AGING AND DISABILITY SERVICES ADMINISTRATION
May 2, 2003
ADSA: BH #2003-010
CARE INFORMATION
Dear Boarding Home Provider:
You are receiving this letter because you provide COPES or Medicaid Personal Care services (MPC) to Medicaid eligible clients. Aging and Disability Services Administration (ADSA) uses a comprehensive assessment (CA) to determine COPES and MPC eligibility and services. This notice is to inform you that ADSA Case Managers will begin using a new assessment tool called CARE.
What does CARE stand for?
CARE = Comprehensive Assessment Reporting Evaluation.
Why is there a new assessment?
A report commissioned by the Office of Financial Management and the Senate;
and a report prepared by Joint Legislative and Executive Task Force on Long
Term Care recommended that ADSA develop an assessment tool that is more objective
and reliable. Also, the new assessment tool needed to more accurately measure
care needs and equitably allocate resources based on medical, cognitive,
behavioral and personal care needs. More in depth review of these reports
and the reasons for CARE are available at the following website: http://www.aasa.dshs.wa.gov/professional/care/.
How will CARE be different?
When conducting or reviewing assessments, the ADSA Case Manager will use a
laptop computer to enter the responses to the CARE questions. When the computer
processes the responses to CARE questions, it will use algorithms to determine
the allowed service hours for in-home services or the client’s daily
rate for adult family home (AFH), adult residential care (ARC), enhanced
adult residential care (EARC), and assisted living (AL). CARE improves the
reliability and consistency of these determinations.
Also, CARE includes a new client-focused payment system that:
- Better reflects time and resources needed to provide care; and
- Considers and accounts for unscheduled task hours, cognitive needs, and informal support system.
In addition, the processing of CARE will outline a service plan of care that will look different and be easier to read.
What is an algorithm?
An algorithm is a computerized formula that makes a determination from the
information gathered by the CARE questions. For example, different algorithms
determine COPES and MPC eligibility, classification and need for nursing
referrals.
Are the assessment questions the same?
CARE will ask some questions differently and also, ask some new questions.
Different terminology will be used for some personal care tasks. For instance,
locomotion in room, locomotion outside of room, and walk in room replaces
ambulation, bed mobility replaces positioning, medication management replaces
self-medication, and toilet use replaces toileting.
Will CARE change the hours of service or daily rate the client receives?
CARE uses algorithms to account for a client’s care needs. Because CARE
more accurately assesses a client’s care needs, the outcome may be that
a client receives fewer or more hours of care or a lower or higher daily rate.
What are my rights if I disagree with the CARE assessment results?
As the provider, you have no appeal rights in regard to CARE. Only the client
has a right to appeal the CARE assessment if he/she thinks the assessment does
not accurately reflect his/her support needs.
When will CARE be used to assess ADSA clients?
Over the next ten months, ADSA will implement use of CARE assessment tool by
geographic region. Once implemented in a geographic region, ADSA will use
CARE to assess all new clients and existing clients at the time of their
reassessment, or sooner if there is a significant change. See the following
website for the exact schedule: http:://www.aasa.dshs.wa.gov/professional/care/.
What are the residential rates the department will pay for clients assessed
by CARE?
ADSA used time study data to develop rates that reflect time and resources
needed to provide care. Based on the time study results and assessment data
and using an algorithm, CARE assigns clients to one of twelve classifications.
Classifications may have the same rate. For instance, even though clients in classifications 1 and 4 have different care needs, the resources needed to provide their care is approximately equal.
