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33 0 obj<> endobj xref 33 45 0000000016 00000 n Technology, Power of Ongoing research around the world continues to confirm the assessment's reliability and validity. The SIS will help the Individualized Service Plan (ISP) team to understand what supports are needed for the person to achieve a richer, fuller life. The term waiver comes from waiving the requirement that in order to receive certain services (such as residential supports, nursing supports, employment supports) the individual must live in an institution. In-Plant Performance System (IPPS) - Revision 4 My Account, Forms in INSTRUCTIONS: Identify the Frequency, Daily Support Time, and Type of Support that is reported necessary for the person to besuccessful in the six activity domains (Parts A-F). The American Association on Intellectual and Developmental Disabilities (AAIDD) is the publisher, copyright holder and sole owner of the SIS. SIS Training (CSBs and providers, please contact your RSS for scheduled training dates). PDF The Office of Developmental Programs (ODP) uses the Supports - WCSI 8403 Colesville Road, Suite 900Silver Spring, MD 20910, Telephone: 202-387-1968 | Fax: 202-387-2193, Privacy Policy | Terms of Use | Sitemap | Contact Us, American Association on Intellectual and Developmental Disabilities (AAIDD). Once the assessment is scheduled, a confirmation email will be sent from KEPRO The SIS-Adult (SIS-A) version is a standardized assessment tool designed to measure the pattern and intensity of supports required by a person aged 16 years or older with an intellectual or other developmental disability to be successful in community settings. At least two people who understand the persons support needs must stay for the entire interview. Enjoy smart fillable fields and interactivity. 0000003824 00000 n Providers applying for a customized rate must have documentation to demonstrate that the individual meets the criteria as described within the provider guidelines. An assessment appears as an assignment on SIS, but has questions for students to answer. A SIS assessment is a meeting with a DDS SIS Assessor and at least two people (respondents) who know a great deal about the individuals daily support needs. From the Select a Template drop-down menu, choose the appropriate document. There are three waivers available for individuals with a developmental disability: Virginia currently has a waiting list to receive a waiver. respondent should be sent by mail the telephone number of a secure conference 0000014548 00000 n Should the individual participate in the interview? On October 1, 2018, Kepro began administering needs assessments for individuals with intellectual disabilities or autism, including those in need of services in the state of Pennsylvania. HCSIS ISP Assessments | Mass.gov An SNI of 100 is average and indicates average support needs. Business. The SIS-A does not focus on identifying an individuals deficits, but rather on identifying the supports an individual needs to achieve their goals. Supports Intensity Scale Adult VersionTM (SIS-ATM). Save or instantly send your ready documents. 0000016354 00000 n In the second year, starting July 2018, people who live at home and also receive Adult Day Health (ADH) services will begin having SIS information used in their ISPs. Learn More About the DOJ Settlement Agreement, DD Waiver Regulations (effective 3/31/21), DBHDS-SIS Standard Operating Procedures and Review Process COVID-19 Version 8.26.22, VA SIS Interview Respondent Info COVID-19 Version 8.26.22, DBHDS SIS COVID-19 Vendor Protocols 8.17.22, SIS & PCP Process in VA 7.22.20 (SIS-A and SIS-C), Analysis of Virginias Level System Utilizing the Supports Intensity Scale, DBHDS VA SIS Reassessment Request 8.17.22, SIS Satisfaction Survey Report 1st Quarter report FY23, SIS Satisfaction Survey Report 2nd Quarter report FY23, SIS Satisfaction Survey 3rd Quarter report FY22, SIS Satisfaction Survey 4th Quarter report FY22, Ascend/Maximus VA SIS Annual Activity Report, Priority Needs Checklist (PNC) v2 5.01.21 (SC completes in WaMS), Critical Needs Summary (CNS) v2 5.01.21 (SC completes in WaMS), DBHDS SIS Scheduling Procedures 10.29.2020, DBHDS VA SIS Reassessment Request Instructions 8.17.22, DBHDS VA SIS Reassessment Request Form8.17.22, New Waiver Slot Assignment Report FY23 Q2, New Waiver Slot Assignment Report FY23 Q1 Updated. Honolulu, HI 96813. 0000016579 00000 n If a respondent does not This can occur at any time during the year. Your information is securely protected, since we adhere to the most up-to-date security requirements. Emailed, faxed, or mailed applications are not accepted. All rights reserved. The SIS-A is completed in an interview-like setting. The tool selected by the Pennsylvania Department of Human Services Office of Developmental Programs (DHS-ODP) is the Supports Intensity Scale Adult Version (SIS-ATM) published and owned by the American Association on Intellectual and Developmental Disabilities (AAIDD). 