Facts About the SIS™ Process

WHO is Ascend and What is Ascend's role?

Ascend Management Innovations (Ascend) is headquartered in Nashville, Tennessee. Ascend has national experience conducting special assessments for many different types of programs and services. We are very excited to bring our expertise to help Pennsylvania meet its goals of implementing a Statewide, standardized assessment.

The Office of Developmental Programs (ODP) has chosen Ascend to conduct the interviews for the universal assessments. ODP requires that the assessment process be independent of State or County government and cannot be a provider of mental retardation services or a current Administrative Entity under contract with ODP. The SIS™ is the instrument selected by the ODP as the tool for the universal needs assessment for waiver participants. Ascend’s task is to ensure that these interviews are done in a respectful and consistent way by every assessor, every time, and in every corner of the Commonwealth.

What is the SIS™?

The assessment instrument the ODP has chosen to use is called the Supports Intensity Scale™ or the SIS™. This instrument was published by the American Association of Intellectual and Developmental Disabilities in 2004. It is designed to measure a person’s support needs. While most other assessments identify tasks that a person can and can’t do, the SIS™ measures the type and intensity of assistance that an individual needs to successfully complete tasks of everyday life. Some areas measured are: home living, community living, lifelong learning, employment, health and safety, social activities, and protection and advocacy. Activities are ranked according to frequency, amount, and type of support within the scale. The SIS™ was designed to:

• Assess support needs of individuals ages 16 to 72
• Determine the intensity of the need; and
• Over time to monitor individual progress and evaluate outcomes.

This assessment is important for many people in different ways. The SIS™ assessment is useful for individuals because it gathers very good information about the individual’s unique support needs. This information can be very helpful in developing a person’s individual support plan. Assessment information can also be helpful to providers, counties, and the ODP for planning purposes, because the data gathered can help identify underserved groups or needs in particular areas.

WHY is a Universal Assessment being conducted?

A universal assessment is required by the federal agency that approves and helps with funding of waiver services, the Centers for Medicare and Medicaid Services (CMS). It also:

• Will provide one source of information to be used in the planning process.
• Provides person-centered and specific information.
• Focuses on level of support needed by a person, not deficits in skills.
• Advances the future capacity of the services and guides future state planning.
• Assists as one of the tools to help in developing the Individual Support Plan (ISP). The ISP is developed by the team, using all available information, including the SIS™ as an assessment tool.

WHEN will interviews begin?

The first assessments will begin in select areas in February of 2008. ODP has committed to prioritizing assessments for people as they come from the waiting list into waiver services. ODP plans to phase in the assessments for people who currently are being served by the waivers. This phasing-in process will occur over a multi-year cycle.

WHO will be conducting interviews?

Ascend’s assessment teams in Pennsylvania include highly trained and qualified full- and part- time assessors. All of our assessors have at least a bachelor’s degree in a field related to developmental disabilities and at least 3 years of experience working with individuals who have intellectual or developmental disabilities. Our assessors are independent, impartial and conflict free. What that means is that our assessors do not have a stake in the outcome of any one particular assessment. To ensure this, ODP and Ascend do not allow an assessor to interview any individual with whom they have had a provider or professional relationship in the past year.

HOW will the information be used?

Assessors will be filling out the SIS™ booklet while they conduct interviews. As our assessors complete each interview, they will fill out the SIS™ interview booklet and will also take extensive notes. It is important for you to know that all information that we learn from these interviews will be kept confidential by us. The assessment is one of the tools used to help in developing the Individual Support Plan (ISP).

WHO can participate in Interviews?

The people interviewed for a SIS™ evaluation are referred to as Respondents. There should be a minimum of two (2) respondents at every SIS™ meeting. The SIS™ meeting should be scheduled as one meeting with all respondents in attendance. Respondents can be the individual, family members, friends, direct support or other staff from residential or day service providers, or the Supports Coordinator (the SC). The SC will use the information gained through the discussion at the SIS™ meeting in the development of the ISP. For this reason, it is recommended that SCs attend the SIS™ meeting as an observer, even if they do not know the individual well enough to participate as a respondent.

