WAC 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 intervention(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 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 intervention(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 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)(persistent 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 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)(persistent 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