0000002416 00000 n Ample time should be allocated Customized Rate Help and Useful Documents, FORM pg-20 Customized Rate Provider Guidelines:Updated 7/1/2022, FORM SF-20-This form is required with submission of all customized rate applications and should be uploaded to WaMS:Updated 1/1/2023. The SISOnline is the AAIDD web-based platform designed to support administering, scoring, and retrieving data and generating reports for the suite of Supports Intensity Scale (SIS) products. The SIS suite of tools includes the Supports Intensity Scale-Adult Version (SIS-A, 2015) for ages 16 years and older, and a Supports Intensity Scale-Children's Version (SIS-C TM, 2016) for ages 5-16 years. 0000011509 00000 n Waivers allow the state to fund certain community-based alternatives to institutional care. JA.001] Scheduling Past Due Regular (5-year) Assessments Supports Coordinators (SCs) and SC Supervisors can submit scheduling information for regular (5-year) past due assessments in Kepro SAM by following the process outlined below. Kepro will perform the assessment to assess the support needs of individuals aged 14 and older, determine the intensity of the need and to monitor individual progress and evaluate outcomes over time. Adjusting paperwork with our comprehensive and intuitive PDF editor is simple. Choose the appropriate printer and click the OK button. If you have questions about the SIS assessment or supports level, contact your case manager. Visit AAIDD's website to learn more. You can decide whether or not to have the assessment count in their grade, and you can have the answers . Edit your blank sis assessment online Type text, add images, blackout confidential details, add comments, highlights and more. If you believe that this page should be taken down, please follow our DMCA take down process, 17 Station St., Ste 3 Brookline, MA 02445. D. Establishment of supports packages, which means a set of assumptions regarding the types and amounts of supports that an individual needs to be adequately supported in the community. .)F8c7#Ulqf2&GSo L2 ~L3dfiSo @,P Pennsylvania: PA Community Living Waiver PA Consolidated Waiver, Intensity Scale (SIS) to be the standardized needs assessment in Pennsylvania for individuals with intellectual disabilities. The survey gathers information about scheduling, the SIS assessor, and the assessment process. SIS Online Users Guide - DocsLib As needed, enter values in the available . At least two people who understand the person's support needs must stay for the entire interview. A. IPPS provides a firsthand, onsite observation of how well employees conduct FSIS inspection and verification procedures in federally-inspected establishments. This requires the individual to have access to a device that has audio and video capabilities. You can also download it, export it or print it out. Initial Assessment Completed when services are requested. USLegal fulfills industry-leading security and compliance standards. "zHZnEM.T*Kap7:#$d$. As an additional level of quality oversight, an ODP Regional SIS Lead and/or KEPRO SIS-A results are normed and validated. PA SIS - Resources and Training Materials - KEPRO Monitor individual progress and evaluate outcomes over time. TM and PA Forms 10/10, Features Set 10/10, Ease of Use 10/10, Customer Service 10/10. Handbook, Incorporation Additional information about the DD waivers, the waiting list, independent housing, and locating service providers can be found at My Life My Community. 0000018787 00000 n DDA Assessment | DSHS - Washington Kepro SAM Scheduling Resources. SIS assessments are conducted during a face-to-face interview by a SIS Assessor who has been trained by AAIDD. Keystone State. Your job is simply to answer these types of questions as well as you can. capabilities, the virtual assessment cannot be completed. Participants, also referred to as respondents, must include at least two people who have known an individual with intellectual or developmental for at least 3 months. Spanish, Localized The Virginia Developmental Disabilities Home and Community-Based Services (HCBS) Waivers help eligible people with a developmental disability (DD) to receive services and supports in the community. 0000074755 00000 n Customized Rates:Waiver Customized Rate Funding: Providers may apply for customized rate funding for individuals who meet certain criteria qualifying them as being an outlier to the current rate structure. The Print Blank Document page appears. Look through the entire form to ensure you have completed all the information and no changes are required. Focus on the individual's supports needs rather than on skill deficits. A Supports Intensity Scale (SIS) assessment determines the daily supports a person with intellectual and development disabilities needs to live as independently as possible in the community. Restrictions apply; refer to the Customized Rate Provider Guidelines (FORM-PG-20). services, For Small The Supports Intensity Scale - Adult Version (SIS-A) is a standardized assessment tool designed to measure the pattern and intensity of supports that a person aged 16 years and older with intellectual and developmental disabilities (IDD) requires to be successful in community settings. 