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JLARC Recommendations(DSHS develop an assessment process that:") f) The ChallengeAddresses 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 " Stakeholder Involvementx Real Choices Group Regional experts WPAS HCS, RCS, MSD, CA=" =WAC DevelopmentFiling 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) " Z,jWAC Development (cont.)TReal 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)+" +Collaborative EffortsA 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" DDD Assessment Benefits  The DDD AssessmentDSupport Assessment Service Level Assessment Individual Support PlanE" EThe New DDD Assessment Process"Module 1: Support AssessmentCollects 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{" {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" Z" Z`" Z2  `"Module 2: Service Level Assessment7Determine 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) 8" 8!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@" @$ADSA s CARE System @CARE is no longer just an assessment, it is a system containing:"A" A DDD / HCS Assessment DifferencesVSIS 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 F" " v" " " FvAssessment Differences (cont.)(ZOther 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)h" " e" qem>0RpImplementation TimelinetStakeholder work groups& & & Communications Efforts& & & & Public Hearing& & & & & & & & & Train case managers& & & & & & Adopt DDD Assessment WAC& Begin using DDD Assessment& Post Implementation Support&  " ZCommunication EffortsInformational 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 StaffB" Z ZWhat to ExpectBefore 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 receive6" Z 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.)" )For More Information. /defghijklmnopqrstuvwxyz{  0` ` ̙33` 333MMM` ff3333f` f` f` 3` ̙33` ̙33` ̙33>?" dd@$v?" d___d@ @` n?" dd@   @@``PJ    @ ` ` pH @`H @`^N0  l$(  l$ l 0 "   RClick to edit Master text styles Second level Third level Fourth level Fifth level!     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S @ Tuc ii y  c  v* G$$GGkk @ Tc ii  ? c  x* G$$GGkkH @ 0.k ? 3380___PPT10.pV0wfcp @(     Ng+ ii y%  $  v* G$$GGkk  Nq+ ii  ?% +  x* G$$GGkk  TX{+ ii y  +  v* G$$GGkk  T+ ii  ? +  x* G$$GGkkH  0.k ? 3380___PPT10.F 'd0^N0 `(    6c   `@ PMore About The DDD Assessment(n  0| @   A new way to assess and plan for supports and services for people with developmental disabilities dPd"T `   "`` 0^  C .Adddbanner3`@ X  C (A2Banner` @  H c  ?"6@ NNN?Np` 0 d*Aging & Disability Services Administration+ 2+f  0&c 0 `  }Chapter 388-828 WAC( 2(r>0H  0޽h ? ffCIfff___PPT10i.\ <+D='  = @B + 'e0^N0 _(    HD'  l"` `      Bw l^#    "T `   "`` 0^  C .Adddbanner3`@ X  C (A2Banner` @  Hc  ?"6@ NNN?Np` 0 d*Aging & Disability Services Administration+ 2+f}  0 2     6 c `  t( DDD caseloads are growing, procedures are poorly defined and effective automated systems to help case managers manage their caseloads are missing.  4C   0lc   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. 4H  0޽h ? ffCIfff___PPT10i.\w$+D='  = @B + 'g0^N0  (  x  c $c l0  c    s *Lc lp c  "8hd"T `   "`` 0^  C .Adddbanner3`@ X  C (A2Banner` @  Hc  ?"6@ NNN?Np` 0 d*Aging & Disability Services Administration+ 2+f  0\  Pg 3  2   0  mMeasures 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&50 Z2  nA d޽h @ ?Dark horizontal"` ffΟ___PPT10i.KPA+D='  = @B + 'h0^N0 H(  x  c $0 l    ~  s * lp0   "T `   "`` 0^  C .Adddbanner3`@ X  C (A2Banner` @  H  ?"6@ NNN?Np) 0 d*Aging & Disability Services Administration+ 2+f  0 p  ^&Build a single assessment system that:' 2' H  0޽h ? ffCIfff___PPT10i.F\2+D='  = @B +f 'i0^N0 e] (  x  c $- l    ~  s *. l     "T `   "`` 0^  C .Adddbanner3`@ X  C (A2Banner` @  H0  ?"6@ NNN?Np) 0 d*Aging & Disability Services Administration+ 2+f)  0,5  >  Since 2004, DDD has held regular meetings with stakeholders who provided input into the development of the DDD Assessment application and rules.  