WAC 388-106-1810. What services may I receive under LTSS NFLOC PE?

You may receive LTSS NFLOC PE services under either of the two steps depending on your needs and requests identified in the LTSS PE screening for step 1 or the LTSS PE assessment for step 2. Steps do not need to be used in order. For example, you may begin services at step 1 or 2. In general, step 1 services are used by clients requesting lesser supports than those using step 2 services. (1) Step 1: After completing an LTSS PE screening and abbreviated care plan, you may receive any of the following services: (a) Personal emergency response system (PERS), as defined in WAC 388-106-0270 ; (b) Home delivered meals, as defined in WAC 388-106-0300 ; (c) Assistive/adaptive technology and equipment, as defined in WAC 388-106-0270 ; (2) Step 2: After completing an LTSS PE assessment and care plan, you may receive any of the services under step 1 or one or more of the following services: (a) Nurse delegation, as defined in WAC 388-106-0270 ; (b) Specialized medical equipment and supplies, as defined in WAC 388-106-0300 ; (c) Community transition or sustainability services as defined in WAC 388-106-0270 , which are nonrecurring set-up items and services to assist with expenses to move from an acute care hospital or diversion from a psychiatric hospital stay to an in-home setting and may include: (i) Security deposits that are required to lease an apartment or home; (ii) Activities to assess need, arrange for, and obtain needed resources, including essential household furnishings; (iii) Set-up fees or deposits for utility or services access, including telephone, electricity, heating, water, and garbage; (iv) Services necessary for your health and safety such as pest eradication and one-time cleaning prior to occupancy; (v) Moving expenses; and (vi) Minor home accessibility modifications necessary for hospital discharge. (d) Community choice guide: Specialty services providing assistance and support to ensure an individual's successful transition to the community, or maintenance of independent living, as defined in WAC 388-106-0300 ; and (e) Supportive housing as defined in chapter 388-106 WAC. (f) Up to a maximum of 103 hours a month of personal care services, as defined in WAC 388-106-0010 ; (i) The number of hours of personal care services you can receive in your own home is determined by five-tier classifications using the CARE tool to assess your characteristics. (ii) The number of hours of personal care services you may receive for the five tier classifications are: (A) Tier 1 is a maximum of 34 hours. (B) Tier 2 is a maximum of 47 hours. (C) Tier 3 is a maximum of 59 hours. (D) Tier 4 is a maximum of 69 hours. (E) Tier 5 is a maximum of 103 hours. (iii) The CARE tool uses the following criteria to place you in a tier classification group: (A) To be eligible for tier 1 classification, you have: (I) An unmet or partially met need with at least three of the following activities of daily living, as defined in WAC 388-106-0010 : or For each activity of daily living, the minimum level of assistance required in each of the following categories: Self-performance is: Support provided is: Eating n/a Setup Toileting Supervision n/a Bathing Supervision n/a Transfer Supervision Setup Bed mobility Supervision Setup Walk in room, or locomotion in room, or locomotion outside immediate living environment Supervision Setup Medication management Assistance required n/a Your need for assistance in any activities listed in this chart did not occur because you were unable or no provider was available to assist you will be counted for the purpose of determining your functional eligibility. For each activity of daily living, the minimum level of assistance required in each of the following categories: Self-performance is: Support provided is: Eating n/a Setup Toileting Supervision n/a Bathing Supervision n/a Transfer Supervision Setup Bed mobility Supervision Setup Walk in room, or locomotion in room, or locomotion outside immediate living environment Supervision Setup Medication management Assistance required n/a Your need for assistance in any activities listed in this chart did not occur because you were unable or no provider was available to assist you will be counted for the purpose of determining your functional eligibility. (II) A cognitive impairment and require supervision due to one or more of the following: disorientation, memory impairment, impaired decision making, or wandering; and (III) An unmet or partially met need with at least one or more of the following: For each activity of daily living, the minimum level of assistance required in each of the following categories: Self-performance is: Support provided is: Eating Supervision One-person physical assist Toileting Extensive assistance One-person physical assist Bathing Physical help with bathing One-person physical assist Transfer Extensive assistance One-person physical assist Bed mobility and turning and repositioning Limited assistance and need One-person physical assist Walk in room, or locomotion in room, or locomotion outside immediate living environment Extensive assistance One-person physical assist Medication management Assistance required daily n/a Your need for assistance in any activities listed in this chart did not occur because you were unable or no provider was available to assist you will be counted for the purpose of determining your functional eligibility. For each activity of daily living, the minimum level of assistance required in each of the following categories: Self-performance is: Support provided is: Eating Supervision One-person physical assist Toileting Extensive assistance One-person physical assist Bathing Physical help with bathing One-person physical assist Transfer Extensive assistance One-person physical assist Bed mobility and turning and repositioning Limited assistance and need One-person physical assist Walk in room, or locomotion in room, or locomotion outside immediate living environment Extensive assistance One-person physical assist Medication management Assistance required daily n/a Your need for assistance in any activities listed in this chart did not occur because you were unable or no provider was available to assist you will be counted for the purpose of determining your functional eligibility. (B) To be eligible for tier 2 classification, you: (I) Require care provided by or under the supervision of a registered nurse or a licensed practical nurse on a daily basis; or (II) Have an unmet or partially met need with at least two of the following activities of daily living, as defined in WAC 388-106-0010 : For each activity of daily living, the minimum level of assistance required in each of the following categories: Self-performance is: Support provided is: Eating Supervision One-person physical assist Toileting Extensive assistance One-person physical assist Bathing Physical help with bathing One-person physical assist Transfer Extensive assistance One-person physical assist Bed mobility and turning and repositioning Limited assistance and need One-person physical assist Walk in room, or locomotion in room, or locomotion outside immediate living environment Extensive assistance One-person physical assist Medication management Assistance required daily n/a Your need for assistance