Wash. Admin. Code § 388-106-0100

Current through Register Vol. 24-21, November 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

(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.