"zHZnEM.T*Kap7:#$d$. INSTRUCTIONS: Identify the Frequency, Daily Support Time, and Type of Support that is reported necessary for the person to besuccessful in the six activity domains (Parts A-F). positive control over one's life. The SIS-A was developed by the American Association on Intellectual and Developmental Disabilities (AAIDD). All rights reserved. Check the box for each section you want to print. concentrating first on 5-year reassessments, prioritizing those that are overdue, and HCSIS ISP Assessments. After the interview, the SIS assessment results are made available to the person or their family member upon request. The SIS-A assessment tool was created by the American Association on Intellectual and Developmental Disabilities (AAIDD). Please see contact information for each Regional Supports Specialist (RSS) at DBHDS RSS Contact Information 7.01.2022. 0000001705 00000 n 275 E. Main Street 4CF Frankfort, KY 40621 Phone: (502) 564-7700 Fax: (502) 564-8917 Hours: Monday-Friday 8:00 am-4:30 pm ET Crisis Lines by County Hotlines/Other Contacts Suicide Prevention Hotline Contact Us PASRR, Incident Reporting, and Mortality Review Fax: (502) 564-2284 Branch Manager Cathy Lerza (502) 782-6222 Us, Delete Please enable scripts and reload this page. This site uses cookies to enhance site navigation and personalize your experience. capabilities, the virtual assessment cannot be completed. What is the SIS-A? $ii@zvE*V@ hhhc**p5B/r(TwF WZ@6GAaL12hx13|d3fu[9YY3mHkd/by9A1a>C=4x00 9 @E} endstream endobj 34 0 obj<> endobj 36 0 obj<> endobj 37 0 obj<>/Font<>/ProcSet[/PDF/Text]/ExtGState<>>> endobj 38 0 obj<> endobj 39 0 obj<> endobj 40 0 obj<> endobj 41 0 obj<> endobj 42 0 obj<> endobj 43 0 obj<> endobj 44 0 obj<> endobj 45 0 obj[/ICCBased 69 0 R] endobj 46 0 obj[/Separation/PANTONE#203298#20CVC 45 0 R 73 0 R] endobj 47 0 obj[/Separation/All 45 0 R 70 0 R] endobj 48 0 obj<> endobj 49 0 obj<> endobj 50 0 obj<> endobj 51 0 obj<> endobj 52 0 obj<>stream PDF Supports Intensity Scale - American Association on Intellectual and Skip table of contents. JA.001] Scheduling Past Due Regular (5-year) Assessments Supports Coordinators (SCs) and SC Supervisors can submit scheduling information for regular (5-year) past due assessments in Kepro SAM by following the process outlined below. A SIS assessment is a meeting with a DDS SIS Assessor and at least two people (respondents) who know a great deal about the individual's daily support needs. . blank sis assessment sis assessment pa PhD AAIDD 2004 OO 1s 2s Subscale destructiveness gestural School Name: STUDENT ENROLLMENT FORM SIS-10W (Revised) Complex Area: Student ID No. SIS Training (CSBs and providers, please contact your RSS for scheduled training dates). PDF 4.1 Supports Intensity Scale Assessments, Referrals and Reviews Supports Intensity Scale - Adult Version (SIS-A). The SIS was designed to: Assess support needs of individuals age 16 and older (SIS-A) Assess support needs of children age 5-15 (SIS-C) Determine the type and intensity of support needed. The SIS Assessor will need to have a virtual view of the individual being assessed. 0000016354 00000 n Changing Password. Service, Contact The SIS will help the Individualized Service Plan (ISP) team to understand what supports are needed for the person to achieve a richer, fuller life. Annual Assessment - Completed yearly to continue receiving services. The Supports Intensity Scale (SIS) is a strength-based, comprehensive assessment tool that measures an individuals support needs in personal, work-related and social activities in order to identify and describe the types and intensity of the supports an individual requires. From the Actions bar, click Print a Blank Document. Its important to understand what supports people need to live a good life in their community. PA SIS - Homepage - KEPRO If you are a caregiver to a consumer or have a family member with an intellectual disability, here's what SIS can do . 