1. (1) DDA determines your respite assessment level using the following table:

   If your Protective Supervision Support Level is:	And your primary caregiver risk level is:	And your backup caregiver risk score is:	And your behavioral acuity level is:	Then your respite assessment level is:
   0	None	1	None	1
   0	None	1	Low	1
   0	None	1	Medium	1
   0	None	1	High	2
   0	None	2 or 3	None	1
   0	None	2 or 3	Low	1
   0	None	2 or 3	Medium	2
   0	None	2 or 3	High	2
   0	Low	1	None	1
   0	Low	1	Low	1
   0	Low	1	Medium	1
   0	Low	1	High	2
   0	Low	2 or 3	None	1
   0	Low	2 or 3	Low	1
   0	Low	2 or 3	Medium	2
   0	Low	2 or 3	High	2
   0	Medium	1	None	1
   0	Medium	1	Low	1
   0	Medium	1	Medium	1
   0	Medium	1	High	2
   0	Medium	2 or 3	None	1
   0	Medium	2 or 3	Low	1
   0	Medium	2 or 3	Medium	2
   0	Medium	2 or 3	High	2
   0	High	1	None	1
   0	High	1	Low	1
   0	High	1	Medium	2
   0	High	1	High	2
   0	High	2 or 3	None	2
   0	High	2 or 3	Low	2
   0	High	2 or 3	Medium	2
   0	High	2 or 3	High	3
   0	Immediate	1	None	1
   0	Immediate	1	Low	1
   0	Immediate	1	Medium	2
   0	Immediate	1	High	2
   0	Immediate	2 or 3	None	2
   0	Immediate	2 or 3	Low	2
   0	Immediate	2 or 3	Medium	2
   0	Immediate	2 or 3	High	3
   1	None	1	None	1
   1	None	1	Low	1
   1	None	1	Medium	1
   1	None	1	High	2
   1	None	2 or 3	None	1
   1	None	2 or 3	Low	1
   1	None	2 or 3	Medium	2
   1	None	2 or 3	High	3
   1	Low	1	None	1
   1	Low	1	Low	1
   1	Low	1	Medium	1
   1	Low	1	High	2
   1	Low	2 or 3	None	1
   1	Low	2 or 3	Low	1
   1	Low	2 or 3	Medium	2
   1	Low	2 or 3	High	3
   1	Medium	1	None	1
   1	Medium	1	Low	1
   1	Medium	1	Medium	2
   1	Medium	1	High	3
   1	Medium	2 or 3	None	1
   1	Medium	2 or 3	Low	2
   1	Medium	2 or 3	Medium	2
   1	Medium	2 or 3	High	3
   1	High	1	None	2
   1	High	1	Low	2
   1	High	1	Medium	2
   1	High	1	High	3
   1	High	2 or 3	None	2
   1	High	2 or 3	Low	2
   1	High	2 or 3	Medium	3
   1	High	2 or 3	High	4
   1	Immediate	1	None	2
   1	Immediate	1	Low	2
   1	Immediate	1	Medium	2
   1	Immediate	1	High	3
   1	Immediate	2 or 3	None	2
   1	Immediate	2 or 3	Low	2
   1	Immediate	2 or 3	Medium	3
   1	Immediate	2 or 3	High	4
   2 or 3	None	1	None	1
   2 or 3	None	1	Low	1
   2 or 3	None	1	Medium	2
   2 or 3	None	1	High	3
   2 or 3	None	2 or 3	None	2
   2 or 3	None	2 or 3	Low	2
   2 or 3	None	2 or 3	Medium	2
   2 or 3	None	2 or 3	High	4
   2 or 3	Low	1	None	1
   2 or 3	Low	1	Low	1
   2 or 3	Low	1	Medium	2
   2 or 3	Low	1	High	3
   2 or 3	Low	2 or 3	None	2
   2 or 3	Low	2 or 3	Low	2
   2 or 3	Low	2 or 3	Medium	2
   2 or 3	Low	2 or 3	High	4
   2 or 3	Medium	1	None	2
   2 or 3	Medium	1	Low	2
   2 or 3	Medium	1	Medium	2
   2 or 3	Medium	1	High	3
   2 or 3	Medium	2 or 3	None	2
   2 or 3	Medium	2 or 3	Low	2
   2 or 3	Medium	2 or 3	Medium	3
   2 or 3	Medium	2 or 3	High	4
   2 or 3	High	1	None	2
   2 or 3	High	1	Low	2
   2 or 3	High	1	Medium	2
   2 or 3	High	1	High	3
   2 or 3	High	2 or 3	None	2
   2 or 3	High	2 or 3	Low	2
   2 or 3	High	2 or 3	Medium	3
   2 or 3	High	2 or 3	High	4
   2 or 3	Immediate	1	None	2
   2 or 3	Immediate	1	Low	2
   2 or 3	Immediate	1	Medium	2
   2 or 3	Immediate	1	High	3
   2 or 3	Immediate	2 or 3	None	2
   2 or 3	Immediate	2 or 3	Low	2
   2 or 3	Immediate	2 or 3	Medium	3
   2 or 3	Immediate	2 or 3	High	4
   4	None	1	None	2
   4	None	1	Low	2
   4	None	1	Medium	2
   4	None	1	High	3
   4	None	2 or 3	None	2
   4	None	2 or 3	Low	2
   4	None	2 or 3	Medium	3
   4	None	2 or 3	High	4
   4	Low	1	None	2