2:   09    D<4___PPT9 TCounties Residential Providers State Advisory Committee Regional Advisory CommitteeU" UH  0޽h ? ffCIfff___PPT10i.F\2+D='  = @B + 'j0^N0  )(  x  c $I l    x  c $J lPP   "T `   "`` 0^  C .Adddbanner3`@ X  C (A2Banner` @  HM  ?"6@ NNN?Np) 0 d*Aging & Disability Services Administration+ 2+f  0R   E Consisted of: 2H  0޽h ? ffCIfff___PPT10i.F\2+D='  = @B + 'k0^N0 @?(  x  c $d l0p    x  c $e l   "T `   "`` 0^  C .Adddbanner3`@ X  C (A2Banner` @  H h  ?"6@ NNN?Np) 0 d*Aging & Disability Services Administration+ 2+f  0Lm @p [#Solicited review and feedback from:$ 2$H  0޽h ? ffCIfff___PPT10i.F\2+D='  = @B + 'l0^N0 `<(  x  c $ l    x  c $ lP   "T `   "`` 0^  C .Adddbanner3`@ X  C (A2Banner` @  Hc  ?"6@ NNN?Np) 0 d*Aging & Disability Services Administration+ 2+f  0 c  X Have resulted in development of:! 2!H  0޽h ? ffCIfff___PPT10i.F\2+D='  = @B +Z  'm0^N0 YQ(    H}  l"`0 p    "T `   "`` 0^  C .Adddbanner3`@ X  C (A2Banner` @  H  ?"6@ NNN?Np` 0 d*Aging & Disability Services Administration+ 2+f  0 0  9  2   0  .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 processesVH50 Z250 F2M50 P2 hhH  0޽h ? ffCIfff___PPT10i.\+D='  = @B + 'n0^N0   (  x  c $ l    ~  s * l    "T `   "`` 0^  C .Adddbanner3`@ X  C (A2Banner` @  H  ?"6@ NNN?Np) 0 d*Aging & Disability Services Administration+ 2+f  0 P` @ ]%The DDD Assessment has three modules:& 2& R   C *Aj01953840@ H  0޽h ? ffCIfff___PPT10i.F\2+D='  = @B +J  'o0^N0 I A  (   0 TA j? l5 { j  ~  s *  l0o      H  ?" >  M Determine Svc Levels( 2  H\  ?" w Y Information & Referral&( 2  H ?#" ``   H ?#" `P  P  Zд  ?"w  <Module 1     T  ?"p hW  <Module 3     T  ?"p W  <Module 2     H ?#" ` P`    H ?#" `` P     H  ?" P >  IPlan for Services( 2"T `   "`^  C .Adddbanner3`@ X  C (A2Banner` @H  0޽h ? ̙33___PPT10i.rAh+D='  = @B + 'p0^N0  *(  x  c $ l0p    ~  s *t l0@i    "T `   "`` 0^  C .Adddbanner3`@ X  C (A2Banner` @  H"  ?"6@ NNN?Np) 0 d*Aging & Disability Services Administration+ 2+f  0 P0M @Purpose: 2  H  0޽h ? ffCIfff___PPT10i.F\2+D='  = @B + 'q0^N0 (  x  c $ l`      s * l@    $"T `   "`` 0^  C .Adddbanner3`@ X  C (A2Banner` @  HH  ?"6@ NNN?Np) 0 d*Aging & Disability Services Administration+ 2+fH  0޽h ? ffCIfff___PPT10i.F\2+D='  = @B + 'r0^N0   $(   x   c $ l   x   c $ lP0   "T `    "`` 0^   C .Adddbanner3`@ X   C (A2Banner` @   H  ?"6@ NNN?Np) 0 d*Aging & Disability Services Administration+ 2+f   0d p  @Purpose: 2  H   0޽h ? ffCIfff___PPT10i.F\2+D='  = @B + 's0^N0 @$(  x  c $ l   x  c $ l 0   "T `   "`` 0^  C .Adddbanner3`@ X  C (A2Banner` @  H  ?"6@ NNN?Np) 0 d*Aging & Disability Services Administration+ 2+f  0 p  @Purpose: 2  H  0޽h ? ffCIfff___PPT10i.F\2+D='  = @B + 't0^N0 `R(  x  c $+ l@     s *82 lP:   "$"T `   "`` 0^  C .Adddbanner3`@ X  C (A2Banner` @  HT4  ?"6@ NNN?Np) 0 d*Aging & Disability Services Administration+ 2+f  0B @ RA 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$%0 F2H  0޽h ? ffCIfff___PPT10i.F\2+D='  = @B + 'u0^N0 $(  $x $ c $tF l   ~ $ s *K l   "T `  $ "`` 0^ $ C .Adddbanner3`@ X $ C (A2Banner` @ $ H M  ?"6@ NNN?Np) 0 d*Aging & Disability Services Administration+ 2+fH $ 0޽h ? ffCIfff___PPT10i.F\2+D='  = @B + 'v0^N0 ,(  ,x , c $\U l   ~ , s * V l0   "T `  , "`` 0^ , C .Adddbanner3`@ X , C (A2Banner` @ , H^  ?"6@ NNN?Np) 0 d*Aging & Disability Services Administration+ 2+fH , 0޽h ? ffCIfff___PPT10i.F\2+D='  = @B + 'w0^N0 4b(  4x 4 c $g l    4 s *e lJ   "T `  4 "`` 0^ 4 C .Adddbanner3`@ X 4 C (A2Banner` @ 4 Ho  ?"6@ NNN?Np) 0 d*Aging & Disability Services Administration+ 2+f 4 0p   D<4___PPT9 `6/1/04 to 1/17/07 6/15/05 to Present 3/27/07 5/14/07 to 6/1/07 6/1/07 6/1/07 7/1/07 to 6/30/08 " 0" F " " P" Z " " UaH 4 0޽h ? ffCIfff___PPT10i.F\2+D='  = @B + 'x0^N0 <(  <x < c $X| l    < c $H lpP`   "T `  < "`` 0^ < C .Adddbanner3`@ X < C (A2Banner` @ < H  ?"6@ NNN?Np) 0 d*Aging & Disability Services Administration+ 2+f < 0d  &http://www1.dshs.wa.gov/ddd/CAP.shtml D'(F%k>0%H < 0޽h ? ffCIfff___PPT10i.F\2+D='  = @B + 