more about the ddd assessment “a new way to assess and plan for supports and services for people...
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More About More About The DDD AssessmentThe DDD Assessment
“A new way to assess and plan for supports and services for people with developmental
disabilities”
Aging & Disability Services Administration
Chapter 388-828 WAC
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What is the DDD Assessment?
Aging & Disability Services Administration
The DDD Assessment is a new assessment process that DDD will begin using on June 1, 2007 to evaluate the support needs of individuals with developmental disabilities prior to making a determination of service need.
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Why was it Developed?
Aging & Disability Services Administration
In 2003, a JLARC performance audit of DDD stated:
“DDD caseloads are growing, procedures are poorly defined and effective automated systems to help case managers manage their caseloads are missing.”
JLARC found that because an assessment process is not consistently applied, it is impossible to determine if clients with similar needs are receiving similar services.
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JLARC RecommendationsDSHS develop an assessment process that:
Aging & Disability Services Administration
• Measures the unique support needs of people with developmental disabilities
• Is administered before a determination of service need is made
• Is consistently applied to all people enrolled in DDD in all parts of the state
• Uses proven, computer-based technology that already exists in DSHS
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The Challenge
• Addresses the unique needs of both children and adult who are enrolled in DDD
• Makes use of similarities between DDD and HCS while preserving each division’s distinct programs
• Obtains needed information to administer all DDD programs and services
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Build a single assessment system that:
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Stakeholder Involvement
• “Real Choices” Group
• Regional experts• WPAS• HCS, RCS, MSD, CA
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Since 2004, DDD has held regular meetings with stakeholders who provided input into the development of the DDD Assessment application and rules.
• Counties • Residential Providers• State Advisory Committee• Regional Advisory
Committee
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WAC Development
• Filing of Pre-proposal Statement of Inquiry on 11/21/05
• Monthly meetings with Real Choices Committee• Internal review of proposed Rules 8/7/06 to 8/18/06• Copy of proposed rules on DDD web-site 9/4/06• Public review of proposed rules 9/4/06 to 9/15/06• Public review of proposed rules 10/2/06 to 10/13/06• Q & A session with WPAS and CLS on 10/19/06• Cost survey (425 AFHs, 33 GHs, 90 SL providers)
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Consisted of:
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WAC Development (cont.)
• Real Choices Committee• Adult Family Home Advisory Board• Boarding Home Advisory Board• WPAS and Columbia Legal Services• HCS, RCS, MSD and Children’s Administration• DSHS Board of Appeals and DSHS Operations
Review• Rules and Policies Assistance Unit (RPAU) • Service Employees International Union (SEIU)
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Solicited review and feedback from:
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Collaborative Efforts
• A standardized assessment process that meets the needs of DDD and the individuals served
• Rules promoting consistent application and understanding of the DDD Assessment process
• Communication materials to inform individuals, families, advocates, and providers about the new DDD Assessment
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Have resulted in development of:
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DDD Assessment Benefits
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• Measures unique support needs of people with developmental disabilities
• Standardizes assessment process used by DDD• Is comprehensive in assessing support needs• Records an individual’s service requests• Improves planning process for developing an ISP• Meets CMS & JLARC expectations• Records an individual’s information electronically
• Integrates current assessment tools and existing case manager work processes
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The DDD Assessment
• Support Assessment • Service Level Assessment• Individual Support Plan
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The DDD Assessment has three modules:
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Intake & Eligibility
No
Paid
Svc
s
Paid or No Paid Services?