275 E. Main Street 4CF Frankfort, KY 40621 Phone: (502) 564-7700 Fax: (502) 564-8917 Hours: Monday-Friday 8:00 am-4:30 pm ET Crisis Lines by County Hotlines/Other Contacts Suicide Prevention Hotline Contact Us PASRR, Incident Reporting, and Mortality Review Fax: (502) 564-2284 Branch Manager Cathy Lerza (502) 782-6222 This can include (but is not limited to) the individuals home, his or her day service provider, or the home of a family member or friend. PDF SIS-Adult Version SIS-Children's Version - Virginia Department of You can use the following methods to assess the SIL value for an instrumented system: . The SIS-A is a standardized assessment that measures the pattern and intensity of supports an adult (16 years and older) with intellectual and developmental disabilities requires to be successful in community settings. SIL Assessment Methods. Click on the link below to access DMAS Forms. Import a form. Maximus Core Capabilities Clinical Services Understand the Assessment Process What to expect at your SIS Assessment Who will participate? SIS-A assessments can be long, sometimes taking between 3 and 4 hours to complete. This second group is called Cohort 2. TTY callers please, Supports Intensity Scale (SIS). In addition, at least one person that has known the individual for at least six months must attend as an additional respondent. What is the SIS-A? The SIS Assessor will not be the person's case manager. Ensures that a website is free of malware attacks. 0000020903 00000 n SIS-A assessments can be long, sometimes taking between 3 and 4 hours to complete. All customized rate applications should be completed using the Waiver Management System (WaMS). The Assessor will make sure that all attendees are ready to begin the interview. If the assessment determines the person is. NOTE: A regular assessment is considered past due when the last SIS was conducted 60 months (5-years) or more the Family and Individual Supports Waiver (FIS), and. DocHub v5.1.1 Released! 1250 Punchbowl Street, Room 463 Show More Table of contents. Service, Contact The Supports Intensity Scale (SIS) is an assessment tool developed by the American Association on Intellectual and Developmental Disabilities (AAIDD) that evaluates practical support requirements for adults with intellectual and developmental disabilities (IDD). Many updates and improvements! Assessments in SIS - Burke Tech Support 0000004200 00000 n DBHDS collects SIS Satisfaction Survey responses from those who choose to complete a survey after participating in a SIS assessment. Below you will find information about DD waivers policies, procedures, Waiver Slot Assignment Committees,theSupport Intensity Scale assessment, and other information to support individuals currently on the DD waivers. The Supports Intensity Scale (SIS) is a strength-based, comprehensive assessment tool that measures an individuals support needs in personal, work-related and social activities in order to identify and describe the types and intensity of the supports an individual requires. If an individual does not have access to a device with audio and video capabilities, the virtual assessment cannot be completed. concentrating first on 5-year reassessments, prioritizing those that are overdue, and A blank record will open where information needed to complete the request is entered. When autocomplete results are available use up and down arrows to review and enter to select. The SIS Assessor will not be the persons case manager. 0000005091 00000 n PA SIS - Homepage - KEPRO The individual being assessed will always be included in their assessment. 0000004980 00000 n TM and PA Supplement assessments through a conservative roll-out strategy, Developmental Disabilities Division (DDD), COVID-19: Information for Participants and Families, COVID-19: Information for Waiver Providers, More information for participants / families, I am a certified adult foster home caregiver, Archive: Correspondence to AFH Caregivers, I want to be a Medicaid I/DD Waiver Provider, Administrative Hearing for Medicaid I/DD Waiver Providers, How to Apply: Medicaid I/DD Waiver Admission, The Road to Supporting Hawaiis Families: Long Description, How to file a grievance about your services, Informal Review and Administrative Hearing, Website Accessibility and Non-Discrimination Notice, Person for whom the SIS is being conducted, Parents/guardian, spouse, or other family members, Direct support staff from the persons home, day program, or employment, Friends, neighbors or community members who know the person well, Develop more effective person-centered service plans (ISP), and. SISOnline supports administering, scoring, and generating reports for AAIDD's suite of SIS products. 02. Specifically, the revisions to the rules are as follows: Paragraph 78.27 (2)"d" in Item 3 has been revised to read as follows: "d. Needs assessment. 0000056145 00000 n It would be best if the interview could take place in a room that is quiet, private, comfortable and appropriate to meet the individuals needs. Kepro SIS Assessment Satisfaction Survey. Share this page. Slot Use Disposition Reports (Item 320 S.1), If you or someone you know is in crisis, contact the 988 Suicide and Crisis Lifeline by calling or texting 988 or visiting 988lifeline.org, Virginia Department of Behavioral Health and Developmental Services, Office of Behavioral Health Wellness (OBHW), Military Service Members, Veterans and Families, Early Intervention for Infants and Toddlers, Individual and Family Support Program (IFSP), Intermediate Care Facilities for Individuals with Developmental Disabilities (ICF/IID), Support Coordination/Case Management Resources, Victims of Eugenics Sterilization Compensation Program, Public Guardianship for Individuals with Intellectual and Developmental Disabilities, Learn about the Individual and Family Support Program (IFSP). 