirements for ICF/MR level of care (LOC) if you are age birth through fifteen years old?

DDD determines you are eligible for ICF/MR 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.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-3080, filed 4/23/07, effective 6/1/07.]



388-828-4000
What is the supports intensity scale (SIS) assessment?

The supports intensity scale assessment is a standardized tool developed by the American Association on Intellectual and Developmental Disabilities (AAIDD), to measure the relative intensity of support needs for persons age sixteen and older.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-4000, filed 4/23/07, effective 6/1/07.]



388-828-4020
What is the purpose of the supports intensity scale (SIS) assessment?

The purpose of the supports intensity scale assessment in the DDD assessment is to determine all of the following:
(1) Your ICF/MR level of care score for DDD 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 HCBS waiver;
(3) Your DDD behavioral and medical acuity levels regardless of your age; and
(4) Your support need acuity levels specific to the:
(a) DDD activities of daily living acuity scale;
(b) DDD interpersonal support acuity scale; and
(c) DDD mobility acuity scale.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-4020, filed 4/23/07, effective 6/1/07.]



388-828-4040
What scales are contained in the supports intensity scale (SIS) assessment?

The supports intensity scale assessment contains the following:
(1) The support needs scale;
(2) The supplemental protection and advocacy scale;
(3) Exceptional medical support needs scale; and
(4) Exceptional behavioral support needs scale.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-4040, filed 4/23/07, effective 6/1/07.]



388-828-4060
What subscales are contained in the support needs scale?

The support needs scale contains the following subscales:
(1) Home living activities;
(2) Community living activities;
(3) Lifelong learning activities;
(4) Employment activities;
(5) Health and safety activities; and
(6) Social activities.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-4060, filed 4/23/07, effective 6/1/07.]



388-828-4080
How does the SIS measure your support need(s) in the support needs and supplemental protection and advocacy scales?

The SIS measures your support needs in the support needs and supplemental protection and advocacy scales using the following three dimensions of support intensity:
(1) Type of support;
(2) Frequency of support; and
(3) Daily support time.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-4080, filed 4/23/07, effective 6/1/07.]



388-828-4100
How is type of support scored in the SIS assessment?

DDD scores the type of support you need to perform the assessed activity using the following rating scale:
Type of Support: What kind of support is needed for the assessed activity?
Answer
Score
None
0
Monitoring
1
Verbal/gestural prompting
2
Partial physical assistance
3
Full physical assistance
4
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-4100, filed 4/23/07, effective 6/1/07.]



388-828-4120
How is frequency of support scored in the SIS assessment?

DDD scores how frequently support is needed for you to perform the assessed activity using the following rating scale:
Frequency: How frequently is support needed for the assessed activity?
Answer
Score
None or less than monthly
0
At least once a month, but not once a week
1
At least once a week, but not once a day
2
At least once a day, but not once an hour
3
Hourly or more frequently
4
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-4120, filed 4/23/07, effective 6/1/07.]



388-828-4140
How is daily support time scored in the SIS assessment?

DDD scores the amount of daily support time you need to perform the assessed activity using the following rating scale:
Daily Support Time: On a typical day when support in this area is needed, how much time should be devoted?
Answer
Score
None
0
Less than 30 minutes
1
30 minutes to less than 2 hours
2
2 hours to less than 4 hours
3
4 hours or more
4
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-4140, filed 4/23/07, effective 6/1/07.]



388-828-4160
How does DDD determine your raw score for each of the activities that are assessed in the support needs and supplemental protection and advocacy scales?

DDD adds the three dimensions of support intensity scores for each activity to determine your raw score for the activity.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-4160, filed 4/23/07, effective 6/1/07.]



388-828-4165
How does DDD determine your total raw score for each subscale in the SIS support needs scale?

(1) DDD adds the raw scores (WAC 388-828-4160) for each activity assessed in each subscale of the SIS support needs scale to determine your total raw score for that subscale.
(2) The raw score for question number 9 in the home living activities subscale (WAC 388-828-4200) "using currently prescribed equipment or treatment" is not included in the total raw score for the home living activities subscale.
[Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-01-080, § 388-828-4165, filed 12/18/12, effective 1/18/13.]



388-828-4180
Are all questions in the support needs and supplemental protection and advocacy scales scored the same way?

Some questions in the support needs and supplemental protection and advocacy scales have scoring limitations and some scores are not available for selection related to the standardization process per AAIDD.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-4180, filed 4/23/07, effective 6/1/07.]



388-828-4200
What activities are assessed in the home living activities subscale of the support needs scale?

The home living activities subscale measures your personal support needs for the following home living activities:
#
Home living activities
Type of support
Frequency of support
Daily support time
Raw score
A1
Operating home appliances/electronics
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
 
A2
Bathing and taking care of personal hygiene and grooming needs
0
1
2
3
4
0
1
2
3
*
0
1
2
3
4
 
A3
Using the toilet
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
 
A4
Dressing
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
 
A5
Preparing food
0
1
2
3
4
0
1
2
3
*
0
1
2
3
4
 
A6
Eating food
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
 
A7
Taking care of clothes, including laundering
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
 
A8
Housekeeping and cleaning
0
1
2
3
4
0
1
2
3
4
0
1
2
*
*
 
A9
Using currently prescribed equipment or treatment
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
 
Total raw score for home living activities:
 
* = Score is not an option per AAIDD.
Note: Question A9 is a question added by DDA. It is for informational purposes only and is not used to calculate scores or levels for service determination.
[Statutory Authority: RCW 71A.12.030 and 71A.12.120. WSR 19-02-020, § 388-828-4200, filed 12/21/18, effective 2/1/19. Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-4200, filed 4/23/07, effective 6/1/07.]