The CARE system is dynamic in nature and ADSA may make adjustments when warranted. The following are the CARE payment rates for each classification, type of facility and geographic area:
| King County | ||||
|---|---|---|---|---|
| CARE Classification | AL |
ARC |
EARC |
AFH |
| Daily Rate | Daily Rate | Daily Rate | Daily Rate | |
| 1 | $62.40 |
$44.27 |
$44.27 |
$44.88 |
| 2 | $67.52 |
$50.17 |
$50.17 |
$50.86 |
| 3 | $75.70 |
$63.94 |
$63.94 |
$56.85 |
| 4 | $62.40 |
$44.27 |
$44.27 |
$44.88 |
| 5 | $69.57 |
$56.07 |
$56.07 |
$56.85 |
| 6 | $82.86 |
$71.81 |
$71.81 |
$64.82 |
| 7 | $67.52 |
$50.17 |
$50.17 |
$50.86 |
| 8 | $75.70 |
$63.94 |
$63.94 |
$64.82 |
| 9 | $94.12 |
$83.62 |
$83.62 |
$84.77 |
| 10 | $69.57 |
$56.07 |
$56.07 |
$64.82 |
| 11 | $75.70 |
$63.94 |
$63.94 |
$72.80 |
| 12 | $94.12 | $83.62 | $83.62 | $84.77 |
| Metropolitan Counties | ||||
|---|---|---|---|---|
| CARE Classification | AL |
ARC |
EARC |
AFH |
| Daily Rate | Daily Rate | Daily Rate | Daily Rate | |
| 1 | $57.29 |
$44.27 |
$44.27 |
$44.88 |
| 2 | $60.36 |
$48.20 |
$48.20 |
$48.87 |
| 3 | $73.66 |
$60.99 |
$60.99 |
$53.85 |
| 4 | $57.29 |
$44.27 |
$44.27 |
$44.88 |
| 5 | $65.47 |
$53.12 |
$53.12 |
$53.85 |
| 6 | $80.82 |
$67.88 |
$67.88 |
$61.83 |
| 7 | $60.36 |
$48.20 |
$48.20 |
$48.87 |
| 8 | $73.66 |
$60.99 |
$60.99 |
$61.83 |
| 9 | $91.05 |
$77.71 |
$77.71 |
$78.79 |
| 10 | $65.47 |
$53.12 |
$53.12 |
$61.83 |
| 11 | $73.66 |
$60.99 |
$60.99 |
$68.81 |
| 12 | $91.05 | $77.71 | $77.71 | $78.79 |
| Metropolitan Counties | ||||
|---|---|---|---|---|
| CARE Classification | AL |
ARC |
EARC |
AFH |
| Daily Rate | Daily Rate | Daily Rate | Daily Rate | |
| 1 | $56.27 |
$44.27 |
$44.27 |
$44.88 |
| 2 | $60.36 |
$47.22 |
$47.22 |
$47.87 |
| 3 | $73.66 |
$60.01 |
$60.01 |
$52.86 |
| 4 | $56.27 |
$44.27 |
$44.27 |
$44.88 |
| 5 | $65.47 |
$52.14 |
$52.14 |
$52.86 |
| 6 | $80.82 |
$65.91 |
$65.91 |
$60.84 |
| 7 | $60.36 |
$47.22 |
$47.22 |
$47.87 |
| 8 | $73.66 |
$60.01 |
$60.01 |
$60.84 |
| 9 | $91.05 |
$74.76 |
$74.76 |
$75.80 |
| 10 | $65.47 |
$52.14 |
$52.14 |
$60.84 |
| 11 | $73.66 |
$60.01 |
$60.01 |
$66.82 |
| 12 | $91.05 | $74.76 | $74.76 | $75.80 |
Thank you for your cooperation, if you have any questions please contact the
following persons.
Implementation
Nicole Williams
willinc@dshs.wa.gov
General Project
Brooke Buckingham buckibe@dshs.wa.gov
Daniel Knutson-Bradac bradadk@dshs.wa.gov
Policy
Terry Rupp rupptl@dshs.wa.gov
Rates
Pat Draleau dralepc@dshs.wa.gov
Jon Ihli ihlijd@dshs.wa.gov
Sincerely,
Tom Kearns, Chief
Office of Rates Management
Bill Moss, Chief
Home and Community Programs
