Developmental Service- Supporting Individual Success (SIS)
The Office of Aging and Disability Services (OADS) is using a new standardized assessment tool for adults with Developmental Disabilities who receive state funding. The Supports Intensity Scale (SIS) measures the practical supports needed by an individual. Support needs measured include the areas of home living, community living, lifelong learning, employment, health and safety, social activities, and protection and advocacy. It's a comprehensive assessment that engages the consumer in a positive interview process. Case managers, guardians and direct support professionals are included in the interview.
Our goals are:
- To use the same tool for everyone.
- To find out what each person's needs are for support.
- To be flexible when a person needs change.
- To make sure that each person gets the resources they need.
- To increase person-centeredness, self-direction, employment and community inclusion.
- To have case managers use the SIS results in Person Centered Planning.
- To look at interview results and review the cost of services provided.
- To complete a SIS interview once every three years for each consumer.
**SIS July 2014 Stakeholder Documents**
On July 24th 2014, the Office of Aging & Disability Services held a Public Stakeholder Meeting to continue the open conversation with Individuals, Family Members, Providers and other stakeholders. This meeting provided a lot of information regarding SIS Assessment outcomes, Level Assignments, Budget Allocation, Rates and Rate changes as well as Fiscal Impact information. Please find a link to several documents either referenced or discussed at this meeting for your review and comment.
We welcome and encourage public comment during this period and will be accepting comments through email at OADS@maine.gov for the whole month of August. The end date for this comment period is September 1st.
The Office of Aging & Disability Services recognizes that for Individuals, Guardians and Providers to get a full picture of the proposed changes recently presented at the Stakeholder meeting that level assignments will need to be provided to all Individuals who have received a SIS assessment. If an Individual has not received a SIS assessment to date, level assignment will be provided for review after completion of the process.
Notification of level assignment will be provided to the Individual or Guardian directly through the Provider responsible for case management coordination. Information was sent out to State and Community case managers on Friday, August 15th, 2014 and is now available for request with a signed release of information. Your case manager will be able to explain to you about the level assignment, the proposed service package and how to make comments.
This information will be for review and comment only, no changes to services will result from this initial process. There will be many opportunities for input and comment prior to final implementation of level assignments, proposed service packages and rates. We appreciate all your feedback about this process and continue to encourage your input.
- ME Stakeholder Mtg Power Point
- ME Stakeholder Mtg Jul 24 HSRI Power Point
- Draft of ME Validation Report
- Final Draft- Policy and Procedures Document
- Fiscal Impact of Proposed Rate Models
- Maine Level Expanded Level Descriptions
- Maine Levels 5 Update
- Provider Survey Results
- Section 21 and 29 Proposed Rate Models
- Section 21 Individual Budgets
- Section 21 Utilization Analysis
- Overview of Proposed Individual Budgets Sec 21
- Overview of Proposed Rates Sec 21 and 29
Frequently Asked Questions
1. What is Supporting Individual Success? Answer
- Supporting Individual Success is the new name for Maine's initiative around standardized assessments and resource allocation. Individuals with developmental disabilities will be interviewed using a tool called the Supports Intensity Scale. The results of that interview will ultimately be tied to individual budgets. Funding will be allocated at the individual level rather than the program or service level. An individual will have choice in the service array, within their individual budget. Supporting Individual Success reflects the core values of the Office of Aging and Disability Services including self-direction, personal choice and community inclusion.
2. What is the Supports Intensity Scales (SIS)? Answer
The Supports Intensity Scale (SIS) is a nationally recognized, valid and reliable assessment tool developed by the American Association on Intellectual and Developmental Disabilities (AAIDD). The SIS focuses on a person's daily support needs and is strengths-based.
3. Why is Maine Implementing the Supporting Individual Success initiative? Answer
- The SIS tool is a reliable method of assessing individual support needs. Maine intends to develop a fair and equitable approach to allocating resources. The current system is not sustainable. Maine's goals include:
- Aligning assessed support needs with funding amounts;
- Supporting 18-20 year olds by using the SIS to inform transition planning and to estimate potential future costs;
- Using some portion of savings to move people on waiting lists into services;
- Encouraging independence for people served by supporting their goal to live a full life in the local community;
- Developing self-directed service options to encourage maximum flexibility within a person's individual budget;
- Using the SIS process and results to inform the Person Centered Planning process; and Improving quality by creating a system that is individualized and sustainable.
4. How does the assessment occur?Answer
A trained and certified interviewer will use the SIS to measure a person's individual support needs. It usually takes about one and a half hours to administer SIS. Some interviews may take up to three hours. The amount of time it takes depends on a number of factors, including the individual's attention span and the number of people in the group. The interview may be held in a variety of locations that offer privacy and comfort such as a person's home, where he or she spends the day, or someplace else like an office.