388-828-4220
What activities are assessed in the community living activities subscale of the support needs scale?

The community living activities subscale measures your personal support needs for the following community living activities:
#
Community living activities
Type of support
Frequency of support
Daily support time
Raw score
B1
Getting from place to place throughout the community (transportation)
0
1
2
3
4
0
1
2
3
*
0
1
2
3
4
 
B2
Participating in recreation/leisure activities in community
0
1
2
3
4
0
1
2
3
*
0
1
2
3
4
 
B3
Participating in preferred community activities (churches, volunteer, etc.)
0
1
2
3
4
0
1
2
3
*
0
1
2
3
4
 
B4
Accessing public buildings and settings
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
 
B5
Using public services in the community
0
1
2
3
4
0
1
2
3
*
0
1
2
3
4
 
B6
Shopping and purchasing goods and services
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
 
B7
Interacting with community members
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
 
B8
Going to visit friends and family
0
1
2
3
4
0
1
2
3
*
0
1
2
3
4
 
Total raw score for community living activities:
 
* = Score is not an option per AAIDD.
[Statutory Authority: RCW 71A.12.030 and 71A.12.120. WSR 19-02-020, § 388-828-4220, filed 12/21/18, effective 2/1/19. Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-4220, filed 4/23/07, effective 6/1/07.]



388-828-4240
What activities are assessed in the lifelong learning activities subscale of the support needs scale?

The lifelong learning activities subscale measures your personal support needs for the following lifelong learning activities:
#
Lifelong learning activities
Type of support
Frequency of support
Daily support time
Raw score
C1
Learning and using problem-solving strategies
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
 
C2
Learning functional academics (reading signs, counting change, etc.)
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
 
C3
Learning health and physical education skills
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
 
C4
Learning self-determination skills
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
 
C5
Learning self-management strategies
0
1
2
3
4
0
1
2
3
*
0
1
2
3
4
 
C6
Participating in training/educational decisions
0
1
2
3
4
0
1
2
3
*
0
1
2
3
*
 
C7
Accessing training/educational settings
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
 
C8
Interacting with others in learning activities
0
1
2
3
4
0
1
2
3
*
0
1
2
3
4
 
C9
Using technology for learning
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
 
Total raw score for lifelong learning activities:
 
* = Score is not an option per AAIDD.
[Statutory Authority: RCW 71A.12.030 and 71A.12.120. WSR 19-02-020, § 388-828-4240, filed 12/21/18, effective 2/1/19. Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-4240, filed 4/23/07, effective 6/1/07.]



388-828-4260
What activities are assessed in the employment activities subscale of the support needs scale?

The employment activities subscale measures your personal support needs for the following employment activities:
#
Employment activities
Type of support
Frequency of support
Daily support time
Raw score
D1
Learning and using specific job skills
0
1
2
3
4
0
1
2
3
*
0
1
2
3
4
 
D2
Accessing/receiving job/task accommodations
0
1
2
3
4
0
1
2
3
*
0
1
2
3
4
 
D3
Interacting with co-workers
0
1
2
3
4
0
1
2
3
*
0
1
2
3
4
 
D4
Interacting with supervisors /coaches
0
1
2
3
4
0
1
2
3
*
0
1
2
3
4
 
D5
Completing work-related tasks with acceptable speed
0
1
2
3
4
0
1
2
3
*
0
1
2
3
4
 
D6
Completing work-related tasks with acceptable quality
0
1
2
3
4
0
1
2
3
*
0
1
2
3
4
 
D7
Changing job assignments
0
1
2
3
4
0
1
2
*
*
0
1
2
3
4
 
D8
Seeking information and assistance from an employer
0
1
2
3
4
0
1
2
3
*
0
1
2
3
4
 
Total raw score for employment activities:
 
* = Score is not an option per AAIDD.
[Statutory Authority: RCW 71A.12.030 and 71A.12.120. WSR 19-02-020, § 388-828-4260, filed 12/21/18, effective 2/1/19. Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-4260, filed 4/23/07, effective 6/1/07.]



388-828-4280
What activities are assessed in the health and safety activities subscale of the support needs scale?

The health and safety activities subscale measures your personal support needs for the following health and safety activities:
#
Health and safety activities
Type of support
Frequency of support
Daily support time
Raw score
E1
Taking medications
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
 
E2
Ambulating and moving about
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
 
E3
Avoiding health and safety hazards
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
 
E4
Obtaining health care services
0
1
2
3
4
0
1
2
3
4
0
1
2
*
*
 
E5
Learning how to access emergency services
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
 
E6
Maintaining a nutritious diet
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
 
E7
Maintaining physical health and fitness
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
 
E8
Maintaining emotional well-being
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
 
Total raw score for health and safety activities:
 
* = Score is not an option per AAIDD.
[Statutory Authority: RCW 71A.12.030 and 71A.12.120. WSR 19-02-020, § 388-828-4280, filed 12/21/18, effective 2/1/19. Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-4280, filed 4/23/07, effective 6/1/07.]



