Diagnosis, Diagnostician, and Required Evidence of Substantial Limitation Diagnosis Diagnostician Substantial Limitation Developmental Delay Not applicable Developmental Delays Meets eligibility requirements for Eligible for Medically Intensive Home Not applicable nursing as defined in WAC Care Program Adaptive functioning assessment with a standard score of and ≤69, Licensed Psychologist or Certified Intellectual Disability Psychological assessment with FSIQ School Psychologist of or Stanford-Binet IV with FSIQ ≤69 of ≤67 Onset prior to age 3, and Cerebral Palsy, or Evidence of the need for direct Licensed Physician Similar brain damage which causes, physical assistance in any 2 of the quadriplegia, hemiplegia, or diplegia following: toileting, bathing, eating, dressing, mobility or communication Seizures are uncontrolled and ongoing or recurring, and Epilepsy, Seizure Disorder Board Certified Neurologist Adaptive functioning assessment with a standard score of ≤69 Onset prior to age 3, and Board Certified Neurologist; Board Autism, Autistic Disorder Certified Psychiatrist; Licensed Adaptive functioning assessment with or Psychologist; Board Certified a standard score of and ≤69, Autism Spectrum disorder (DSM-5) Developmental and Behavioral For diagnosis from DSM-5 FSIQ of with severity level of 2 or 3 in both Pediatrician; ARNP associated with or evidence that person meets ≤84, columns an Autism or Developmental Center DSM-IV-TR criteria Adaptive functioning assessment with a standard score of and ≤69, Another neurological or other FSIQ of or Stanford-Binet IV with ≤77 condition similar to Intellectual Licensed Physician FSIQ of or if under age 20, ≤75, Disability scores in both Broad Reading & Broad Math can replace FSIQ ≤69 testing
Diagnosis, Diagnostician, and Required Evidence of Substantial Limitation Diagnosis Diagnostician Substantial Limitation Developmental Delay Not applicable Developmental Delays Eligible for Medically Intensive Home Care Program Not applicable Meets eligibility requirements for nursing as defined in WAC Intellectual Disability Licensed Psychologist or Certified School Psychologist Adaptive functioning assessment with a standard score of ≤69, and Psychological assessment with FSIQ of ≤69 or Stanford-Binet IV with FSIQ of ≤67 Cerebral Palsy, or Similar brain damage which causes, quadriplegia, hemiplegia, or diplegia Licensed Physician Onset prior to age 3, and Evidence of the need for direct physical assistance in any 2 of the following: toileting, bathing, eating, dressing, mobility or communication Epilepsy, Seizure Disorder Board Certified Neurologist Seizures are uncontrolled and ongoing or recurring, and Adaptive functioning assessment with a standard score of ≤69 Autism, Autistic Disorder or Autism Spectrum disorder (DSM-5) with severity level of 2 or 3 in both columns Board Certified Neurologist; Board Certified Psychiatrist; Licensed Psychologist; Board Certified Developmental and Behavioral Pediatrician; ARNP associated with an Autism or Developmental Center Onset prior to age 3, and Adaptive functioning assessment with a standard score of ≤69, and For diagnosis from DSM-5 FSIQ of ≤84, or evidence that person meets DSM-IV-TR criteria Another neurological or other condition similar to Intellectual Disability Licensed Physician Adaptive functioning assessment with a standard score of ≤69, and FSIQ of ≤77 or Stanford-Binet IV with FSIQ of ≤75, or if under age 20, scores in both Broad Reading & Broad Math ≤69 can replace FSIQ testing
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