0000001196 00000 n 0000006225 00000 n Monitor individual progress and evaluate outcomes over time. The SIS is a nationally normed assessment tool for people with intellectual and developmental disabilities. Proudly founded in 1681 as a place of tolerance and freedom. FSIS Directive 4430.3, Revision 3, In-Plant Performance System (IPPS), 9/11/12. In addition, IPPS assesses employees' demonstrated knowledge of job requirements . #1 Internet-trusted security seal. The first group is called Cohort 1. Theft, Personal Waiver Services - Virginia Department of Behavioral Health and 0000002129 00000 n Click on the link below to access DMAS Forms. Forms 10/10, Features Set 10/10, Ease of Use 10/10, Customer Service 10/10. Many states use the results of the SIS to determine necessary supports and services for the individual. The results of the SIS , other assessment information, and the person-centered planning process shall establish the basis for the individual support plan. An assessment appears as an assignment on SIS, but has questions for students to answer. Using our solution completing Sis Assessment Pa requires just a couple of minutes. Guarantees that a business meets BBB accreditation standards in the US and Canada. The DDA Assessment is designed to measure the individual support needs of persons with intellectual and developmental disabilities over a broad spectrum of life areas and activities. The Supports Intensity Scale (SIS) is an assessment tool developed by the American Association on Intellectual and Developmental Disabilities (AAIDD) that evaluates practical support requirements for adults with intellectual and developmental disabilities (IDD). It also assesses employment support needs. request a break any time one is needed. Intensity Scale (SIS) tools on the Department's Web site, nor can it provide blank assessments because of copyright restrictions on those proprietary tools. (2015) The SIS-A is a standardized assessment tool designed to measure the pattern and intensity of supports that a person aged 16 years and older with intellectual disability requires to be successful in community settings. SIS-A data can also be used to examine support needs across comparable groups for a number of purposes, including program planning, projecting future population needs, analyzing resource distribution, and program evaluation. The assessor will explain how the interview works. .)F8c7#Ulqf2&GSo L2 ~L3dfiSo @,P Kentucky Cabinet for Health and Family Services Sis Assessment Pa - Fill Online, Printable, Fillable, Blank - pdfFiller The psychometric and technical properties are provided in the User's Manual. 0000073872 00000 n HWr6NW}S,'U;KCLhDiD:= HRqZ"={vl&M=x2 respondent should be sent by mail the telephone number of a secure conference This assessment evaluates practical support requirements for adults with intellectual and developmental disabilities (IDD). The SIS-A is completed in an interview-like setting. 0000005648 00000 n At least two people who understand the person's support needs must stay for the entire interview. Ongoing research around the world continues to confirm the assessment's reliability and validity. The SIS-A assessor records information discussed in the interview and provides clarifying information about specific questions as needed. Developmental Disabilities Division (DDD), COVID-19: Information for Participants and Families, COVID-19: Information for Waiver Providers, More information for participants / families, I am a certified adult foster home caregiver, Archive: Correspondence to AFH Caregivers, I want to be a Medicaid I/DD Waiver Provider, Administrative Hearing for Medicaid I/DD Waiver Providers, How to Apply: Medicaid I/DD Waiver Admission, The Road to Supporting Hawaiis Families: Long Description, How to file a grievance about your services, Informal Review and Administrative Hearing, Website Accessibility and Non-Discrimination Notice, Person for whom the SIS is being conducted, Parents/guardian, spouse, or other family members, Direct support staff from the persons home, day program, or employment, Friends, neighbors or community members who know the person well, Develop more effective person-centered service plans (ISP), and. Send blank sis assessment via email, link, or fax. The SIS-A has all the domains necessary to identify student's post-secondary support needs as required by the IDEA. This is a chance to think about different goals the person may achieve. Here's how it works 01. 03. Your information is securely protected, since we adhere to the most up-to-date security requirements. A general progression from the initial steps of the initial to the more advanced and follow-up types of training are: SIS Stakeholder Training/Respondent Orientation. Waivers fund a variety of supports including those that: provide medical care enable employment enable community living provide behavioral interventions The Virginia Developmental Disabilities Home and Community-Based Services (HCBS) Waivers help eligible people with a developmental disability (DD) to receive services and supports in the community. Below is a description of what will need to be done differently when scheduling and A blank datasheet for the Risk Matrix Internal assessment appears. The SIS suite of tools includes the Supports Intensity Scale-Adult Version (SIS-A, 2015) for ages 16 years and older, and a Supports Intensity Scale-Children's Version (SIS-C TM, 2016) for ages 5-16 years. 