in any activities listed in this chart did not occur because you were unable or no provider was available to assist you will be counted for the purpose of determining your functional eligibility. For each activity of daily living, the minimum level of assistance required in each of the following categories: Self-performance is: Support provided is: Eating Supervision One-person physical assist Toileting Extensive assistance One-person physical assist Bathing Physical help with bathing One-person physical assist Transfer Extensive assistance One-person physical assist Bed mobility and turning and repositioning Limited assistance and need One-person physical assist Walk in room, or locomotion in room, or locomotion outside immediate living environment Extensive assistance One-person physical assist Medication management Assistance required daily n/a Your need for assistance in any activities listed in this chart did not occur because you were unable or no provider was available to assist you will be counted for the purpose of determining your functional eligibility. (C) To be eligible for tier 3 classification, you have an unmet or partially met need with at least three of the following activities of daily living, as defined in WAC 388-106-0010 : For each activity of daily living, the minimum level of assistance required in each of the following categories: Self-performance is: Support provided is: Eating Supervision One-person physical assist Toileting Extensive assistance One-person physical assist Bathing Physical help with bathing One-person physical assist Transfer Extensive assistance One-person physical assist Bed mobility and turning and repositioning Limited assistance and need One-person physical assist Walk in room, or locomotion in room, or locomotion outside immediate living environment Extensive assistance One-person physical assist Medication management Assistance required daily n/a Your need for assistance in any activities listed in this chart did not occur because you were unable or no provider was available to assist you will be counted for the purpose of determining your functional eligibility. For each activity of daily living, the minimum level of assistance required in each of the following categories: Self-performance is: Support provided is: Eating Supervision One-person physical assist Toileting Extensive assistance One-person physical assist Bathing Physical help with bathing One-person physical assist Transfer Extensive assistance One-person physical assist Bed mobility and turning and repositioning Limited assistance and need One-person physical assist Walk in room, or locomotion in room, or locomotion outside immediate living environment Extensive assistance One-person physical assist Medication management Assistance required daily n/a Your need for assistance in any activities listed in this chart did not occur because you were unable or no provider was available to assist you will be counted for the purpose of determining your functional eligibility. (D) To be eligible for tier 4 classification, you: (I) Require care provided by or under the supervision of a registered nurse or a licensed practical nurse on a daily basis; and (II) Have an unmet or partially met need with at least three of the following activities of daily living, as defined in WAC 388-106-0010 : For each activity of daily living, the minimum level of assistance required in each of the following categories: Self-performance is: Support provided is: Eating Supervision One-person physical assist Toileting Extensive assistance One-person physical assist Bathing Physical help with bathing One-person physical assist Transfer Extensive assistance One-person physical assist Bed mobility and turning and repositioning Limited assistance and need One-person physical assist Walk in room, or locomotion in room, or locomotion outside immediate living environment Extensive assistance One-person physical assist Medication management Assistance required daily n/a Your need for assistance in any activities listed in this chart did not occur because you were unable or no provider was available to assist you will be counted for the purpose of determining your functional eligibility. For each activity of daily living, the minimum level of assistance required in each of the following categories: Self-performance is: Support provided is: Eating Supervision One-person physical assist Toileting Extensive assistance One-person physical assist Bathing Physical help with bathing One-person physical assist Transfer Extensive assistance One-person physical assist Bed mobility and turning and repositioning Limited assistance and need One-person physical assist Walk in room, or locomotion in room, or locomotion outside immediate living environment Extensive assistance One-person physical assist Medication management Assistance required daily n/a Your need for assistance in any activities listed in this chart did not occur because you were unable or no provider was available to assist you will be counted for the purpose of determining your functional eligibility. (E) To be eligible for tier 5 classification, you: (I) Are bedfast/chairfast, as defined by you are confined primarily to a bed or recliner, or if you are wheelchair dependent when not in a bed or recliner; and (II) Require care provided by or under the supervision of a registered nurse or a licensed practical nurse on a daily basis; and (III) Have an unmet or partially met need with at least three of the following activities of daily living, as defined in WAC 388-106-0010 : For each activity of daily living, the minimum level of assistance required in each of the following categories: Self-performance is: Support provided is: Eating Supervision One-person physical assist Toileting Extensive assistance One-person physical assist Bathing Physical help with bathing One-person physical assist Transfer Extensive assistance One-person physical assist Bed mobility and turning and repositioning Limited assistance and need One-person physical assist Walk in room, or locomotion in room, or locomotion outside immediate living environment Extensive assistance One-person physical assist Medication management Assistance required daily n/a Your need for assistance in any activities listed in this chart did not occur because you were unable or no provider was available to assist you will be counted for the purpose of determining your functional eligibility. For each activity of daily living, the minimum level of assistance required in each of the following categories: Self-performance is: Support provided is: Eating Supervision One-person physical assist Toileting Extensive assistance One-person physical assist Bathing Physical help with bathing One-person physical assist Transfer Extensive assistance One-person physical assist Bed mobility and turning and repositioning Limited assistance and need One-person physical assist Walk in room, or locomotion in room, or locomotion outside immediate living environment Extensive assistance One-person physical assist Medication management Assistance required daily n/a Your need for assistance in any activities listed in this chart did not occur because you were unable or no provider was available to assist you will be counted for the purpose of determining your functional eligibility.