5. Who will participate in a SIS Interview?Answer
Participants in the interview include respondents and observers. Respondents answer questions in the interview. At least two respondents are required. The person whose support needs are being assessed may serve as a respondent. People who know the consumer well and are very familiar with their day to day support needs also participate as respondents. Respondents must have known the person for at least three months and have had recent opportunities to support the person in one or more environments for substantial periods of time (at least several hours per setting.) Respondents are typically service providers who are direct support staff, or family members who provide daily support to the person. In addition to direct support staff from the home, support staff from community and work settings may be respondents.
The case manager participates in the SIS interview and will act as an observer if he or she is not familiar with the person's daily support needs. A guardian or family member may be a respondent or an observer, depending on their involvement in daily support to the person. When there are enough respondents, the case manager may act as an observer. Observers may include advocates. Respondents and observers will stay until the interview is completed. The person served may leave at any time.
6. Should clinicians be part of a SIS interview?Answer
The SIS measures support needs. It is not a clinical assessment. SIS respondents should have supported the person-served for at least 3 months and should be familiar with the person's day to day support needs. Typically, direct service professionals are best equipped to speak to an individual's day to day needs in areas such as bathing, toileting, meal planning, etc. Clinicians are welcome to participate as observers in the same capacity as case managers or others who are not familiar with the person's day to day support needs.
7. What kind of questions will be asked in the interview?Answer
The interviewer will ask about the supports a person needs at home, in the community, with friends and at school or work at this date in time. Other questions will focus on a person's needs in the areas of health and safety and essential medical and behavioral supports. Rather than looking several years back at historical behavior or events, SIS questions focus on current support needs.
8. How does the SIS interview capture the support needs of people with extraordinary needs?Answer
Answers on specific SIS questions will indicate that a person may have extraordinary medical or behavioral needs. The SIS interviewer will then ask a series of supplemental questions to gather additional information. Individuals, identified through this process as having extraordinary needs, will receive a comprehensive record review to ensure that the SIS has accurately captured their current support needs.
9. What happens after the SIS interview?Answer
The interviewer will send a report of the assessment results to the case manager after the interview. The case manager will then share the SIS results with the person-served and his or her guardian if there is one. With the person's permission, the case manager may send the report to the person's provider agencies.
10. Does the SIS interview replace a Person Centered Planning meeting?Answer
No. The Person-Centered Planning meeting will continue to be held once a year for every person served. The SIS interviews will be held once every three years. Information on the person's support needs from the SIS will be used to help inform the Person-Centered Plan. You can get a lot of information during an interview that is useful in developing a plan. The SIS is a conversation starter!
11. Will the SIS assessment change my eligibility for the Medicaid Waiver?Answer
12. What has Maine accomplished already?Answer
The initial phase of the SIS initiative began in March 2012 when SIS interviewers assessed a random sample of 500 individuals who receive Section 21 MaineCare Waiver services. These interviews were completed in September 2012. The Human Services Research Institute analyzed data collected from these interviews and produced a report summarizing its findings in November 2012. SIS interviewers are now assessing a random sample of 700 individuals who are receiving Section 21 services. They will then proceed to interview the remainder of persons on Section 21. A rate study will be conducted and funding levels will eventually be tied to individual SIS results.Maine has held stakeholder meetings with self-advocates, providers, advocates and others to gather input and share information. The Department has contracted with a provider to conduct a rate study. Following the January 2013 stakeholder meeting a name was selected for this initiative - Supporting Individual Success. Supporting Individual Success is person centered and is reflective of both the Supports Intensity Scale interview results and the plan for pairing those results with individual budgets.
13. Where can I get more information about Supporting Individual Success?Answer
- For more updated information about Maine's implementation of this initiative, Click Here
- You may also visit AAIDD's website for more information on the Supports Intensity Scale:
- You may contact:
- Quality Assurance/Quality Improvement Manager
Maine Department of Health & Human Services
Office of Aging and Disability Services
SHS# 11, 32 Blossom Lane
Augusta, ME 04333
- Phone: (207) 287-9200
14. Will interviews conducted during the pilot phase be redone? Answer
- The initial phase of the SIS initiative began in March 2012 when interviewers assessed a random sample of 500 individuals who receive Section 21 MaineCare Waiver services. These interviews, which were voluntary, were completed in September 2012. The Human Services Research Institute (HSRI) analyzed data collected from these interviews and produced a report summarizing its findings.
HSRI recommended that the Department consider the initial 500 sample as a pilot. This is consistent with recommendations made to other states that are implementing the SIS in conjunction with rate setting. To ensure quality of the interview, which is now a required assessment, and accuracy of the data, those individuals who participated in the pilot will have another SIS interview. A rate study will be conducted and funding levels will eventually be tied to individual SIS results.
- AAIDD SIS Website
- Maine SIS: Analysis of Individual Expenditures for those Receiving the Supports Intensity Scale (pdf*)
- Printable Brochure (pdf*)
- Supporting Individual Success - HSRI June 2013 Stakeholder Presentation (pdf*)