1

ODP’s Standardized Assessment & Related Processes

2

Agenda

Overview of Ascend & Workforce/Quality practices

Scheduling matters & Respondent criteria

Assessment practices (intro, order, participation expectations, scales, PA

Supplement, rating nuances, etc.)

3

Streamlined IDD Assessments

Ascend, now a MAXIMUS company, conducts high-quality IDD &

waiver assessments. We have conducted over 70,000 in PA

assessments since 2008.

4

Quality Improvement Organization (QIO)

A group of health quality experts, clinicians, and consumers organized to

improve the care delivered to people.

QIOs work under the direction of the CMS to assist with quality

improvement and to review quality concerns for the protection of

beneficiaries.

States receive increased federal dollars for assessments conducted

through an QIO or QIO-like entity.

5

The Pennsylvania Workforce

Program Manager, Jennifer Sieminski (NE PA based)

jennifersieminski@maximus.com Ext 3255

Regional Coordinator, Jamie McCartney (NW PA based)

jamiemccartney@maximus.com Ext. 3252

Regional Quality Leads (3)

• Rebecca Lieb (Cambria County)

• Suzann Savidge (Berks County)

• Monica Tompkins (Montgomery County)

• + Jamie McCartney

6

Assessors

Approximately 25 assessors (small group is important) and increasing

– 44% have been around over 5 years

– Avg. length of service: 4 years 6 months

Ascend provides ongoing quality checks:

– Training/IRQRs (qualification necessary)

– Monthly quality enhancement opportunities

– Each assessment is reviewed by the quality dept.

– Satisfaction surveys taken seriously

– Maintenance of a relationship with AAIDD

7

Scheduling

Ascend maintains the scheduling of assessments:

– Routinely due (5 year rotation)

– Those submitted and approved as expedited (urgent)

• new to waiver, significant life change

*ODP grants/approves the completion of assessments & determines Priority

Groups (PGs 1, 2, and 3)

8

SC Portal

All scheduling begins in the SC Portal (previously ASAP)

• Needs to be checked routinely

• SC suggests location, respondent list and any accommodations

• Is also where the urgent requests are submitted

The scheduler (assessor or in-house) receives the info and begins the

coordination process.

9

Scheduling Best Practices

Have a well rounded team present including but not limited to:

– the individual

– someone from home setting who can speak to the person’s day to

day needs (required from 2017 on)

Set aside at least 2hrs. to complete the meeting

Put a meeting on hold if the person’s status/needs are unknown and/or

seek higher approval

10

Respondent Criteria: Required for Validity

All attendees are considered respondents and must sign in, but not

everyone meets criteria.

Respondents who meet criteria have:

– Known the individual for at least 3 months

– Had recent direct contact over the last 3 months

– Can speak knowledgably about needs in current and potential

situations

A minimum of 2 people who meet RC must attend for the length of the

interview.

11

The Individual as a Respondent

We strongly recommend the individual attend or be available to meet and

be involved to the best of their ability and interest

Do they meet RC?- Depends…

– Can they provide detailed and accurate information about their

current and potential needs?

– They do NOT need to be able to use the scale

It is best to avoid meetings with the individual +1

12

Cancelations & Conference Calls

We will accommodate reasonable requests to cancel but can have the

meeting when enough RCs are avail.

Assess quality/accuracy: If a home representative doesn’t show-we

typically defer to the SC as to how to proceed.

We will not hold assessments where a residential agency is involved and

not represented.

Conference Call participation is primary for family and should be

requested in advance for approval.

13

Assessment Introduction

SIS® overview

SIS® Purpose

Basic team roles

SIS® summary report access

Demographic info/support providers verified

Distribution of reference material

Sign in sheet

– Confidentiality

– Need to avoid Medicaid fraud (intentional inflation)

– Verifies respondent criteria/attendees

14

15

2017 Changes

SISOnline/SISVenture

SIS-A versus the classic SIS

– Mainly formatting/order differences

– Potential collection of more demographic info

– 3 additional medical items (hypertension, allergies, and diabetes)

– Additional semantics added to the scales

The addition of 6 more supplemental questions

No upper age cap

16

Best Practices for Participation

Arrive/start on time

Stay on track- limit off topic discussions and interruptions during the

interview

Participation from everyone

Consider the # of people involved

17

Assessors are Expected to:

Ask and explain each SIS® question

Explain the rating scales

Ask questions about the chosen ratings

Ask what is important to/for the individual

Establish consensus & document any concerns

Be courtesy and respectful

Be transparent

Report abuse, neglect, exploitation

18

Respondent Teams are Expected to:

Help us understand the support

Work with the assessor

Provide what is important to/for

Be courtesy and respectful

Rate for success

19

Assessment Order

The PA Supplement (first 10 questions)

Section 1 of the SIS (Exceptional Medical and Behavioral Support Needs)

The PA Supplement (remaining 5 questions)

Section 2 of the SIS (Support Needs Index)

Section 3 of the SIS (Supplemental Protection and Advocacy Scale)

20

The PA Supplement: 1st 10 Questions

21

The PA Supplement (items 1-10)

1. Mobility supports

2. Transferring supports

3. Vision supports

4. Hearing supports

5. Communication supports

6. Safety supports

7. The need for treatment or monitoring of physical health conditions

8. The presence of a psychiatric diagnosis

9. Supports received if the person takes psychotropic medications

10. Telephone use

22

Exceptional Medical and Behavioral Support Needs

Current & Exceptional (besides meds/appts/beyond what’s usual)

Rate for the intensity of support not for diagnosis or behavior

23

The PA Supplement (remaining 5 questions )

24

The PA Supplement (remaining 5 questions )

Three main categories:

– Health Risks (SQ 1)

– Severe Community Risk (SQ 2&3)

– Severe Risk or Injury to Self (SQ 4 and 5)

Each item has subitems, if triggered (letters a-e)

25

Health Risks

26

Severe Community Risk

27

Severe Community Risk

28

Severe Risk or Injury to Self

29

Severe Risk or Injury to Self

30

SIS Sections 2 & 3

Part A – Home Living

Part B – Community Living

Part C – Lifelong Learning

Part D – Employment

Part E – Health & Safety

Part F – Social Activities

Protection & Advocacy

31

Main Rating Scale

Rate for success

– This is not necessarily

current support

We don’t rate for

– agency policy

– what the ISP says

– segregated settings

*Don’t shrink the world

*Don’t over or underestimate

*Maintain rating for success

32

Main Rating Scale Nuances

Rate for what is typical (dominant), not best day or worst day

• This does not over ride the idea of success

Items are to be rated holistically

The TOS chosen, gets rated in the FQ and DST

There can be multiple ways to rate an item

– The tool is robust

– A 3-2-1 is the same as a 2-2-2 is the same as a 1-3-2

Congruency of certain items is expected within the SIS/PA Supplement

33

Wrapping up the SIS

Reference folders are collected

The assessor submits the assessment via SISOnline and uploads the

signature sheet

The Quality dept. reviews the assessment materials consistency and

completeness and reassigns the final report to the SCO in three weeks

or less.

34

Ascend’s Role

Ascend’s role is to administer the SIS®, not score it. We:

– have no vested interest in the score

– no access to score

– cant change a SIS Needs Level/Needs Group

As always, please review the assessment and direct any questions about

the actual SIS items, the PA Supplement and/or its personalization to

Ascend in a timely manner.

Thank you!!