CCDC Position On The New Combined DD Waiver, HB15-1318 - Concerns from the People

Submitted by admin on September 12, 2015 - 9:50pm

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HB  15-­‐  1318  provides  for  a  single  Medicaid  waiver  to  provide  for  home  and  community  based  services  for  adults  with  intellectual  and  developmental  disabilities  (IDD).  The  Department  of  Health  Care  Policy  and  Financing  (HCPF)  administers  this  program  through  the  Department  of  Intellectual  and  Developmental  Disabilities  (Department).    
A  key  component  of  this  legislation  requires  the  Department  to  justify  the  continued  use  of  the  Supports  Intensity  Scale  (SIS)  used  to  assess  adults  with  IDD.  Our  experience  as  families  and  advocates  for  those  with  IDD  demonstrates  that  much  of  this  data  is  false  or  misleading  and  has  a  negative  impact  on  the  lives  of  those  who  undergo  this  assessment.  
Some  of  us  have  participated  in  HCPF’s  Assessment  Tool  Stakeholder  group  charged  with  developing  a  new  assessment  tool  for  all  those  covered  by  Medicaid  waivers.    We ask that you support efforts to require the HCPF to transition away from the SIS and have all Long Term Services and Supports (LTSS) clients use the new tool once that is implemented.

How HCPF Presents the SIS: The Truth:

The  SIS  Assessment  identifies  individual  strengths  and  support  needs  and  assists  the  case  manager  in  the  development  of  a  Service  Plan.  
The  Support  Level  utilizes  five  sections  of  the  SIS,  along  with  other  additional  factors  to  determine  an  individual’s  level  of  support  needs.  
There  are  procedures  in  place  to  ask  for  a  new  SIS  assessment  and/or  dispute  the  findings  of  the  SIS.    


Legal Jeopardy for the State

HCPF  uses  the  SIS  solely  for  resource  allocation.  Case  managers  do  not  use  the  data  for  support  planning.  The  SIS  was  not  developed  for  this  purpose.  As  used,  the  SIS  fails  to  capture  information  needed  to  support  basic  welfare  and  safety.  
The  state  uses  only  three,  (a,b,e)  for  its  algorithm.  The  SIS  misses  wide  areas  of  needs.  

The  state  does  not  follow  its  own  rules  for  SIS  re-­‐ assessments  and  reviews.  Also,  requesting  a  SIS  review  is  difficult  and  risky  for  families.  Few  Community  Centered  Boards  (CCBs)  encourage  families  to  ask  for  a  reassessment  or  to  challenge  the  findings  of  the  SIS.  And  families  risk  having  the  evaluation  result  in  a  lowering  of  the  intensity  scale.    

The  Arc  of  New  Mexico  recently  won  a  court  injunction  against  the  state  of  New  Mexico  for  improper  use  of  the  SIS  as  a  cost  allocation  tool.  The  order  requires  the  state  to  restore  all  services  that  had  been  reduced  due  to  the  improper  use  of  the  SIS.  Additionally,  families  will  be  able  to  appeal  reductions  through  an  administrative  fair  hearing.  
These  are  just  a  few  of  the  reasons  we  believe  that  the  state  needs  to  reconsider  its  continued  use  of  the  SIS  as  a  resource  allocation  tool.  Please  contact  me  (  for  a  more  comprehensive  report  on  the  history  of  the  SIS  in  Colorado. 

Thank you for your attention to this important matter.


Read more:

The New Combined DD Waiver  Concerns from the People HB 15-1318.

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