388-828-4300
What activities are assessed in the social activities subscale of the support needs scale?

The social activities subscale measures your personal support needs for the following social activities:
#
Social activities
Type of support
Frequency of support
Daily support time
Raw score
F1
Using appropriate social skills
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
 
F2
Participating in recreation /leisure activities with others
0
1
2
3
4
0
1
2
3
*
0
1
2
3
4
 
F3
Socializing outside the household
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
 
F4
Making and keeping friends
0
1
2
3
4
0
1
2
3
*
0
1
2
3
4
 
F5
Engaging in loving and intimate relationships
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
 
F6
Socializing within the household
0
1
2
3
4
0
1
2
3
*
0
1
2
3
4
 
F7
Communicating with others about personal needs
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
 
F8
Engaging in volunteer work
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
 
Total raw score for social activities:
 
* = Score is not an option per AAIDD.
[Statutory Authority: RCW 71A.12.030 and 71A.12.120. WSR 19-02-020, § 388-828-4300, filed 12/21/18, effective 2/1/19. Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-4300, filed 4/23/07, effective 6/1/07.]



388-828-4320
What activities are assessed in the supplemental protection and advocacy activities subscale?

The supplemental protection and advocacy activities subscale measures your personal support needs for the following protection and advocacy activities:
#
Protection and advocacy activities
Type of support
Frequency of support
Daily support time
Raw score
G1
Advocating for self
0
1
2
3
4
0
1
2
3
*
0
1
2
3
4
 
G2
Making choices and decisions
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
 
G3
Protecting self from exploitation
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
 
G4
Exercising legal/civic responsibilities
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
 
G5
Belonging to and participating in self-advocacy/support organizations
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
 
G6
Obtaining legal services
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
 
G7
Managing money and personal finances
0
1
2
3
4
0
1
2
3
4
0
1
2
3
4
 
G8
Advocating for others
0
1
2
3
4
0
1
2
3
*
0
1
2
3
4
 
Total raw score for protection and advocacy activities:
 
* = Score is not an option for AAIDD.
[Statutory Authority: RCW 71A.12.030 and 71A.12.120. WSR 19-02-020, § 388-828-4320, filed 12/21/18, effective 2/1/19. Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-4320, filed 4/23/07, effective 6/1/07.]



388-828-4340
How does DDD determine your support score for each of the items identified in the SIS exceptional medical and behavioral support needs scales?

DDD examines the amount of support you need for medical treatments and behavioral support using the following rating scale:
Answer
Score
No support needed
0
Some support needed
1
Extensive support needed
2
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-4340, filed 4/23/07, effective 6/1/07.]



388-828-4360
What exceptional medical support activities are evaluated to assess your medical support needs?

The SIS exceptional medical support needs scale measures your personal support needs for the following medical support need(s) activities:
#
Medical supports needed
No support needed
Some support needed
Extensive support needed
1.
Inhalation or oxygen therapy
0
1
2
2.
Postural drainage
0
1
2
3.
Chest PT
0
1
2
4.
Suctioning
0
1
2
5.
Oral stimulation or jaw positioning
0
1
2
6.
Tube feeding (e.g., nasogastric)
0
1
2
7.
Parenteral feeding (e.g., IV)
0
1
2
8.
Turning or positioning
0
1
2
9.
Dressing of open wound(s)
0
1
2
10.
Protection from infectious diseases due to immune system impairment
0
1
2
11.
Seizure management
0
1
2
12.
Dialysis
0
1
2
13.
Ostomy care
0
1
2
14.
Lifting and/or transferring
0
1
2
15.
Therapy services
0
1
2
16.
Hypertension
0
1
2
17.
Allergies
0
1
2
18.
Diabetes
0
1
2
19.
Other(s) - specify
0
1
2
Subtotal scores of 1s and 2s:
 
 
Add subtotals scores for 1s and 2s for total exceptional medical support needs score:
 
[Statutory Authority: RCW 71A.12.030 and 71A.12.120. WSR 19-02-020, § 388-828-4360, filed 12/21/18, effective 2/1/19. Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-4360, filed 4/23/07, effective 6/1/07.]



388-828-4380
What exceptional behavioral support activities are evaluated to assess your behavioral support needs?

The SIS exceptional behavioral support needs scale measures your personal support needs for the following behaviors:
#
Behavioral supports needed
No support needed
Some support Needed
Extensive support needed
1.
Prevention of emotional outbursts
0
1
2
2.
Prevention of assault or injury to others
0
1
2
3.
Prevention of property destruction (e.g. fire setting, breaking furniture)
0
1
2
4.
Prevention of stealing
0
1
2
5.
Prevention of self-injury
0
1
2
6.
Prevention of suicide attempts
0
1
2
7.
Prevention of PICA (ingestion of inedible substances)
0
1
2
8.
Prevention of nonaggressive but inappropriate behavior (e.g., exposes self in public, exhibitionism, inappropriate touching or gesturing)
0
1
2
9.
Prevention of sexual aggression
0
1
2
10.
Prevention of substance abuse
0
1
2
11.
Prevention of wandering
0
1
2
12.
Maintenance of mental health treatments
0
1
2
13.
Managing attention-seeking behavior*
0
1
2
14.
Managing uncooperative behavior*
0
1
2
15.
Managing agitated/over reactive behavior*
0
1
2
16.
Managing obsessive/repetitive behavior*
0
1
2
17.
Prevention of other serious behavior problem(s) - Specify:
0
1
2
Subtotal scores of 1s and 2s:
 
