Personal Care Limitation Extension Process

Overview

This webpage is intended as a resource for individuals interested in information about the Limitation Extension process. The Limitation Extension process allows you to request additional personal care hours to fully complete your Activities of Daily Living - ADLs and Instrumental Activities of Daily Living - IADLs.  You must make the request in writing and provide additional information noted below. If you have specific requests, contact the Limitation Extension - LE Committee at LEcommittee@dshs.wa.gov.

• The Limitation Extension process is available to Personal Care eligible clients under age 21.
• A Limitation Extension is when DSHS authorized more personal care hours than were authorized by your DDA Care Assessment and Exception to Rule - ETR.
• The DDA client or their legal representative may request a Limitation Extension for additional personal care hours to correct, improve, or prevent further deterioration of the client’s condition after requesting an ETR. You may provide any documentation that you believe will show your need for additional hours. In addition, the following must be provided:
• An explanation of the hours necessary to complete your ADLS and IADLs;
• Documentation of the supports available to you over the course of a week; and
• An explanation of why informal supports are not available to provide the assistance you are requesting.

Eligibility

You can request a Limitation Extension if:

• You have already asked for an ETR for personal care and have a DDA ETR decision or
• It has been more than 30 calendar days since you asked for an ETR and DDA has not made a decision on your request.

The LE Committee may ask you for additional information and ask you to participate in an in-home review of your functional abilities by an occupational therapist or another qualified medical professional.

When the LE Committee makes their decision, you will receive a Planned Action Notice - PAN explaining the decision.  If you disagree with the LE Committee’s decision, you will have administrative hearing rights.

If you would like to request a Limitation Extension, email LEcommittee@dshs.wa.gov and a packet will be sent to you. You will need to include the client’s name, address and your contact information.

Documents

• Limitation Extension FAQs (pdf)
• DSHS 22-019(X) EPSDT Brochure (pdf)

Forms

• DSHS 10-503, Limitation Extension Evaluation (doc)
• DSHS 10-504, Limitation Extension Request for Clients Under Age 21 (doc)
• DSHS 10-505, Limitation Extension Task Explanation (doc)
• DSHS 10-506, Limitation Extension Request Checklist (doc)

Resource Links

• Early Periodic Screening, Diagnosis and Treatment (EPSDT)
• Personal Care Assessment Keys

To contact the Limitation Extension Committee: lecommittee@dshs.wa.gov