Scoring of the DON Except for Respite Cases

Section 679 Section 679.30  Scoring of the DON Except for Respite Cases a)         An individual receiving a 14 or more on the Mini-Mental Status Examination shall receive "zero" points towards his/her column A score. An individual receiving less than 14 points shall receive an additional "10" points added to his/her column A score for the determination of eligibility and a SCM. b)         The remaining two sections of the DON measure the individual's ability to complete the ADLs. The ADLs are specifically:  eating, bathing, grooming, dressing, transferring, incontinence care, preparing meals, being alone, telephoning, managing money, routine health care tasks (or those health care tasks not requiring specialized training), specialized health care tasks (or those requiring assistance from trained medical practitioners), necessary travel outside the home, laundry, and housework. 1)         Part A of the DON measures the individual's need for assistance in the completion of each of the ADLs on the following rating scale. A)        None ("0" points) – the individual can perform all essential components of the ADL with or without an existing assistive device; B)        Minimal ("1" point) – the individual can perform most of the ADL, with or without an existing assistive device, but requires some supervision and/or assistance to ensure the task is fully completed; C)        Moderate ("2" points) – the individual requires a great deal of supervision and/or assistance, with or without existing assistive devices, in the completion of the essential components of the task; and D)        Severe ("3" points) – the individual cannot perform any of the essential components of the task, with or without existing assistive devices and requires constant supervision and/or assistance. 2)         Part B of the DON measures the individual's unmet need for care in the completion of the ADLs on the following scale. A)        None ("0" points) – the individual has no unmet need for care in that the individual needs no assistance in completion of the essential components of the task, or family and/or other resources already provide for this task; B)        Minimal ("1" point) – the individual's need for assistance in the completion of the task is met at least 50% of the time, and, without periodic assistance, there is a risk to the individual's health and safety; C)        Frequent ("2" points) – the individual's need for assistance in the completion of the task is met less than 50% of the time and, without assistance, there is moderate risk to the individual's health and safety; and D)        Constant ("3" points) – the individual's need for assistance in the completion of the task is seldom (less than 10% of the time) or never met and, without assistance, there is extreme risk to the individual's health and safety. c)         In administering the DON for children, the assessor should ensure the ratings given reflect limitations due to the individual's disability and not the individual's age and/or the additional burden placed on the caregiver. 1)         On Part A, determine if a child of the individual's age should be able to complete all or part of the task. If the inability to perform the task relates only to the individual's age, a score of "zero" should be given. Otherwise, score "1", "2", or "3" according to the individual's impairment level. 2)         On Part B, determine the additional burden placed on a caregiver providing the service. If, because of the individual's age, there is no increased burden, a score of "0" should be given. If there is an increased burden on the caregiver due to the individual's disability, score "1", "2", or "3" according to the increased level of burden in providing the task.