 
Add subtotals scores for 1s and 2s for total exceptional behavioral support needs scores:
 
* #13-16 are questions added by DDA. They are used as part of the DDA behavior acuity scale and are not used to calculate SIS percentiles.
[Statutory Authority: RCW 71A.12.030 and 71A.12.120. WSR 19-02-020, § 388-828-4380, filed 12/21/18, effective 2/1/19. Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-4380, filed 4/23/07, effective 6/1/07.]



388-828-4400
How 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 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
[Statutory Authority: RCW 71A.12.030 and 71A.12.120. WSR 19-02-020, § 388-828-4400, filed 12/21/18, effective 2/1/19. Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-4400, filed 4/23/07, effective 6/1/07.]



388-828-4420
How does DDD determine your percentile rank and standard score for each subscale in the SIS support needs scale?

DDD uses the following table to convert your total raw score for each subscale into a percentile ranking:
If your raw score for the following SIS subscale is:
 
 
Home Living
Community Living
Lifelong Learning
Employment Support
Health and Safety
Social Activities
Then your percentile rank for the SIS subscale is:
And your standard score for the SIS subscale is:
 
 
 
 
 
 
˃99
20
˃88
˃94
 
 
 
 
˃99
19
87-88
93-94
 
 
 
 
˃99
18
85-86
91-92
 
 
˃97
 
99
17
81-84
88-90
˃96
˃95
92-97
˃97
98
16
77-80
84-87
92-96
91-95
86-91
91-97
95
15
73-76
79-83
86-91
85-90
79-85
84-90
91
14
68-72
74-78
79-85
78-84
72-78
76-83
84
13
62-67
69-73
72-78
70-77
65-71
68-75
75
12
55-61
63-68
64-71
61-69
57-64
58-67
63
11
48-54
56-62
55-63
52-60
49-56
48-57
50
10
40-47
49-55
46-54
42-51
42-48
38-47
37
9
32-39
41-48
36-45
32-41
34-41
28-37
25
8
25-31
33-40
27-35
23-31
27-33
19-27
16
7
18-24
25-32
18-26
15-22
20-26
10-18
9
6
11-17
16-24
9-17
7-14
13-19
3-9
5
5
3-10
6-15
<9
<7
7-12
<3
2
4
<3
<6
 
 
1-6
 
1
3
 
 
 
 
<1
 
<1
2
 
 
 
 
 
 
<1
1
[Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-01-080, § 388-828-4420, filed 12/18/12, effective 1/18/13. Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-4420, filed 4/23/07, effective 6/1/07.]



388-828-4440
How does DDD determine your SIS support needs index percentile ranking?

(1) DDD determines your SIS support needs index percentile ranking by adding together the standard scores (WAC 388-828-4420) for the following supports intensity scale assessment subscales:
(a) Home living activities in WAC 388-828-4200.
(b) Community living activities in WAC 388-828-4220.
(c) Lifelong learning activities in WAC 388-828-4240.
(d) Employment activities in WAC 388-828-4260.
(e) Health and safety activities in WAC 388-828-4280.
(f) Social activities in WAC 388-828-4300.
(2) Your standard scores for the above scales are added together to determine the sum of the standard scores.
(3) The supplemental protection and advocacy activities scale, and the exceptional medical and behavioral supports scales are not used in determining your support needs index percentile ranking.
(4) The sum of the standard scores is converted to your support needs index percentile ranking using the following table:
If the sum of the standard scores is:
Your support needs index percentile is:
≥91
˃99
90
99
89
99
88
99
87
98
86
98
85
97
84
97
83
96
82
95
81
95
80
94
79
93
78
92
77
91
76
89
75
87
74
86
73
84
72
82
71
81
70
77
69
75
68
73
67
70
66
68
65
65
64
63
63
58
62
55
61
53
60
50
59
47
58
45
57
39
56
37
55
35
54
32
53
30
52
27
51
25
50
23
49
19
48
18
47
16
46
14
45
13
44
13
43
9
42
8
41
7
40
6
39
5
38
5
37
4
36
3
35
3
34
2
33
2
32
1
31
1
30
1
≤29
<1
[Statutory Authority: RCW 71A.12.030 and 2012 c 49. WSR 13-01-080, § 388-828-4440, filed 12/18/12, effective 1/18/13.]



388-828-5000
What is the DDD protective supervision acuity scale?

The DDD protective supervision acuity scale is an assessment of your protective supervision support need(s).
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-5000, filed 4/23/07, effective 6/1/07.]



388-828-5020
How is information in the protective supervision acuity scale used by DDD?

