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016.06.73-220.300. Tiering

AR ADC 016.06.73-220.300Arkansas Administrative CodeEffective: January 1, 2024

West's Arkansas Administrative Code
Title 016. Department of Human Services
Division 06. Division of Medical Services
Rule 73. Section II -- Arkansas Independent Assessment (Aria)
Section 220.000. Developmental/Intellectual Disabilities Services
Effective: January 1, 2024
Ark. Admin. Code 016.06.73-220.300
016.06.73-220.300. Tiering
Currentness
A. Tier Definitions:
1. Tier 2 means that the beneficiary scored high enough in certain areas to be eligible for paid services and supports.
2. Tier 3 means that the beneficiary scored high enough in certain areas to be eligible for the most intensive level of services, including 24 hours a day/7 days a week paid supports and services.
B. Tiering Logic:
1. DDS tier logic is organized by categories of need, as follows:
a. Safety: Your ability to remain safe and out of harm's way
b. Behavior: Behaviors that could place you or others in harm's way
c. Self-Care: Your ability to take care of yourself, such as bathing yourself, getting dressed, preparing your meals, shopping, or going to the bathroom
Tier 2: Institutional Level of Care
Tier 3: Institutional Level of Care and may need 24 hours a day/7 days a week paid supports and services to maintain current placement
Safety Level High
A. Self-Preservation Score > = 16
A. Self-Preservation Score > = 4
AND
AND
B. Caregiving Capacity/Risk Score = 11
B. Caregiving Capacity/Risk Score > = 6
AND
AND
C. Caregiving/Natural Supports Score of = 7
C. Caregiving/Natural Supports Score > = 6
AND
AND
D. Mental Status Evaluation Score (in the home) Score = 5
D. Mental Status Evaluation Score (in the home) = 3 or 4
AND
AND
E. Mental Status Evaluation Score (in the community) Score = 3
E. Mental Status Evaluation Score (in the community) = 2
Safety Level Medium
A. Self-Preservation Score > = 4
AND
B. Caregiving Capacity/Risk Score > = 6
AND
C. Caregiving/Natural Supports Score > = 6
AND
D. Mental Status Evaluation Score (in the home) = 2
AND
E. Mental Status Evaluation Score (in the community) = 2
Safety Level Low
A. Self-Preservation Score > = 4
AND
B. Caregiving Capacity/Risk Score > = 6
AND
C. Caregiving/Natural Supports Score > = 6
AND
D. Mental Status Evaluation Score (in the home) = 1
AND
E. Mental Status Evaluation Score (in the community) Score = 1
Behavior Level High
Behavior Level High
A. Neurodevelopmental Score of 2
A. Neurodevelopmental Score of 2
AND
AND
B. Psychosocial Subdomain Score of > = 5 -- < = 7 in at least ONE of the following Subdomains:
B. Psychosocial Subdomain Score of > = 8 -- < = 9 in at least TWO of the following Subdomains:
Aggressive Toward Others, Physical;
Aggressive Toward Others, Physical;
Injurious to Self;
Injurious to Self;
Manic Behaviors;
Manic Behaviors;
PICA;
PICA;
Property Destruction;
Property Destruction;
Psychotic Behaviors;
Psychotic Behaviors;
Susceptibility to Victimization;
Susceptibility to Victimization;
Wandering/Elopement;
Wandering/Elopement
AND
OR
C. Caregiving Capacity/Risk Score of > = 6
A. Neurodevelopmental Score of 2
AND
AND
D. Caregiving/Natural Supports Score of > = 5]
B. Psychosocial Subdomain Score of > = 8 -- < = 9 in at least THREE of the following Subdomains:
OR
Aggressive Toward Others Verbal/Gestural;
A. Neurodevelopmental Score of 2
Agitation;
AND
Anxiety;
B. Psychosocial Subdomain Score of > = 5 -- < = 7 in at least THREE of the following Subdomains:
Difficulties Regulating Emotions;
Aggressive Toward Others, Verbal/Gestural;
Impulsivity;
Agitation;
Injury to Others (Unintentional);
Anxiety
Intrusiveness;
Difficulties Regulating Emotions;
Legal Involvement;
Impulsivity;
Socially Unacceptable Behavior;
Injury to Others (Unintentional);
Verbal/Gestural;
Intrusiveness;
Withdrawal
Legal Involvement;
Socially Unacceptable Behavior;
Withdrawal
C. AND at least one of the following scores:
Caregiving Capacity/Risk Score of > = 9
Caregiving/Natural Supports Score of > = 5
Behavior Level Low
Behavior Level Low
A. Neurodevelopmental Score of 2
A. Neurodevelopmental Score of 2
AND
AND
B. Psychosocial Subdomain Score of > = 3 -- < = 4 in at least ONE of the following Subdomains:
