REQUIRED FOR AFH RESIDENTS WITH DD
DDA Negotiated Care Plan
Professional RN assessment and care plan development for adult family home residents with developmental disabilities, ensuring compliance with WAC 388-76-10355 requirements.
$500 per assessment
The DDA Negotiated Care Plan is a critical document that ensures adult family home residents with developmental disabilities receive appropriate, person-centered care that meets both DDA service requirements and Washington Administrative Code (WAC) 388-76-10355 regulations for adult family homes.
What Is a DDA Negotiated Care Plan?
According to Washington State's Developmental Disabilities Administration, the Negotiated Care Plan is a written document required by state regulation that translates a resident's DDA assessment and preliminary care plan into specific, actionable directives for adult family home providers.
This essential document bridges the gap between DDA service authorizations and daily care delivery, ensuring that adult family home staff understand exactly what care and support services the resident needs, how to provide them, and when additional professional intervention is required.
Purpose and Regulatory Requirement
WAC 388-76-10355 mandates that adult family homes develop and maintain a negotiated care plan for each resident. For residents with developmental disabilities receiving DDA services, this plan must be developed in collaboration with the resident, family members, DDA case resource manager, and the adult family home provider.
The plan serves multiple critical functions:
- Translates professional assessments into practical, daily care instructions
- Ensures all parties understand care expectations and responsibilities
- Provides legal documentation of planned care delivery
- Facilitates care continuity and quality monitoring
- Supports appropriate use of DDA-funded services
Who Needs a Negotiated Care Plan?
All adult family home residents with developmental disabilities who are receiving DDA services require a Negotiated Care Plan. This includes individuals with:
Eligible Populations
- Intellectual Disability: Adults with cognitive impairments requiring ongoing support
- Autism Spectrum Disorder: Individuals needing structured routines and behavioral support
- Developmental Delays: Adults with significant functional limitations originating before age 22
- Genetic Syndromes: Down syndrome, Fragile X, and other conditions with developmental impacts
- Cerebral Palsy: Individuals with physical and potentially cognitive impairments
- Dual Diagnosis: Those with both developmental disabilities and mental health conditions
Timing Requirements
The Negotiated Care Plan must be completed:
- Before or immediately upon admission to the adult family home
- Within timeframes specified by DDA for service initiation
- Whenever significant changes occur in resident needs or services
- According to the individualized service plan review schedule
Required Components of the Negotiated Care Plan
WAC 388-76-10355 specifies mandatory elements that every Negotiated Care Plan must address
Care and Services List
A comprehensive list of all care and services to be provided, including:
- Personal care assistance (bathing, grooming, toileting, dressing)
- Medication administration and monitoring
- Specialized health procedures or nursing tasks
- Behavioral support interventions
- Therapeutic activities and skill development
- Community integration and social participation
- Provider identification for each service
- Scheduling and frequency for all services
Medication Management Instructions
Detailed guidance for medication handling, including:
- How the resident obtains medications when away from the home
- Emergency medication protocols
- Medication storage and security requirements
- Administration assistance protocols
- Side effect monitoring parameters
- Procedures for medication changes or refills
Preferences and Choices
Documentation of resident preferences regarding:
- Daily routines and schedules
- Food preferences, dietary restrictions, and meal routines
- Grooming and personal care preferences
- Activity choices and leisure interests
- Social interaction preferences
- Environmental preferences (noise, lighting, temperature)
Crisis Planning Procedures
When applicable, detailed procedures for:
- Foreseeable crisis situations specific to the individual
- De-escalation strategies for behavioral crises
- Emergency contact protocols
- When to seek medical or behavioral health intervention
- Documentation requirements during and after crises
- Follow-up procedures and plan revisions
Communication Strategies
Essential information about communication, including:
- Identification of communication barriers or limitations
- Effective communication methods for the individual
- Nonverbal communication techniques
- Use of communication devices or augmentative systems
- How to assess pain or discomfort in non-verbal individuals
- Behavioral communication patterns
Supervision Parameters
Clear statement of the resident's ability to be left unattended, specifying:
- Whether the resident can be left alone
- If yes, the maximum length of time
- Circumstances under which alone time is appropriate
- Safety measures required during unattended periods
- Monitoring methods and check-in schedules
Hospice Care Planning
If applicable, coordination with hospice services including a separate hospice care plan integrated with the Negotiated Care Plan.
Our Negotiated Care Plan Development Process
Comprehensive, collaborative approach ensuring all regulatory requirements are met
Record Review and Coordination
Review of DDA assessment, individualized service plan, medical records, behavioral support plans, and any existing care documentation. Coordination with DDA case resource manager to understand service authorizations and support needs.