It is important that each respondent knows the individual in a day-to-day way and that they have known the individual on a day-to-day basis for at least 3 months, although others may observe, if appropriate. A respondent must also be comfortable talking about intimate details of a person’s life and support needs.

Ideally, the informants gathered for the SIS™ interview should have knowledge of the individual across most settings that have been relevant in the past 3 months. That is, informants represent knowledge of the individual at different times of the day, evening and night; across both week days and week ends; across home and work or community settings; during both quiet and active periods; when the individual is in group and in solitary activities. The ODP is working with Ascend to determine the best method of identifying respondents for these interviews.

Should the individual participate in the interview?

Individuals are absolutely invited to participate. It is not required, though. The decision about whether or not the individual participates in the practice interviews is entirely up to each individual and family, according to what works best for you.

HOW will I be contacted?

Staff from Ascend will typically call individuals and families to confirm basic information, preferred respondents, and interview locations. Ascend scheduling staff may also work with Supports Coordinators to assist with identifying respondents and to help coordinate scheduling. During our initial call to the person or persons that ODP instructs us to call, Ascend staff will ask who should be in the interview. We will also ask if there are any special accommodations that should be taken into consideration during the interview. This would be a good time to let Ascend know of cultural preferences, speech/language or hearing difficulties or low English proficiency speakers that may require the assistance of an interpreter.

WHAT will happen on the day of the interview?

The assessor will explain how the interview works. During the interview, the assessor will ask you questions like:

• What type of support does Jane need to successfully get dressed each day?
• How frequently does Jane need this type of support?
• On a typical day when support of this type is needed, how much time should be devoted?

Your job is simply to answer these types of questions as well as you can. If an individual and a family member don’t 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 SIS™ publishers have let us know that once assessors are “experts” the interview can be expected to take 2 1/2 to 3 hours to complete.

At the end of the interview, our assessor will give respondents a satisfaction survey that can be mailed to Ascend or completed online at our website. This survey is a very important opportunity for individuals and families to give us feedback and help us ensure that interviews are conducted respectfully and that respondents have a good experience as information is shared.

WHERE will interviews take place?

The assessment meeting should take place wherever the individual and other respondents choose. It should be a place where all respondents agree to meet. This can include but is not limited to the individual’s home, their day service provider, or the home of a family member or friend. If the individual has chosen not to participate in the assessment meeting, the respondents may choose the meeting location. It would be best if the interview could take place in a room that is quiet, comfortable and appropriate to meet the individual’s needs.

HOW can I give Ascend and the ODP feedback about my experiences?

At the end of the interview, our assessor will give respondents a satisfaction survey that can be mailed to Ascend or completed online at our website. This survey is a very important opportunity for individuals and families to give us feedback and help us ensure that interviews are conducted respectfully and that respondents have a good experience as information is shared.

HOW will quality be ensured?

Quality is very important to us. Ascend will use several different ways to make sure we are doing quality and respectful assessments. First, all assessors must participate in a very thorough training over a two week period. One part of the training is held by certified SIS™ trainers. The SIS™ trainers are experts who work for the publisher of the SIS™. They will teach the assessors how to conduct interviews and how to complete the SIS™. They will also observe the assessors in practice interviews. At the end of the training, all the assessors must pass extensive testing to make sure that they are completing the assessments according to all of the publisher’s rules. Assessors will also be trained by staff from the Office of Developmental Programs about the service system, Everyday Lives, and Pennsylvania’s Medicaid waivers. Ascend also teaches a very thorough training about the process, our rules, and what we expect.

Once the first training is complete, every assessment is monitored for quality. Ascend has a full team of staff whose job is to monitor the quality of the assessments and review the satisfaction surveys. The quality team meets regularly with the assessors to provide results about the quality review process. They also provide ongoing training.

WHERE can I get more information?

If you have questions or concerns about Ascend or our assessment staff, contact us toll free at 1-877-431-1388. If you would like information about the SIS™ instrument (how it was developed and what it measures), a good place to start is to look at the information posted at the SIS™ website, which is www.siswebsite.org. If you have questions about how the Supports Coordinators will use the assessment information or about services offered by the Office of Developmental Programs, call 1-888-565-9435. You may submit additional questions to Ascend by clicking here.