'y0^N0 D(  Dx D c $ l    D c $ lP`0   "T `  D "`` 0^ D C .Adddbanner3`@ X D C (A2Banner` @ D Hx  ?"6@ NNN?Np) 0 d*Aging & Disability Services Administration+ 2+fH D 0޽h ? ffCIfff___PPT10i.F\2+D='  = @B + 'z0^N0  L(  Lx L c $ز l    L c $0 lP`0   "T `  L "`` 0^ L C .Adddbanner3`@ X L C (A2Banner` @ L H迃  ?"6@ NNN?Np) 0 d*Aging & Disability Services Administration+ 2+fH L 0޽h ? ffCIfff___PPT10i.F\2+D='  = @B + '{0^N0 @T(  Tx T c $xȃ l `   "T `  T "`` 0^ T C .Adddbanner3`@ X T C (A2Banner` @ T H̓  ?"6@ NNN?Np) 0 d*Aging & Disability Services Administration+ 2+f~ T 0Pу  `0 | Visit the DDD Assessment Project Website: http://www1.dshs.wa.gov/ddd/CAP.shtml or Contact your Case Resource Manager V{-%%l>0.SH T 0޽h ? ffCIfff___PPT10i.F\2+D='  = @B +|0 p(  d  c $@XK   c   s *čc @ )  c  vbThe audience for this presentation is those who have been involved along the way with this project& .the boards, parent organization leadership, vendors or school personnel, etc.H  0.k ? 3380___PPT10.`0SZ0  (  d  c $@XK      s *H\ @ )    pDSHS Policy expects that individuals have an assessment prior to having services authorized and paid for by DDD.H  0.k ? 3380___PPT10.`* 0   : (  d  c $@XK       s * @ )    $ * JLARC = Joint Legislative audit & Review Committee. Presenter: The 2003 performance audit was the result of increasing scrutiny regarding the management practices of the Division of Developmental Disabilities and was its fourth report of the Division in less than 3 years. After extensive fieldwork and careful analysis, JLARC concluded that DDD s existing assessment procedures could not ensure that clients with similar needs were receiving similar services. JLARC determined that DDD s existing assessment tools failed in one of two ways: They either failed to link assessment of service need with a service plan, or The procedures governing their use were so poorly defined or followed that inconsistency was a predictable outcome. As a result, policy makers were unable to: Determine if clients with similar needs are getting similar services and whether approved levels of service are too high, too low, appropriate or inappropriate; Without an accurate understanding of the service needs of clients  For example: an acuity measure - policy makers could not answer basic budget questions used in determining whether the Division s funding was appropriate. #-A.)A,ZHH  0.k ? 3380___PPT10.`P 40 D(  d  c $@XK      s *D @ |    . Presenter: Measures the unique support needs of people with developmental disabilities: The Federal and State governments have identified people with developmental disabilities as a distinct population because of their unique support needs in learning (habilitation). Because of this, DDD needs an assessment process that is designed to measure these unique support needs in an effort to improve planning of supports and services to foster an individual s ability to learn, grow, and become more independent. Is administered before a determination of service need is made: The basic purpose of an assessment is to determine if a service is needed. DDD believes this approach will promote consistency, fairness, and objectivity in determining service needs. Is consistently applied to all people enrolled in DDD in all parts of the state: Our understanding of this is that all individuals must be assessed prior to decision-making about service needs and that the developed assessment process will evaluate individual need in all DDD programs and services. Uses proven, computer-based technology that already exists in DSHS: The sheer size of the Division s caseload requires development of a computer-assisted means of recording client information, measuring acuity levels and managing service administration. Since DDD was moved to the new ADSA, DSHS believed that the CARE system could be adapted for use in assessing the support needs of people with developmental disabilities. CARE was selected because it had proven itself as an effective means in promoting: 1) accurate assessments and service plans; 2) Accurate eligibility determination for corresponding benefit administration, and structure for assessing risk indicators in reducing liability and protecting vulnerable adults. ZARE  M  A  S   D    HH  0.k ? 