On-Site Assessment
In-person evaluation at the adult family home including observation of the resident, interviews with the resident (to the extent possible), consultation with family members, and discussion with AFH providers about care delivery capabilities and routines.
Plan Development
Creation of the comprehensive Negotiated Care Plan addressing all WAC-required elements, translating professional assessments into practical daily care instructions, and incorporating resident preferences and person-centered planning principles.
Review and Finalization
Presentation of the draft plan to all stakeholders for input and agreement, incorporation of feedback and revisions as needed, obtaining required signatures, and distribution of final plan to resident, family, AFH provider, and DDA case resource manager.
Why Professional RN Development Matters
While Negotiated Care Plans can theoretically be developed by AFH providers, professional RN assessment and plan development provides significant advantages:
Clinical Expertise
- Understanding of complex medical and medication issues
- Ability to identify subtle health concerns requiring monitoring
- Knowledge of developmental disability-specific health risks
- Skills in translating medical information for non-medical caregivers
Regulatory Knowledge
- Thorough understanding of WAC 388-76-10355 requirements
- Familiarity with DDA policies and service authorization processes
- Experience with documentation standards and compliance
- Knowledge of nurse delegation regulations when applicable
Objectivity and Quality
- Independent professional assessment of care needs
- Comprehensive, unbiased evaluation
- Quality documentation meeting regulatory standards
- Credibility with DDA case resource managers and regulators
Documentation and Follow-Up
Upon completion, you receive comprehensive documentation including:
Deliverables
- Complete Negotiated Care Plan addressing all WAC-required elements
- Assessment summary documenting the basis for plan recommendations
- Signed acknowledgment forms from all required parties
- Distribution copies for resident, family, AFH provider, and DDA
- Digital and/or hard copy formats as requested
Follow-Up Support
- Consultation with AFH staff on plan implementation
- Response to questions from DDA case resource managers
- Clarification of care instructions as needed
- Recommendations for plan updates when circumstances change
Integration with Other Services
The Negotiated Care Plan works in conjunction with other services, including:
- Functional Assessment & PBSP for behavioral support needs
- Individual Instruction & Support Plan for skill development
- Adult family home nurse delegation services
- Change in Condition Assessment when needs change
- Ongoing 90-Day Supervisory Visits for continued monitoring
According to the CDC, comprehensive care planning is essential for individuals with developmental disabilities to achieve optimal health and quality of life outcomes.
Frequently Asked Questions
What is a DDA Negotiated Care Plan?
A DDA Negotiated Care Plan is a written document required by WAC 388-76-10355 that translates a resident's DDA assessment and preliminary care plan into specific, actionable directives for adult family home providers. It includes care services, medication management instructions, activity preferences, crisis planning procedures, communication strategies, and supervision parameters.
Who needs a DDA Negotiated Care Plan?
All adult family home residents with developmental disabilities who are receiving DDA services require a Negotiated Care Plan. This is a regulatory requirement per WAC 388-76-10355 and must be completed before or shortly after admission to ensure appropriate care delivery.
How much does a DDA Negotiated Care Plan cost?
The DDA Negotiated Care Plan assessment and development service costs $500. This includes comprehensive record review, in-person assessment, collaboration with the DDA case resource manager and adult family home provider, development of the complete Negotiated Care Plan document, and all required WAC-compliant documentation.
What is included in a Negotiated Care Plan?
Per WAC 388-76-10355, Negotiated Care Plans must include: a list of care and services to be provided with provider identification and scheduling; instructions for medication management when away from the home; documentation of activity preferences and choices regarding food, routines, and grooming; crisis planning procedures if needed; identification of communication barriers and nonverbal techniques; and a statement of the resident's ability to be left unattended for specific time periods.
How long does it take to complete a Negotiated Care Plan?
The on-site assessment portion typically takes 2-3 hours, plus additional time for record review, DDA coordination, and documentation completion. The complete process from initial referral to final plan delivery usually takes 3-5 business days, though expedited timelines can be accommodated for new admissions when needed.
Do you coordinate with DDA case resource managers?
Yes. Coordination with DDA case resource managers is an essential part of Negotiated Care Plan development. We communicate throughout the process to ensure the plan accurately reflects the individualized service plan, addresses all identified needs, and provides appropriate guidance for adult family home providers implementing DDA-authorized services.
When does a Negotiated Care Plan need to be updated?
Negotiated Care Plans should be updated when there are significant changes in the resident's health status, behavioral needs, medication regimen, or level of support required. Updates are also needed when DDA service authorizations change, when new services are added, or when the individualized service plan is revised. Annual review and update is recommended even without significant changes.
Schedule DDA Negotiated Care Plan Development
Professional RN assessment and care plan development ensuring WAC 388-76-10355 compliance for adult family home residents with developmental disabilities. Call Seattle Nurse Delegation at .
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