(1) Information obtained in the protective supervision acuity scale is one of the factors used by DDD to determine:
(a) The amount of waiver respite, if any, that you are authorized to receive;
(b) Your individual and family services level, if you are authorized to receive individual and family services per chapter 388-832 WAC; and
(c) Your residential service level of support, if you are authorized to receive a residential service listed in WAC 388-828-9510.
(2) The protective supervision acuity scale is not used when determining your medicaid personal care or waiver personal care; and
(3) The information is used for reporting purposes to the legislature and the department.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 09-06-047, § 388-828-5020, filed 2/25/09, effective 3/28/09; WSR 08-12-037, § 388-828-5020, filed 5/30/08, effective 7/1/08; WSR 07-10-029, § 388-828-5020, filed 4/23/07, effective 6/1/07.]



388-828-5040
What questions are asked in the DDD protective supervision acuity scale?

The three questions that are asked for the DDD protective supervision acuity scale are in WAC 388-828-5060.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-5040, filed 4/23/07, effective 6/1/07.]



388-828-5060
How does DDD score each question?

DDD selects one answer per each question that best describes your reported need.
(1) What level of monitoring does the client typically require during awake hours?
Answers
Definitions
Score
Independent
Can be left unattended. Might occasionally show poor judgement, but does not require routine access to a support person.
0
Remote (e.g., a week or more)
Can be left unattended for extended periods of time, but requires access to a support person either via phone or someone who visits the person weekly or so.
1
Periodic (e.g., every couple of days)
Can be left unattended for a couple of days, but requires access to a support person who checks in every few days via telephone or in person.
2
Monitoring (e.g., half day, unstructured)
Can be left unattended for several hours at a time (2-4 hours) to engage in independent activities, but needs access to a support person daily for guidance or assistance.
3
Close proximity (e.g., 1-2 hours, structured)
Can be left unattended for short periods of time (1-2 hours), provided that the environment is strictly structured and that a support person can respond quickly in an emergency situation.
4
Onsite (e.g., on property)
Cannot be left unattended. Requires a support person on the property at all times, at least during awake hours.
5
Line of sight/earshot (e.g., close observation)
Cannot be left unattended. Requires a support person within the room or within earshot of the client's location at all times during awake hours.
6
(2) What assistance does the client need to handle unfamiliar or unexpected situations?
Answers
Definitions
Can resolve independently
The client can generally handle unfamiliar or unexpected situations. The client shows generally good judgment and awareness of personal safety.
Can resolve with remote assistance
The client can handle unfamiliar or unexpected situations by calling or contacting someone remotely for assistance (e.g., by telephone or email). The support person does not need to be physically present.
Needs someone physically present to assist
When unfamiliar or unexpected situations occur, generally someone must be present or come to the client to help the client resolve the issue.
Needs full physical assistance
The client cannot generally participate in resolving such situations; someone else must resolve them.
(3) Is client able to summon help?
Answers
Definitions
Can call someone on telephone
Client can discern when help is needed and contact someone via telephone or other electronic means. This includes dialing 911, using speed dial to contact someone, email, radio, or dialing a phone number.
Can seek help outside the house, nearby
Client can discern when help is needed and can summon a remote caregiver, neighbor, or other person outside the house or nearby to assist when necessary.
Can seek help inside house
Client can discern when help is needed and can summon a caregiver or roommate within the house to assist when necessary.
Cannot summon help
Client is unable to summon help or discern a dangerous situation that would require help.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-5060, filed 4/23/07, effective 6/1/07.]



388-828-5080
How does DDD determine your adjusted protective supervision acuity score?

DDD determines your adjusted protective supervision acuity score by applying the following age-based score adjustments to your level of monitoring score for question number one in WAC 388-828-5060:
If you are:
Then your age-based score adjustment is:
18 years or older
Score is equal to your level of monitoring score
16-17 years of age
Subtract 2 from your level of monitoring score
12-15 years of age
Subtract 3 from your level of monitoring score
8-11 years of age
Subtract 4 from your level of monitoring score
5-7 years of age
Subtract 5 from your level of monitoring score
0-4 years of age
Subtract 6 from your level of monitoring score
If your adjusted level of monitoring score is a negative number, your adjusted protective supervision acuity score is zero.
Example: If you are fifteen years old and "close proximity, (e.g., 1-2 hours, structured)" is identified as your level of monitoring score, your adjusted protective supervision acuity score is: Your close proximity score of four minus age-based score adjustment of three. For age twelve through fifteen, this equals an adjusted protective supervision score of one.
[Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW. WSR 08-12-037, § 388-828-5080, filed 5/30/08, effective 7/1/08; WSR 07-10-029, § 388-828-5080, filed 4/23/07, effective 6/1/07.]



388-828-5100
How does DDD determine your protective supervision support level?

DDD uses the following table in determining your protective supervision support level:
If your Adjusted Protective Supervision Score is:
Then your Protective Supervision Support Level is:
5-6
High
3-4
Medium
1-2
Low
0
None
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-5100, filed 4/23/07, effective 6/1/07.]



388-828-5120
What is the DDD caregiver status acuity scale?

The DDD caregiver status acuity scale is an assessment of risks associated with your caregiver's ability to provide care.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-5120, filed 4/23/07, effective 6/1/07.]



388-828-5140
How is information in the DDD caregiver status acuity scale used by DDD?

