Wash. Admin. Code § 388-106-0100

Current through Register Vol. 24-09, May 1, 2024
Section 388-106-0100 - How does the CARE tool measure mood and behaviors?
(1) When you do not meet the criteria for the clinically complex classification group, or the criteria for exceptional care, or for in-home only have a cognitive performance scale score of five or six, then the mood and behavior criteria listed in subsections (3) and (4) below determines your classification group. If you are eligible for more than one "B" group classification based on the two methodologies, CARE will place you in the highest group for which you qualify.
(2) For each behavior that was assessed and documented in the CARE tool , the department will determine a status as "current behavior" or "past behavior" as defined in WAC 388-106-0010.
(3) CARE places you in the mood and behavior classification group only if you have one or more of the behavior/moods that also meets the listed status, frequency, and alterability as identified in the following chart:

Behavior/Mood

AND Status, Frequency & Alterability

Assaultive (not during personal care)

Current behavior

Combative during personal care

Current behavior

Combative during personal care

Past behavior, addressed with current interventions

Many incidences of uncontrollable crying tearfulness

Current behavior, frequency 4 or more days per week

Delusions

Past behavior, addressed with current interventions

Depression score of 14 or greater

N/A

Inappropriate nakedness

Current behavior and not easily altered

Easily irritable/agitated requiring interven-tion(s)

Current behavior and not easily altered

Eats nonedible substances/objects (Pica)(persistent for at least a month)

Current behavior

Eats nonedible substances/objects (Pica)(persistent for at least a month)

Past behavior, addressed with current interventions

Hallucinations

Current behavior

Hiding items

Past behavior, addressed with current interventions

Hoarding

Past behavior, addressed with current interventions

Mental health therapy/program

Needs

Nonhealth related repetitive anxious complaints/questions

Current behavior, daily

Nonhealth related repetitive complaints/questions

Past behavior, addressed with current interventions

Repetitive movement/pacing, hand wringing, fidgeting

Current behavior, daily

Resistive to care with words/gestures (does not include informed choice)

Current behavior

Resistive to care with words/gestures (does not include informed choice)

Past behavior, addressed with current interventions

Sexual acting out

Current behavior

Sexual acting out

Past behavior, addressed with current interventions

Inappropriate spitting

Current behavior and not easily altered

Inappropriate spitting

Past behavior, addressed with current interventions

Breaks/throws items

Current behavior

Unsafe smoking

Current behavior and not easily altered

Disturbs household at night when others are sleeping and requires intervention

Current behavior

Wanders exit seeking

Current behavior

Wanders exit seeking

Past behavior, addressed with current interventions

Wanders not exit seeking

Current behavior

Wanders not exit seeking

Past behavior, addressed with current interventions

Yelling/screaming

Current behavior, frequency 4 or more days per week

or

(4) CARE places you in the mood and behavior classification group if you have a behavior point score greater than 1, your CPS score (as defined in WAC 388-106-0090 ) is greater than 2, and your ADL score (as defined in WAC 388-106-0105 ) is greater than 1.

Status

Intervention

Frequency

Weight

Past

No intervention

N/A

0

Past

With intervention

N/A

0.25

Current

N/A

1-3 days per wk

0.5

Current

N/A

4-6 days per wk

0.75

Current

N/A

Daily

1

Each current behavior (as shown in the table below) has a value from .5 to 6 depending on the severity and alterability. Each status combination (shown in the table above) has a weight from 0 to 1. Behavior points are determined by multiplying the value of each current behavior (from the list below) by the weight of the status combination (above). Behavior points for past behaviors will be determined by multiplying the easily altered value of the behavior from the table below by the appropriate weight from the table above (0 or .25).

The list of behaviors below is divided into categories. Each category has a point limit of how many points can be counted toward the total behavior point score as detailed below. The total behavior point score is determined by totaling the weight-adjusted values for each category below.

Behavior

Value

Easily Altered/Past

Not Easily Altered

1. Many incidences of uncontrollable crying , tearfulness

.5

1

2. Easily irritable/agitated

.5

1

3. Obsessive regarding own health or body functions

.5

1

4. Repetitive physical movement/pacing, hand wringing, fidgeting

.5

1

5. Hiding items

.5

1

6. Hoarding

.5

1

7. Inappropriate verbal noise

.5

1

8. Wanders, not exit seeking

.5

1

Maximum total points after adjusting for status for behaviors 1-8 = 2

9. Repetitive anxious complaints/questions

1

2

10. Rummages/takes belongings of others

1

2

11. Verbally abusive

1

2

12. Yelling or screaming

1

2

13. Inappropriate spitting

1

2

14. Unrealistic fears and suspicions

1

2

15. Accuses others of stealing

1

2

Maximum total points after adjusting for status for behaviors 9-15 = 3

16. Resistive to care with words/gestures

2

3

17. Disturbs household at night when others are sleeping, requires intervention

2

3

18. Unsafe cooking

2

3

19. Inappropriate toileting/menses activity

2

3

20. Unsafe smoking

2

3

21. Left home and gotten lost

2

3

22. Inappropriate nakedness

2

3

Maximum total points after adjusting for status for behaviors 16-22 = 4

23. Intentional self-injury

4

5

24. Wanders/Exit seeking

4

5

25. Sexual acting out

4

5

26. Intimidating/threatening (no physical contact)

4

5

27. Assaultive (not during personal care)

4

5

28. Breaks, throws items

4

5

Maximum total points after adjusting for status for behaviors 23-28 = 10

29. Deliberate fire setting behaviors

5

6

30. Combative during care

5

6

31. Eats nonedible substances/objects (Pica)(per-sistent for at least a month)

5

6

32. Deliberate sexual violence

5

6

Maximum total points after adjusting for status for behaviors 29-32 = 12

Wash. Admin. Code § 388-106-0100

Amended by WSR 20-23-124, Filed 11/18/2020, effective 12/19/2020

Reviser's note: The typographical error in the above section occurred in the copy filed by the agency and appears in the Register pursuant to the requirements of RCW 34.08.040.