0000023087 00000 n The SIS-A is designed as an interview of the individual, with participation from a team of friends and supporters. . Respondent teams should plan on logging in to the meeting ten minutes prior to the 13. The SIS-ATMfocuses on the level of support needed by a person instead of evaluating deficits in skills. PDF Scheduling Past Due Regular (5-year) Assessments 0000005168 00000 n Before the interview begins, the SIS Assessor will explain the interview process and answer questions from the attendees. quality staff may listen in on the assessment. Together, we aim to support Pennsylvanians with developmental disabilities and/or autism to achieve greater independence, choice and opportunity in their daily lives. Individuals are absolutely invited to participate. FSIS Directive 4430.3, Revision 3, In-Plant Performance System (IPPS), 9/11/12. People who receive services are strongly encouraged to be at their SIS interview. ODP-Reinstatement of SIS and PA Supplement It identifies the types and amount of support each person needs to be successful. This can occur at any time during the year. At Kepro, our goal is to build healthier communities in partnership with those we serve. Sis assessment pa: Fill out & sign online | DocHub TM) and Pennsylvania (PA) Supplement Since its inception in 1876, AAIDD has produced guidelines naming, defining, and diagnosing the condition known today as intellectual disability. AAIDD is the oldest and largest professional society concerned with intellectual disability. From the yellow left-hand navigation menu, click on CLIENT SIS ASSESSMENTS. Type text, add images, blackout confidential details, add comments, highlights and more. ARC 3184C - Iowa Administrative Rules A blank datasheet for the Risk Matrix Internal assessment appears. In the third year, starting July 2019, people who live at home and do not attend ADH, but receive other services will begin having SIS information used in their ISPs. Developmental Disabilities (AAIDD) and Keystone Peer Review Organization (KEPRO) to line to dial in. The SIS is a nationally normed assessment tool for people with intellectual and developmental disabilities. 0000071115 00000 n HCSIS Individual Support Plan (ISP) is a module that monitors the creation, revision, and preliminary approval of ISP planning documents. The Supports Intensity Scale (SIS) is the tool DDD is using to understand the kind of supports people need, based on their individual circumstances, to be successful at home and in the community. If you have any questions, please reach out to your SIS Regional Lead. The assessment tools, submission requests and approval process will remain the same. (See rating key below.) However, it is not required. The SIS-A TM focuses on the level of support needed by a person instead of evaluating deficits in skills. Attorney, Terms of PDF 4.1 Supports Intensity Scale Assessments, Referrals and Reviews This assessment evaluates practical support requirements for adults with intellectual and developmental disabilities (IDD). 0000006500 00000 n 0000064853 00000 n Maximus U.S. Services first partnered with AAIDD and states in 2007 to develop SIS programs. Kentucky Cabinet for Health and Family Services There are three sections in the DDA Assessment: Washington State Department of Social and Health Services, Aging and Long-Term Support Administration (ALTSA), Developmental Disabilities Administration (DDA), Facilities, Finance and Analytics Administration (FFA). Guarantees that a business meets BBB accreditation standards in the US and Canada. The SIS-A assessment tool was created by the American Association on Intellectual and Developmental Disabilities (AAIDD). Highest customer reviews on one of the most highly-trusted product review platforms. blank sis assessment sis assessment pa PhD AAIDD 2004 OO 1s 2s Subscale destructiveness gestural School Name: STUDENT ENROLLMENT FORM SIS-10W (Revised) Complex Area: Student ID No. Scheduling Expedited Requests. Assessments in SIS. 0000001705 00000 n Experience a faster way to fill out and sign forms on the web. For Initial Assessments and then every five years, the Case Manager will ask every question in the SIS to ensure all support needs are up to date; this is called a Directed Assessment (on average, this takes about 3 hours). PDF Supports Intensity Scale - American Association on Intellectual and The Children's Support Assessment is used for clients aged 15 and younger. We use cookies to improve security, personalize the user experience, enhance our marketing activities (including cooperating with our marketing partners) and for other business use. Supports Intensity Scale (SIS) Assessment What to expect of your assessment This assessment evaluates practical support requirements for adults with