(1) Information obtained in the DDD caregiver status acuity scale is one of the factors used by DDD to determine:
(a) The amount of waiver respite, if any, that you are authorized to receive; and
(b) Your individual and family services level, if you are authorized to receive individual and family services.
(2) The DDD caregiver status acuity scale does not affect service determination for the medicaid personal care or waiver personal care assessment; and
(3) The information is used for reporting purposes to the legislature and the department.
[Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW. WSR 08-12-037, § 388-828-5140, filed 5/30/08, effective 7/1/08; WSR 07-10-029, § 388-828-5140, filed 4/23/07, effective 6/1/07.]



388-828-5160
When is a collateral contact an informal caregiver?

A collateral contact is an informal caregiver when the person provides you supports without payment from DDD for a service.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-5160, filed 4/23/07, effective 6/1/07.]



388-828-5180
When is a collateral contact a formal caregiver?

A collateral contact is a formal caregiver when the person receives payment from DDD to provide you a service.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-5180, filed 4/23/07, effective 6/1/07.]



388-828-5200
When is a collateral contact a backup caregiver?

A collateral contact is only a backup caregiver when:
(1) He or she has been identified as an informal caregiver; and
(2) He or she is available to provide assistance as an informal caregiver when other caregivers are unavailable.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-5200, filed 4/23/07, effective 6/1/07.]



388-828-5220
Are you allowed to identify more than one person as a backup caregiver?

There are no limitations regarding the number of persons you are allowed to identify as backup caregivers.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-5220, filed 4/23/07, effective 6/1/07.]



388-828-5240
Who is your primary caregiver?

Your primary caregiver is the formal or informal caregiver who provides you with the most support.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-5240, filed 4/23/07, effective 6/1/07.]



388-828-5260
What questions are asked in the DDD caregiver status acuity scale and how are your caregiver's answers scored?

The DDD caregiver status acuity scale consists of six questions that must be answered by your primary caregiver. Scores for each question are determined based on your primary caregiver's response for each question.
(1) Overall, how stressed do you feel in caring for the client?
Answers
Score
Not stressed
0
Somewhat stressed
4
Very stressed
9
(2) Other care giving for persons who are disabled, seriously ill, or under age 5?
Answers
Score
Client is the only person who requires direct care
0
Part-time responsibility for one or more additional persons
1
Full-time responsibility for one additional person
2
Full-time responsibility for two or more additional persons
4
(3) Factors that make it hard to be a caregiver for client?
Answers
Score
Decline in physical health
1
Decline in emotional health
1
Negative impact on employment
1
Getting less than 5 hours of uninterrupted sleep because of care giving
1
Health or safety impact
1
Other issues than impact care giving
1
(4) How much do these things impact your ability to care for the client?
Answers
Score
Little or no impact
0
Possible impact, no concrete evidence
1
Concrete evidence of reduced care
4
Unable
9
(5) Is the client creating significant stress on other household members?
Answers
Score
Stable and healthy
0
Clearly identifiable signs of stress
4
Serious risk of failure
9
(6) How long do you expect to continue providing care?
Answers
Score
2 or more years
0
6 months to 2 years
0
1 to 6 months
4
Less than 1 month
9
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-5260, filed 4/23/07, effective 6/1/07.]



388-828-5280
Which caregiver risk factors determine the caregiver risk level?

The following criteria are used to determine a caregiver's risk level:
If the following criteria are met:
Then your caregiver risk factor (s) are:
(1) You have a score of "less than 1 month" for question 6 ("How long do you expect to continue providing care?") in WAC 388-828-5260.
Immediate risk of loss of caregiver
(2) You have not identified any collateral contacts in the CARE system as having a contact role of "informal caregiver;" and
(3) You have not identified any collateral contacts in the CARE system as having a contact role of "formal caregiver;" and
(4) You have not identified any collateral contacts in the CARE system as having a contact role of "backup caregiver;" and
(5) You do not have a paid provider, authorized by DDD, to provide supports for a DDD paid service; and
(6) You have an adjusted protective supervision score of 3 or more in WAC 388-828-5080.
No caregiver, and needs one
(7) You have identified one of your collateral contacts in the CARE system as having a contact role of primary caregiver; and
(8) Your primary caregiver is 70 years of age or older; and
(9) Your primary caregiver lives with you in the same residence.
Aging caregiver
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-5280, filed 4/23/07, effective 6/1/07.]



388-828-5300
How does DDD determine a caregiver risk level?

(1) The following table reflects the criteria that are used to calculate the caregiver risk level score:
Your scores for the following questions in
Your Caregiver Risk Level
Your score for question 4
Your score for question 5
Your score for question 6
 
0
0
0
None
0
0
4
Medium
0
0
9
Immediate
0
4
0
Medium
0
4
4
Medium
0
4
9
Immediate
0
9
0
High
0
9
4
High
0
9
9
Immediate
1
0
0
Low
1
0
4
Medium
1
0
9
Immediate
1
4
0
Medium
1
4
4
Medium
1
4
9
Immediate
1
9
0
High
1
9
4
High
1
9
9
Immediate
4
0
0
Medium
4
0
4
Medium
4
0
9
Immediate
4
4
0
Medium
4
4
4
Medium
4
4
9
Immediate
4
9
0
High
4
9
4
High
4
9
9
Immediate
9
0
0
High
9
0
4
High
9
0
9
Immediate
9
4
0
High
9
4
4
High
9
4
9
Immediate
9
9
0
High
9
9
4
High
9
9
9
Immediate
(2) If your maximum scores for questions four, five, and six are four or less and you have an "Aging caregiver" risk factor in WAC 388-828-5280, your caregiver risk level is medium.
(3) If your caregiver risk factor is "No caregiver, and needs one" in WAC 388-828-5280, your caregiver risk level is immediate regardless of your scores for questions four, five, and six.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-5300, filed 4/23/07, effective 6/1/07.]