B. Psychosocial Subdomain Score of > = 8 -- < = 9 in at least ONE of the following Subdomains:
Aggressive Toward Others, Physical;
Aggressive Toward Others, Physical;
Injurious to Self;
Injurious to Self;
Manic Behaviors
Manic Behaviors;
PICA;
PICA;
Property Destruction;
Property Destruction;
Psychotic Behaviors;
Psychotic Behaviors;
Susceptibility to Victimization;
Susceptibility to Victimization;
Wandering/Elopement
Wandering/Elopement]
C. AND at least one of the following scores:
OR
Caregiving Capacity/Risk Score of < = 8
A. Neurodevelopmental Score of 2
Caregiving/Natural Supports Score of < = 3
AND
OR
B. Psychosocial Subdomain Score of > = 8 -- < = 9 in at least TWO of the following Subdomains:
A. Neurodevelopmental Score of 2
Aggressive Toward Others, Verbal/Gestural;
AND
Agitation;
B. Psychosocial Subdomain Score of >=5-<=7 in at least one of the following Subdomains:
Anxiety;
Aggressive Toward Others, Verbal/Gestural;
Difficulties Regulating Emotions;
Agitation;
Impulsivity;
Anxiety
Injury to Others (Unintentional);
Difficulties Regulating Emotions;
Intrusiveness;
Impulsivity;
Legal Involvement;
Injury to Others (Unintentional);
Socially Unacceptable Behavior;
Intrusiveness;
Withdrawal
Legal Involvement;
Socially Unacceptable Behavior;
Withdrawal
C. AND at least one of the following scores:
Caregiving Capacity/Risk Score of < = 8
Caregiving/Natural Supports Score of < = 3
Self-Care Level High
Self-Care Level High
A. Neurodevelopmental Score of 2
A. Neurodevelopmental Score of 2
AND
AND
B. Scores within stated range in at least THREE of any of the following:
B. Treatments/Monitoring Score of at least 2
1. ADL's:
C. AND at least one of the following scores:
Score of at least 4 in Eating
Caregiving Capacity/Risk Score > = 10
Score of at least 5 in Bathing
Caregiving/Natural Supports Score of = 7
Score of at least 4 in Dressing
Score of at least 3 in Toileting
Score of at least 4 in Mobility
Score of at least 4 in Transfers
2. Functional Communication:
Score of 2 or 3 in Functional Communication
3. IADLs:
Score of 3 in any of the following IADLs
(Meal Preparation, Housekeeping, Finances, Shopping)
4. Safety:
Self-Preservation Score of >=4
AND a score in at least one of the following areas:
Caregiving Capacity/Risk Score of > = 9
Caregiving/Natural Supports Score of > = 4
Treatment/Monitoring Score of at least 2
Self-Care Level Medium
A. Neurodevelopmental Score of 2
AND
B. Scores within stated range in at least THREE of any of the following:
1. ADLs:
Score of 1-11 in Eating
Score of 1-11 in Bathing
Score of 1-10 in Dressing
Score of 1-11 in Toileting
Score of 1-10 in Mobility
Score of 1-10 in Transfers
2. Functional Communication:
Score of 1 in Functional Communication
3. IADLs
Score of 3 in any of the following IADLs:
(Meal Preparation, Housekeeping, Finances, Shopping)
4. Safety:
Self-Preservation Score of > = 2
AND a score in at least one of the following areas:
Caregiving Capacity/Risk Score of > = 9
Caregiving/Natural Supports Score of > = 4
Self-Care Level Low
Self-Care Level Low
A. Neurodevelopmental Score of 2
A. Neurodevelopmental Score of 2
AND
AND
B. Scores within stated range in at least THREE of any of the following combinations:
B. Scores within stated range in at least THREE of any of the following combinations:
Score of 1-11 in Eating
Score of at least 4 in Eating
Score of 1-11 in Bathing
Score of at least 5 in Bathing
Score of 1-10 in Dressing
Score of at least 4 in Dressing
Score of 1-11 in Toileting
Score of at least 3 in Toileting
Score of 1-10 in Mobility
Score of at least 4 in Mobility
Score of 1-10 in Transfers]
Score of at least 4 in Transfers
OR
C. AND at least one of the following scores:
Neurodevelopmental Score of 2
Caregiving Capacity/Risk Score of >= 10
AND
Caregiving/Natural Supports Score of 7
Score of >=1 in any of the following:
IADLs (Meal Preparation, Housekeeping, Finances, Shopping)
When you see “AND”, this means you must have a score in this area AND a score in another area. When you see “OR”, this means you must have a score in this area OR a score in another area.

Credits

Adopted Jan. 1, 2019. Amended Jan. 1, 2024.
Current with amendments received through March 15, 2024. Some sections may be more current, see credit for details.
Ark. Admin. Code 016.06.73-220.300, AR ADC 016.06.73-220.300
End of Document