Assessment Details Report
Service Level Assessment
Individual Support Plan
Start
Case Mgmt and
Services
Support Assessment
Paid Svcs
Case Mgmt
The New DDD Assessment Process
Determine Svc Levels
Information & Referral
Mod
ule
1
Module 3Module 2
Plan for Services
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Module 1: Support Assessment
• Collects a common set of assessment information for every enrolled individual
• Promotes consistency in evaluating a person’s support need acuity levels
• Contains Supports Intensity Scale (SIS) Assessment • Determines ICF/MR Level of Care standard for potential
waiver eligibility• Identifies who receives the Service Level and Individual
Support Plan modules in their DDD Assessment
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Purpose:
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What is the SIS Assessment?• A standardized assessment developed by
AAIDD, the American Association on Intellectual and Developmental Disabilities
• SIS measures:• habilitation and training needs of people with
developmental disabilities age 16 and older • Supports needed for 49 life activities, 8
protection & advocacy activities, 15 medical conditions, and 13 problem behaviors
• Measures focus on the type, frequency, and duration of supports a person needs to be successful
Aging & Disability Services Administration
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Module 2: Service Level Assessment
• Determine service levels and/or number of hours for Medicaid/Waiver personal care
• Identify service levels for residential rate study• Determine a seizure acuity level for reporting
purposes only• Identify employment support levels for people
receiving county services (these levels are not used in rate setting)
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Purpose:
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Module 3: Individual Support Plan
• Create a written plan that includes acuity scores generated from the support assessment
• Document referral information• Authorize DDD paid services that people are
approved to receive• Identify health and welfare needs and the plan to
meet those needs for individuals on the waiver• Describe DDD’s expectations of providers
Aging & Disability Services Administration
Purpose:
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ADSA’s CARE SystemCARE is no longer just an assessment, it is a system containing:
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• A user-interface that is similar for both HCS and DDD• Client details • DDD Intake and Eligibility• The DDD Assessment for DDD clients• The Personal Care Assessment for HCS clients• A system interface for authorizing payments for HCS
clients• Support / service plans
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DDD / HCS Assessment Differences
•SIS questions measure supports needed to be successful in the future
•DDD has incorporated new assessment panels into the CARE system interface which are visible only in DDD Assessments
•Caregiver Status, Protective Supervision, and Behavior Acuity scales in Support Assessment are only used to calculate service levels for Waiver respite
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Assessment Differences (cont.)•Other acuity scales (ADL, Medical, Interpersonal) are currently used only for the residential shadow rates study
•DDD Sleep, Employment Support, and Mental Health panels are only visible to DDD and are used in the residential shadow rates study
•Both DDD and HCS Assessments contain new Allergy and Seizure panels (these do not effect algorithms)
Aging & Disability Services Administration
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Implementation Timeline•Stakeholder work groups………•Communications Efforts…………•Public Hearing………………………•Train case managers………………•Adopt DDD Assessment WAC…•Begin using DDD Assessment…•Post Implementation Support…
Aging & Disability Services Administration
6/1/04 to 1/17/076/15/05 to
Present3/27/07 5/14/07 to 6/1/076/1/076/1/077/1/07 to 6/30/08
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Communication Efforts• Informational flyers to self-advocates, families, and
stakeholders• Informational DVDs, newsletters by the Arc of
Washington and the DD Council• Monthly talking points for DDD Field Services Staff• Web-site regarding Assessment project• Presentations to:
– Statewide residential & employment conferences– State & Regional Advisory Committees– Residential & other service providers– DDD Field Services Staff
Aging & Disability Services Administration
http://www1.dshs.wa.gov/ddd/CAP.shtml
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What to Expect• Before an assessment is due, individuals and families
will be contacted in advance to schedule a meeting• They will receive an appointment notice and
information about the new DDD Assessment• A case manager will perform the assessment face-to-
face with the individual and at least one other person who knows him or her well
• The assessment will take place in the individual’s home
• They will receive a copy of the Assessment Details, or an Individual Support Plan, depending on the services they receive
Aging & Disability Services Administration
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Remember• Everyone will be asked the same questions.• There are no right or wrong answers.• Case managers, advocates and representatives
are available to answer questions about the assessment.
• Services cannot be authorized without an assessment.
• Individuals have the same rights to appeal that they have now.
Aging & Disability Services Administration
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For More Information
Aging & Disability Services Administration
Visit the DDD Assessment Project Website:
http://www1.dshs.wa.gov/ddd/CAP.shtml or
Contact your Case Resource Manager