388-828-5320
How does DDD determine the availability of a backup caregiver?

DDD's determination of availability of a back up caregiver is based on the responses of you and your respondent(s) to the following question:
(1) Under what conditions are other caregivers available?
Answers available for selection
Score
Routinely provides care
0
Upon request
2
Emergency only
4
No other caregiver available
9
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-5320, filed 4/23/07, effective 6/1/07.]



388-828-5340
How does DDD determine whether a backup caregiver lives with you?

You or your respondent identifies that your backup caregiver(s) lives with you.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-5340, filed 4/23/07, effective 6/1/07.]



388-828-5360
How does DDD determine the risk level score of your backup caregiver not being able to provide the supports you need when you need them?

The following table identifies the criteria that are used to calculate the risk level score of your backup caregiver not being able to provide the supports you need when you need them:
If the availability of your backup caregiver is:
Then your risk level score is:
(1) Your backup caregivers are available routinely or upon request as evidenced by a score of 0 to 2 for question 1 of the backup caregiver subscale; and
(2) You have a person identified as a backup caregiver that does not live with you evidenced by the "Lives with client" checkbox not being selected as contact details information for him or her.
1
(Not at risk)
(3) Your backup caregivers are available upon an emergency only basis evidenced by a score of 4 for question 1 of the backup caregiver subscale; or
(4) "Lives with client" has been selected for all of the persons you have identified as your backup caregivers.
2
(Some risk)
(5) You have no other caregiver available evidenced by a score of 9 for question 1 of the backup caregiver subscale.
3
(High risk)
[Statutory Authority: RCW 71A.12.30 [71A.12.030] and Title 71A RCW. WSR 08-12-037, § 388-828-5360, filed 5/30/08, effective 7/1/08; WSR 07-10-029, § 388-828-5360, filed 4/23/07, effective 6/1/07.]



388-828-5380
What is the DDD activities of daily living (ADL) acuity scale?

The DDD activities of daily living acuity scale is an algorithm that determines your ADL support needs level.
(1) The DDD activities of daily living acuity scale does not affect service determination for the medicaid personal care or waiver personal care assessments; and
(2) The information is used for reporting purposes to the legislature and the department.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-5380, filed 4/23/07, effective 6/1/07.]



388-828-5400
What does the activities of daily living (ADL) acuity scale measure?

The DDD ADL acuity scale measures:
(1) Your ADL support needs level from the support assessment for children if you are age birth through fifteen years old; or
(2) Your ADL support needs level from the SIS assessment if you are age sixteen or older.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-5400, filed 4/23/07, effective 6/1/07.]



388-828-5420
How does DDD determine your ADL support needs score if you are age birth through fifteen?

If you are a child age birth through fifteen, your ADL support needs score is the total of your acuity scores for each of the following ADL questions in the support assessment for children:
ADL questions from the Support Assessment for Children in WAC 388-828-3040
Question #
Text of ADL Questions:
1
Dress and Groom self
2
Toilet self
3
Eat at age level
4
Move around
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-5420, filed 4/23/07, effective 6/1/07.]



388-828-5440
How does DDD use your ADL support needs score for the support assessment for children?

(1) DDD uses your ADL support needs score and the following table to determine your ADL support needs level for the support assessment for children:
If your ADL support needs score is:
Then your ADL support need level is:
Value
11 to 16
High
3
7 to 10
Medium
2
2 to 6
Low
1
0 or 1
None
0
(2) If your acuity score is four for any of the ADL questions in WAC 388-828-3040, your ADL support needs level is determined to be high.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-5440, filed 4/23/07, effective 6/1/07.]



388-828-5460
How does DDA determine your ADL support needs score if you are age sixteen or older?

(1) If you are age sixteen or older, your ADL support needs score is the total adjusted "Type of support" scores from the following SIS questions:
ADL questions from the SIS assessment in WAC 388-828-4200 and 388-828-4280
Question #
Text of ADL questions:
A2
Bathing and taking care of personal hygiene and grooming needs
A3
Using the toilet
A4
Dressing
A6
Eating food
E1
Taking medications
E2
Ambulating and moving about
(2) If your "Frequency of support" score for a SIS ADL question is zero or one, adjust your "Type of support" score for that question to zero.
(3) If your "Frequency of support" score for a SIS ADL support question is two, three, or four, no adjustment is needed to your "Type of support" score.
Example:
SIS ADL Questions
Text of SIS ADL Questions
If your "Frequency of Support" score is:
And your
"Type of Support" score is:
Then your adjusted "Type of Support" score is:
A2
Bathing and taking care of personal hygiene and grooming needs
1
2
0
A3
Using the toilet
3
3
3
A4
Dressing
3
3
3
A6
Eating food
1
2
0
E1
Taking medications
3
2
2
E2
Ambulating and moving about
0
0
0
Your SIS ADL support needs score:
8
[Statutory Authority: RCW 71A.12.030 and 71A.12.120. WSR 19-02-020, § 388-828-5460, filed 12/21/18, effective 2/1/19. Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-5460, filed 4/23/07, effective 6/1/07.]