3380___PPT10.TP`U0  (  d  c $@XK      s * @ )    WDDD = Division of Developmental Disabilities HCS = Home and Community Services DivisionXX H  0.k ? 3380___PPT10.``<0 L(  d  c $@XK      s *< @ )    6VWPAS = Washington Protection & Advocacy System HCS = Home and Community Services Division RCS = Residential Care Services Division MSD = Management Services Division CA = Children s Administration (DSHS) Real Choices Members: People First  Donna Lowary King County Parent Coalition  Margaret Lee Thompson and Joanne Oneill Washington Protection & Advocacy System (WPAS)  Andrea Abrahamson The ARC of Washington  Sue Elliot, Executive Director The DDD Council  Ed Holen, Executive Director Residential Provider  Tony Farr Association of County Human Services  Susan Chriest Employment Services consultant  Karen Hoffman DDD self-advocates - Tami Davis and Robert Wardell DPPPbBc]H  0.k ? 3380___PPT10.Q\`* 0   0: (  d  c $@XK   $   s * @ )  $  $bAFH = Adult Family Home GH = Group Home SL = Supported Living CLS = Columbia Legal Services WAC Development Filing a Pre-proposal Statement of Inquiry on 11/21/05 almost a year and half ago. Real choices committee met monthly between 6/05 to 10/06 Conducted Internal review 8/7/06 to 8/18/06  received 318 comments Copy of proposed rules put on DDD website on 9/4/06 Conducted public review 9/4/06 to 9/15/06  received 167 comments Received 7 comments from WPAS/CLS on 9/22/06 Conducted public review 10/2/06 to 10/13/06  received 39 comments Met with representative form WPAS/CLS on 10/19/06 Received 9 comments from WPAS/CLS on 10/27/06 Conducted cost survey of AFH, SL, GH, and Companion home providers 9/06 to 11/06. Filed CR 102 on 1/23/07. The CR 102 is part of the public rule development process. It is the formal notification to the public that the DSHS wants to change its rules. It also causes the public hearing to be held. mD\    ` ) H  2  J HH  0.k ? 3380___PPT10.`=8 0   P(  d  c $@XK   $   s *9$ @ )  $  WPAS = Washington Protection & Advocacy System HCS = Home and Community Services Division RCS = Residential Care Services Division MSD = Management Services Division CA = Children s Administration (DSHS) Breakdown of comments; Real Choices Committee - multiple comments were incorporated in the proposed draft or in policy training. AFH Advisory Board and the Boarding Home Advisory board - no comments WPAS/CLS had 16 comments  multiple comments were incorporated in the proposed draft or in policy training. HCS, RCS, MSD, CA  multiple comments that were incorporated into the proposed WAC DSHS Board of appeals  no comments DSHS Operations review  comments surrounded how new process would effect workload RPAU  Comment recommending formatting, grammatical edits, etc. SEIU  At this time, the DDD Assessment only effects IPs providing services to individuals approved to receive waiver respite. 2  AHH  0.k ? 3380___PPT10.`pj0 pz(  d  c $@XK   $   s *S$ @ )  $  d,Note: DDD has also worked collaboratively with the DD Council and the Arc of Washington to develop communication materials that were distributed in November and May of 2007. More will be distributed in June: DVD  DDTV: Focus on the Assessment Newsletter   Family Matters  Quarterly newsletter from DDD 3 Flyers  Informing families building Trust Bulletins on DDD Assessment - DDC It is anticipated that the DDC and Arc will distribute these materials to members on their lists and that these members will forward information to people with developmental disabilities and families on their lists. We will also have copies available for others to use. H  0.k ? 3380___PPT10.`i0 y(  d  c $@XK   $   s *1$ @ )  $  cOCMS = Centers for Medicaid and Medicare Services ISP = Individual Support PlanH  0.k ? 