   4	Low	1	Low	2
   4	Low	1	Medium	2
   4	Low	1	High	3
   4	Low	2 or 3	None	2
   4	Low	2 or 3	Low	2
   4	Low	2 or 3	Medium	3
   4	Low	2 or 3	High	4
   4	Medium	1	None	2
   4	Medium	1	Low	2
   4	Medium	1	Medium	3
   4	Medium	1	High	3
   4	Medium	2 or 3	None	2
   4	Medium	2 or 3	Low	3
   4	Medium	2 or 3	Medium	3
   4	Medium	2 or 3	High	4
   4	High	1	None	2
   4	High	1	Low	2
   4	High	1	Medium	3
   4	High	1	High	3
   4	High	2 or 3	None	2
   4	High	2 or 3	Low	3
   4	High	2 or 3	Medium	4
   4	High	2 or 3	High	4
   4	Immediate	1	None	2
   4	Immediate	1	Low	2
   4	Immediate	1	Medium	3
   4	Immediate	1	High	3
   4	Immediate	2 or 3	None	2
   4	Immediate	2 or 3	Low	3
   4	Immediate	2 or 3	Medium	4
   4	Immediate	2 or 3	High	4
   5	None	1	None	2
   5	None	1	Low	2
   5	None	1	Medium	3
   5	None	1	High	4
   5	None	2 or 3	None	3
   5	None	2 or 3	Low	3
   5	None	2 or 3	Medium	4
   5	None	2 or 3	High	5
   5	Low	1	None	2
   5	Low	1	Low	2
   5	Low	1	Medium	3
   5	Low	1	High	4
   5	Low	2 or 3	None	3
   5	Low	2 or 3	Low	3
   5	Low	2 or 3	Medium	4
   5	Low	2 or 3	High	5
   5	Medium	1	None	2
   5	Medium	1	Low	2
   5	Medium	1	Medium	3
   5	Medium	1	High	4
   5	Medium	2 or 3	None	3
   5	Medium	2 or 3	Low	3
   5	Medium	2 or 3	Medium	4
   5	Medium	2 or 3	High	5
   5	High	1	None	2
   5	High	1	Low	2
   5	High	1	Medium	3
   5	High	1	High	4
   5	High	2 or 3	None	3
   5	High	2 or 3	Low	3
   5	High	2 or 3	Medium	4
   5	High	2 or 3	High	5
   5	Immediate	1	None	2
   5	Immediate	1	Low	2
   5	Immediate	1	Medium	3
   5	Immediate	1	High	4
   5	Immediate	2 or 3	None	3
   5	Immediate	2 or 3	Low	3
   5	Immediate	2 or 3	Medium	4
   5	Immediate	2 or 3	High	5
   6	None	1	None	2
   6	None	1	Low	3
   6	None	1	Medium	3
   6	None	1	High	4
   6	None	2 or 3	None	3
   6	None	2 or 3	Low	3
   6	None	2 or 3	Medium	4
   6	None	2 or 3	High	5
   6	Low	1	None	2
   6	Low	1	Low	3
   6	Low	1	Medium	3
   6	Low	1	High	4
   6	Low	2 or 3	None	3
   6	Low	2 or 3	Low	3
   6	Low	2 or 3	Medium	4
   6	Low	2 or 3	High	5
   6	Medium	1	None	3
   6	Medium	1	Low	3
   6	Medium	1	Medium	3
   6	Medium	1	High	4
   6	Medium	2 or 3	None	3
   6	Medium	2 or 3	Low	4
   6	Medium	2 or 3	Medium	4
   6	Medium	2 or 3	High	5
   6	High	1	None	3
   6	High	1	Low	3
   6	High	1	Medium	4
   6	High	1	High	4
   6	High	2 or 3	None	4
   6	High	2 or 3	Low	4
   6	High	2 or 3	Medium	5
   6	High	2 or 3	High	5
   6	Immediate	1	None	3
   6	Immediate	1	Low	3
   6	Immediate	1	Medium	4
   6	Immediate	1	High	4
   6	Immediate	2 or 3	None	4
   6	Immediate	2 or 3	Low	4
   6	Immediate	2 or 3	Medium	5
   6	Immediate	2 or 3	High	5

2. (2) DDA adds one level to your respite assessment level when your respite assessment level is determined to be a one, two, three, or four and you have a score of four for question two "Other caregiving for persons who are disabled, seriously ill, or under five" in the DDA caregiver status acuity scale. See WAC 388-828-5260.
3. (3) If you are a child or youth subject to a dependency action through DCYF or a tribal court, DDA will reduce your respite allocation amount by the number of hours you or your caregiver are eligible to receive through DCYF or a tribal child welfare agency.

[Statutory Authority: RCW 71A.12.030, 71A.12.380, 71A.12.380(1), and 42 C.F.R. 441.301. WSR 25-15-103, s 388-828-5980, filed 7/17/25, effective 8/17/25. Statutory Authority: RCW 71A.12.030 and Title 71A RCW. WSR 07-10-029, § 388-828-5980, filed 4/23/07, effective 6/1/07.]