intellectual and developmental disabilities (IDD). Theft, Personal Updated: 08/18/2020. What will happen on the day of the interview? Complete all the required fields (these are yellow-colored). green phases of Governor Wolfs Plan to Reopen Pennsylvania. For this reason, the respondent must have known the individual very well from direct experience and for at least 3 months. We make that possible through giving you access to our full-fledged editor effective at altering/correcting a document?s initial textual content, adding special boxes, and putting your signature on. Note: should an agency desire training for their staff regarding SIS assessments, please contact the SIS team at Once Intake and Eligibility has determined a person is DDA Eligible and the person has requested a DDA service, an assessment is necessary to determine whether a person will receive paid services. Create Test: Displays a new blank SIS Proof Test record on the Proof Test Definition page. 0000006225 00000 n The SISmeeting will be scheduled as a single meeting with all respondents in attendance. 0000074817 00000 n If an individual and a family member dont quite agree on the answers to a question at first, the assessor may ask extra questions to be sure that we understand your viewpoints and help with the process of coming to agreement. The Assessor will need to know how much support is needed for the person to fully engage in these activities. For information on the Service Level Assessment: Melissa Randles, State Plan Services Unit Manager. The SIS is an interview tool that measures the support needs, or level of assistance, a person with developmental disabilities needs to fully participate in their community. For more information on the DDA Assessment check out WAC Chapter 388-828. IV-102 A3 - Mental Restriction Form - Hopkinsmedicine, PAIN MANAGEMENT CENTER REFERRAL FORM - Stagnes, Grow Clinic Referral Form - Boston Medical Center - Bmc, Identity ISP Manual for Individuals with ID - Department of Human Services PDF Virtual/Remote Interview Respondent Guide 0000013052 00000 n select individuals identified by ODP. 0000005044 00000 n Register for Webinars & Member-Only Forums, Consortium for Constituents with Disabilities, Supports Intensity Scale - Adult Version (SIS-A) (2015), Supports Intensity Scale- Children's Version(SIS-C) (2016), Supports Intensity Scale - Adult Version(SIS-A): Annual Review Protocol (2018), Person-Centered Planning With the Supports Intensity Scale - Adult Version: A Guide for Planning Teams (2017), Normed with a culturally diverse group of over 1,300 people with intellectual and developmental disabilities, Normed in 33 states and two Canadian provinces, Psychometric properties are documented in peer reviewed journals around the world, Normed with a culturally diverse group of children with intellectual and developmental disabilities. From the Actions bar, click Print a Blank Document. Waivers fund a variety of supports including those that: provide medical care enable employment enable community living provide behavioral interventions If the respondent cannot participate virtually and has access to a landline phone, the 0000008121 00000 n The SIS Assessor will ask about activities at home, in the community, and with friends and family. Supports Intensity Scale - Adult Version (SIS-A). The SIS was designed to: Assess support needs of individuals age 16 and older (SIS-A) Assess support needs of children age 5-15 (SIS-C) Determine the type and intensity of support needed. This ensures the assessor is given the most accurate information about the persons needs and abilities that will result in the person receiving the correct level of support to improve their quality of life. HWr6NW}S,'U;KCLhDiD:= HRqZ"={vl&M=x2 Everyone enrolled in the Innovations Waiver will complete a SIS assessment. (2015) The SIS-A is a standardized assessment tool designed to measure the pattern and intensity of supports that a person aged 16 years and older with intellectual disability requires to be successful in community settings. 12VAC30-122-200. Supports Intensity Scale requirements - Virginia If an individual does not have access to a device with audio and video What are the levels of supports intensity scale? Significant Change Assessment Completed when there is a significant change in the clients support needs, such as an increase in medical or behavioral supports. The SIS will be conducted every 3 years for every person 16 years and older receiving DDD services. INTRODUCTION: The Office of Developmental Programs, together with stakeholders from across Waiver/Program TitlePA Community HealthChoices (CHC) Quality / Outcome Assessment: PA PA Media (formerly the Press Association) is a multimedia news agency, and the national Use professional pre-built templates to fill in and sign documents online faster. assessment start time. capabilities. This requires the individual to have access to a device that has audio and video A SIS assessment is required for everyone who receives DD waiver services. Rating options are: 4=full physical assistance; 3=partial physical assistance; 2=verbal/gestural prompting; 1=monitoring; 0=none.

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