3380___PPT10.`L 0 +(  d  c $@XK   $   s *$ @ )  $   H  0.k ? 3380___PPT10.`%x0 jb(  d  c $@XK   $ V  s *_$ @ A(  $  lWhat does the new DDD Assessment process look like? There are three distinct parts, or modules, in the new DDD assessment: Module 1: Support Assessment This includes the SIS scale for those age 16+, caregiver needs assessment, behavior issues and protective supervision. If the person does not receive paid services the assessment stops here and the person will receive a copy of the results. Module 2: Service Level Assessment If a DDD client is currently authorized to receive paid services or authorized for new services, that person will be asked questions by the CRM to determine need and the level of services that will be authorized. Module 3: Individual Support Plan (ISP) When services are authorized, an individual support plan is completed in this module. It will describe the services that are authorized and will be printed and given to the person to keep. \m4H#&H  0.k ? 3380___PPT10.py.S`0 p(  d  c $@XK   $    s *<$ @ )  $  Z @ ICF/MR = Intermediate Care Facility for the Mentally Retarded Presenter: Module One is the support assessment. It s purpose is to: Collects a common set of assessment information Promotes consistency in evaluating an individual s support need acuity levels Contains Supports Intensity Scale (SIS) Assessment (which we will talk about in the next slide) 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 ITEIP processes have NOT CHANGED for kids age 0 through 2. The DDD authorizations are used to assure funding is available for assisting in comprehensive early intervention services. However, ITEIP uses their assessment and creates the Individualized Family Service Plan (IFSP). For more information about ITEIP, visit http://www1.dshs.wa.gov/iteip/ It is important to note that: If a person is not approved for any paid service, the Assessment ends here and the person is given a copy of the assessment details report and PAN with information regarding their appeal rights. DDD anticipates that there will be an increase in requests for administrative hearings. This is primarily related to the following: Our new  PANdemic world which requires a planned action notice for any department decision (this includes acuity scores). Our plan to record a person s service requests. Since there is limited funding, these individuals will receive a PAN with a denial of their request and information regarding their right to appeal. Z" ZZ@ZZK :  =       ,H 3HH  0.k ? 3380___PPT10.`C6~ 0 : 2  (  d  c $@XK   $ &   s *$ @ )  $  The SIS Assessment was developed over a 5 year period out of recognition that society s perception of what is possible for people with developmental disabilities has changed over the years. This change has resulted in the expectation that with supports, people with developmental disabilities can live successful, meaningful lives in the community. SIS was normed on a sample of 1306 people over the age of 16 who live in 33 states and two Canadian provinces. DDD will be providing information to the authors on SIS scores so that this norming process can continue as the sample size grows. Three dimensions of support are measured for each activity/task: type, frequency and duration. Note: AAIDD has approved of DDD adding 6 questions to the SIS for our own use. They are: Home Living Activities subscale:  Using currently prescribed equipment or treatment Except Medical subscale:  Diabetes management Except Behavior subscale:  Managing attention seeking behavior ,  Managing uncooperative behavior ,  Managing agitated / over reactive behavior  Managing obsessive / repetitive behavior O_O_P 7,e/,|HH  0.k ? 3380___PPT10.