1. (1) DDA determines your individual and family services 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 unadjusted individual and family services 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 individual and family services level when your individual and family services level is determined to be:

   1. (a) Level one, two, three, or four; and
   2. (b) 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.

[Statutory Authority: RCW 71A.12.030 and 71A.16.050. WSR 21-19-093, § 388-828-9040, filed 9/17/21, effective 10/18/21. Statutory Authority: RCW 71A.12.010, 71A.12.030, and Title 71A RCW. WSR 09-21-033, § 388-828-9040, filed 10/13/09, effective 11/13/09. Statutory Authority: RCW 71A.12.030, 71A.12.040, and 2007 c 283. WSR 08-16-121, § 388-828-9040, filed 8/5/08, effective 9/5/08.]