CCDC Position On The New Combined DD Waiver, HB15-1318 - Concerns from the People
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 (firstname.lastname@example.org) for a more comprehensive report on the history of the SIS in Colorado.
Thank you for your attention to this important matter.