`@i0  0(  d  c $@XK   $   s *$ @ )  $  &The purpose of the second module, the Service Level Assessment, is to: 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 to the legislature and the department Identify employment support levels for individuals receiving county services (these levels are not used in rate setting) In the future, it will also establish service levels for other paid services (like the Individual and Family Services program). DG\" " G H  0.k ? 3380___PPT10.``n0 [SP(  d  c $@XK   $ G  s *`$ @ )  $  m The individual support plan is the 3rd of the 3 modules in the DDD Assessment This is the module where planning and authorization occurs for the services that the person will receive. The information in the Support Assessment module feeds the Service Level Assessment module, which in turn, contributes to the information in the Individual Support Plan (ISP). Ln%) k H  0.k ? 3380___PPT10.`[-b 0 p r(   d   c $@XK   $    s *+ @ )  $  \Presenter: With the implementation of the DDD Assessment, the conceptual view of CARE has changed from being an assessment for one service to a system that contains multiple assessments that are used for different purposes. DDD has been approved to administer a  Lite version of the MPC assessment. This means that when DDD case managers administer a Medicaid personal care assessment, they are only required to complete the mandatory fields that are used in the Medicaid personal care algorithm. The other panels that are not required are still available for use at the discretion of the case resource managers professional judgment. Part of the reason for allowing this is that much of the information on the non-mandatory panels is measured in the DDD Support Assessment and was considered redundant. The other was that this non-mandatory information did not effect the algorithm for MPC.  xvH   0.k ? 3380___PPT10.`[-0 ((  (d ( c $@XK   +   ( s *h+ @ )  +  7The DDD / HCS assessments are different: one is future-looking and the other is past-looking. SIS questions measure supports needed to be successful compared to the personal care assessment which measures personal competence. This is different than the MPC assessment used by HCS that looks at competence in the immediate past. DDD has incorporated new assessment panels into the CARE interface which are visible only in DDD Assessments. The incorporation of these new panels into the CARE interface was necessary to obtain additional information that is currently used to administer other DDD programs and services . Note: Panel refers to the visual, user interface in the DDD Assessment computer application where assessment questions are typically organized by topic and the person/respondent answers are recorded. DH ( 0.k ? 3380___PPT10.`[-0 +#0(  0d 0 c $@XK   +  0 s *)+ @ )  +  uThe hyperlink will take you to the Residential Rates Shadow Period FAQs on the DDD Assessment Project Internet site. vvH 0 0.k ? 3380___PPT10.`[-0 8(  8d 8 c $@XK   +  8 s */+ @ )  +  JPresenter: In preparation of implementing the DDD Assessment, our development schedule is the following: DDD Council is sending information out at various intervals during the assessment project. They work through their mailing lists, the Arc and parent coalitions. Post-implementation support consists of having 3 DDD Assessment experts in each region. Every CRM will have at least one assessment  shadowed within the first 90 days of implementation and their first 5 assessments reviewed by these experts before being allowed to move the assessment to current status to ensure that they are completed accurately. Shadow Review  Regional experts will attend at least one assessment with a case resource manager to evaluate their use of prescribed  Best Practices in administering a DDD Assessment. & H 8 0.k ? 3380___PPT10.M_a]K0 ^V@(  @d @ c $@XK   + J @ s *5+ @ )  +  tArc = Advocates for the rights of citizens with developmental disabilities DDC = Developmental Disabilities Council Hu RH @ 0.k ? 3380___PPT10.`E`0 2*H(  Hd H c $@XK   +  H s *L+ @ )  +  lThe assessment will take place in the client s home/place of residence. 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