388-828-5480
How does DDD determine your ADL support needs level for the SIS assessment?

(1) DDD uses your ADL support needs score and the following table to determine your ADL support needs level for the SIS assessment if you are age sixteen or older:
If the sum of your adjusted ADL support needs score for the SIS is:
Then your ADL support needs level for the SIS is:
Value
16 to 24
High
3
10 to 15
Medium
2
2 to 9
Low
1
0 or 1
None
0
(2) If you have a "Type of support" score of four for any of the questions listed in WAC 388-828-5460, your ADL support needs level for the SIS assessment is determined to be high.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-5480, filed 4/23/07, effective 6/1/07.]



388-828-5500
What is the DDD behavioral acuity scale?

The DDD behavioral acuity scale is an assessment of your behavioral support needs based on your scores from the SIS exceptional behavior scale.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-5500, filed 4/23/07, effective 6/1/07.]



388-828-5520
How is information in the DDD behavioral acuity scale used by DDD?

(1) Information obtained in the DDD behavioral acuity scale is one of the factors used by DDD to determine:
(a) The amount of waiver respite, if any, that you are authorized to receive;
(b) Your individual and family services level, if you are authorized to receive individual and family services per chapter 388-832 WAC; and
(c) Your residential service level of support, if you are authorized to receive a residential service listed in WAC 388-828-9510.
(2) The DDD behavioral acuity scale does not affect service determination for the medicaid personal care or waiver personal care assessment.
(3) The information is used for reporting purposes to the legislature and the department.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 09-06-047, § 388-828-5520, filed 2/25/09, effective 3/28/09; WSR 08-12-037, § 388-828-5520, filed 5/30/08, effective 7/1/08; WSR 07-10-029, § 388-828-5520, filed 4/23/07, effective 6/1/07.]



388-828-5540
How does DDD determine if you have a prominent behavior?

You are determined to have a prominent behavior when a question in WAC 388-828-4380 has a support score of one or two.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-5540, filed 4/23/07, effective 6/1/07.]



388-828-5560
Do all prominent behaviors get scored?

If you have two or more prominent behaviors, DDD will ask you and your respondent(s) for input and must select only one behavior to be scored as your most prominent behavior.
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-5560, filed 4/23/07, effective 6/1/07.]



388-828-5580
How does DDD determine the frequency of your most prominent behavior?

If you have a prominent behavior, DDD asks you and your respondent(s) to identify the frequency of occurrence of your most prominent behavior using the following table:
If the frequency of occurrence of your most prominent behavior is:
Then your score for frequency is:
Less than once per month
Rare
1 to 3 times per month
Occasional
1 to 4 times per week
Occasional
1 to 3 times daily
Frequent
4 or more times daily
Frequent
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-5580, filed 4/23/07, effective 6/1/07.]



388-828-5600
How does DDD determine the severity of your most prominent behavior?

If you have a prominent behavior, DDD asks you and your respondent(s) to identify the severity of your most prominent behavior using the following table:
If the characteristics of your most prominent behavior are:
Then your score for severity is:
Your behavior may be uncooperative, inconvenient, repetitive, and/or require time intensive support. However, your behavior is not considered aggressive or self-injurious.
Minor incidents
Your behavior, if allowed to continue over time, may result in life-threatening harm for yourself and/or others.
Potentially dangerous
Your behavior without immediate intervention will result in life-threatening harm for yourself and/or others.
Life threatening
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-5600, filed 4/23/07, effective 6/1/07.]



388-828-5620
How does DDD determine the type of caregiver assistance you receive to help you keep your most prominent behavior under control?

DDD asks you and your respondent(s) to identify the type of caregiver assistance you receive to help you keep your most prominent behavior under control using the following table:
If the caregiver assistance provided to support your most prominent behavior is:
Then your score for caregiver assistance is:
Your respondent reports that you do not require any assistance to keep your most prominent behavior under control.
No supervision, Oversight
Your respondent reports that you may at times require supervision and verbal redirection to keep your most prominent behavior under control.
Verbal redirection
Your respondent reports that you require occasional physical guidance of limbs and/or caregiver intervention to keep your most prominent behavior under control.
Occasional physical guiding or intervention
Your respondent reports that you require in-sight supervision at all times and may require 1 to 2 person physical restraint or removal from the area to keep your most prominent behavior under control.
In-Sight Supervision -Physical restraint
[Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-5620, filed 4/23/07, effective 6/1/07.]



388-828-5640
How does DDD determine your behavioral acuity level?

DDD uses your frequency, severity, and caregiver assistance scores to determine your behavioral acuity level using the following table:
If your score for
frequency is:
And your score
for severity is:
And your score for
caregiver assistance is:
Then your behavioral acuity level is:
Rare
Minor
None
Low
Verbal redirection
Low
Physical guiding or selection
Low
Physical restraint
Low
Potentially Dangerous
None
Low
Verbal redirection
Low
Physical guiding or selection
Medium
Physical restraint