The NC Division of Medical Assistance has posted a proposed amendment to the CAP-MR/DD Clinical Coverage Policy related to the Supports Intensity Scale. The language is below but click here to view the entire proposed policy. Comments may be submitted through the website (click here) by April 10, 2011.
The Proposed Language:
The Supports Intensity Scale™ (SIS) is an assessment tool that, when administered properly, measures an individual’s intensity of need for supports to participate fully in community life. SIS is used in person-centered planning to assist individuals in developing strength based, not deficit based, plans. The 3 sections of the SIS are:
a. Supports Needs Scale;
b. Supplemental Protection and Advocacy Scale; and
c. Exceptional Medical and Behavioral Supports Needs.
The SIS was piloted in seven Local Management Entity (LME) Catchment areas due to legislative mandate that the results of the SIS assessment be used to assign clients with developmental disabilities to one of the tiers within the CAPMR/DD Waiver and to other needed services, according to their relative intensity of need. A technical amendment will be submitted to CMS requiring that the completed SIS be done for individuals in all LME Catchment areas receiving CAP MR/DD funding in order to comply with the legislation and to begin work towards building a funding model to distribute funding based on intensity of need. Beginning with Initial Plans and Continued Need Reviews (CNRs) effective 7/1/11 and after, the SIS will be required to be submitted with the Initial Plan of Care or CNR to the appropriate Utilization Review (UR) Vendor for approval of CAP Waiver Services. Reassessment will occur every three years.
The Proposed Language:
The Supports Intensity Scale™ (SIS) is an assessment tool that, when administered properly, measures an individual’s intensity of need for supports to participate fully in community life. SIS is used in person-centered planning to assist individuals in developing strength based, not deficit based, plans. The 3 sections of the SIS are:
a. Supports Needs Scale;
b. Supplemental Protection and Advocacy Scale; and
c. Exceptional Medical and Behavioral Supports Needs.
The SIS was piloted in seven Local Management Entity (LME) Catchment areas due to legislative mandate that the results of the SIS assessment be used to assign clients with developmental disabilities to one of the tiers within the CAPMR/DD Waiver and to other needed services, according to their relative intensity of need. A technical amendment will be submitted to CMS requiring that the completed SIS be done for individuals in all LME Catchment areas receiving CAP MR/DD funding in order to comply with the legislation and to begin work towards building a funding model to distribute funding based on intensity of need. Beginning with Initial Plans and Continued Need Reviews (CNRs) effective 7/1/11 and after, the SIS will be required to be submitted with the Initial Plan of Care or CNR to the appropriate Utilization Review (UR) Vendor for approval of CAP Waiver Services. Reassessment will occur every three years.
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