0000018787 00000 n A SIS assessment is required for everyone who receives DD waiver services. From the Select a Template drop-down menu, choose the appropriate document. An SNI of 100 is average and indicates average support needs. Click the OK button. It is an assessment tool developed by the American Association on Intellectual and Developmental Disabilities (AAIDD) that measures the type and amount of support that a person with intellectual and/or developmental disabilities (I/DD) needs to be successful. 1250 Punchbowl Street, Room 463 & Estates, Corporate - Share your form with others This will allow time for troubleshooting any connectivity The Children's Support Assessment is used for clients aged 15 and younger. Spanish, Localized Entry Date Entry Code Room For school use only INSTRUCTIONS: PRINT 0000003824 00000 n Sis Assessment Pa - Fill and Sign Printable Template Online If an individual does not have access to a device with audio and video 0000004980 00000 n DD Case Management Related Forms & InformationThe following are forms and information useful to case managers/support coordinators related to adding an individual to the DD Waivers Wait List, preparing for Waiver Slot Assignment Committee meetings, SIS-related forms & instructions, and requesting an emergency or reserve slot: Please contact your Regional Supports Specialist (RSS) for questions or more information about the above resources at DBHDS RSS Contact Information 7.01.2022. For information on the Service Level Assessment: Melissa Randles, State Plan Services Unit Manager. 0000009938 00000 n BCN crisis plan handwrite form 05-2009doc - mvbcn, Name Date Core Double Bubble Maps Compare Contrast, PRACTICE WORKSHEET A Writing a Thesis Statement. 0000064853 00000 n The assessment meeting should take place wherever the individual and other respondents choose. Kepro to Administer Need Assessments for Pennsylvania Supports Intensity Scale (SIS) Assessment | Maximus Page 1 of 4 [PA SIS. BACKGROUND. SIS-A results are normed and validated. We make that possible through giving you access to our full-fledged editor effective at altering/correcting a document?s initial textual content, adding special boxes, and putting your signature on. Save or instantly send your ready documents. The survey gathers information about scheduling, the SIS assessor, and the assessment process. Many updates and improvements! Results include a visual profile of high and low intensity support needs, an index score, and a percentile ranking. Virtual assessments may take longer to complete. Maximus U.S. Services first partnered with AAIDD and states in 2007 to develop SIS programs. The Support Intensity Scale (SIS) is used for clients aged 16 and older. A recognized SIS-A assessor asks individuals (and people familiar with an individuals needs) questions. %PDF-1.4 % 2023 State of New Hampshire All rights reserved, An official NEW HAMPSHIRE government website, Communication Access & Language Assistance, Alcohol, Tobacco & Other Substance Misuse, Resources for DHHS Providers, Small Business & Nonprofits, Watch this video for tips on preparing for your SIS interview, American Association on Intellectual and Developmental Disabilities (AAIDD) Frequently Asked Questions, About the Supports Intensity Scale Adult Version (SIS-A). NOTE: If this bond is being executed by power of attorney, a copy must be attached. This information is essential in understanding the needs of the individuals we serve and assists Case Resource Managers with development of Person-Centered Service Plans. An individuals responses will be scored according to a standard protocol and the resulting score will be something that is comparable across individuals. 12VAC30-122-200. Supports Intensity Scale requirements - Virginia The Supports Intensity Scale is a unique assessment tool dedicated exclusively to identifying and measuring the supports needs of persons with intellectual disabilities in order to help them lead a regular, independent life. For Initial Assessments and then every five years, the Case Manager will ask every question in the SIS to ensure all support needs are up to date; this is called a Directed Assessment (on average, this takes about 3 hours).