1. What to Expect in a
ReBAR Assessment
Interview
Orientation for CDDP, County,
and Provider Staff participating
in assessment interviews
3-10-09

2. What Will You Learn Today?
• Why Oregon is doing assessments
• What the SIS assessment is and who created it
• Who will get an assessment
• What the assessment measures
• What the assessment interview will be like
• Examples of assessment questions and ratings
• How Oregon will use the information
• How YOU can prepare for an interview
2

3. ReBAR: Restructuring Budgets,
Assessments & Rates
ReBAR is a project to restructure DD Comprehensive
Services rates to make them more:
Sensible: understandable to all and directly related to a
consumer’s support needs
Portable: consumers can carry their level of need
assessment and an appropriate budget as they move or
change providers or settings
Fair: Allocations are uniformly determined – individuals
with similar needs get similar budgets
3

4. ReBAR Changes Start With . .
“A” for an Assessment
for each individual consumer
4

5. Why does the State
want to do assessments?
Because Oregon wants a fair way to
measure everyone’s support needs.
5

6. Over the next 5 years…
All adults living in
or moving into
DD group homes
or Supported
Living programs…
…will get a
ReBAR
assessment.
6

7. The ReBAR Assessment is an
Interview
What do you need?
Asking the consumer and
participants like YOU some
questions.
7

8. The list of questions will come
from a tool called the SIS
Supports SIS®
Intensity
Scale…
or SIS
8

9. The group that wrote the
interview questions is AAIDD:
American
Association on
Intellectual and
Developmental
Disabilities
9

10. AAIDD
is the largest association in the world for people
with developmental disabilities.
10

11. Supports SIS®
Intensity
Scale
What Does “Supports” Mean in
the SIS Assessment?
11

12. “Supports” means the
assistance the consumer needs to
do something successfully.
“Success” means a level of
performance, involvement,
and participation in an activity
that is comparable to that of
typical adults without
disabilities.
12

13. What Does “Intensity” Mean
in the SIS Assessment?
Supports SIS®
Intensit
y
Scale
13

14. Intensity is the level of support a
consumer needs.
• Lots of
support.
• Some
support.
• A little
support.
SUPPORT
14

15. What Does “Scale” Mean
in the SIS Assessment?
Supports SIS®
Intensity
Scale
15

16. “Scale ” means a standardized
way to measure support needs
Score = 1-2-3-4-5-6-
16

17. The SIS assessment measures
support needs to find out:
what type of support is
needed
how often support is
needed
how much support is
needed
17

18. What will an Interview be like?
18

19. Who will be at the interview?
The Interviewer and • Consumer
• Case Manager
• Guardian or
Family member
• 1-2 staff from
home
• 1-2 staff from
day or work
19

20. Each person at the interview:
• Should have known the consumer
for at least 3 months.
•Should know about supports needed
•Should be prepared and feel free to
share information when asked
20

21. Together, the This will take
about 3
group meets hours.
with the
interviewer.
21

22. During the interview-YOU and
others should:
Answer all the questions even if they don’t
seem to apply to the consumer now
or in the future.
 Be ready to describe supports if asked.
This is what makes the assessment picture
complete and person- centered.
Fill out a survey at the end of the interview
about what worked and didn’t work in the
assessment process.
22

23. What if YOU know any
topics that may:
• make the consumer feel
uncomfortable or
• trigger uncomfortable
responses
 Help the consumer tell the
interviewer or
Tell the interviewer yourself,
before the interview starts if
possible 23

24. Who is the interviewer?
An experienced person who is trained
to do SIS assessments will ask
the questions.
Training
SPD Interviewer Notebook
24

25. What will the interviewer do?
Explain the
interview process.
Ask you the
interview
questions.
Write down your
answers on a
computer.
25

26. The Interviewer will work with the
group to reach agreement about
supports needed, because…
• Not everyone sees the
consumer the same way or
doing the same things
• Some items have many
parts
• Consumers need different
supports in different settings
26

27. What Kind of Questions
Will Be Asked at the Interview?
27

28. The interviewer will ask about:
 All parts of a consumer’s everyday life
Some areas that are very personal
Things that may not be happening now
but could happen in the future
Let’s look at sample questions in each
section of the SIS
28

29. Section 1: Activity Domains
• Home Living
• Community Living
• Lifelong Learning
• Employment
• Social Activities
• Health & Safety
29

30. Example: In Home
Living, a question you
will be asked about is:
Bathing-Personal Grooming:
(Showering, bathing, shaving, menstrual
cycle)
•Does___ need support for personal grooming?
•If so, what type of support is needed?
•How often is it needed?
•How much time does the support take each day?
30

31. Example: In Community
Living, a question you will
be asked about is:
Transportation:
(Getting from place to place in the community -
going shopping, to the bank, to leisure
activities)
•Does___ need support for transportation?
•If so, what type of support is needed?
•How often is it needed?
•How much time does the support take on a day it occurs?
31

32. Example: In Life Long
Learning, a question you
will be asked about is:
Learning Functional Academics:
(Using a watch, keeping a schedule)
•Does___ need support to follow a schedule?
•If so, what type of support is needed?
•How often is it needed?
•How much time does the support take?
32

33. Example: In Employment,
a question you will be asked
about is:
Changing Job Assignments:
(Difficulty in adapting to changes in work
tasks, supports for job transition)
•Does___ need support at times of change?
•If so, what type of support is needed?
•How often is it needed?
• When needed, how much time does the
support take?
33

34. Example: In Social
Activity, a question you
will be asked about is:
Socializing in the home:
(Social interaction with roommates)
•Does___ need support to socialize?
•If so, what type of support is needed?
•How often is it needed?
•How much time does the support take?
34

35. Example: In Health & Safety, a
question you will be asked about
is:
Taking medication:
(At the correct time and prescribed level)
• How often is medication taken each day?
• How much support is needed to take
medication?
• How long does it take someone to help with
daily medication?
35

36. Section 2: Protection and Advocacy
• Advocating for Self
• Managing Money - Finances
• Protecting Self -Exploitation
• Participating Self-Advocacy
• Obtaining Legal Services
• Exercising Responsibilities
• Making Choices Decisions
• Advocating For Others
36

37. Example: In Protection and
Advocacy, a question you will be
asked about is:
Advocating For Self:
(Expressing personal preferences including
wants and needs, understanding choices
and decisions)
• What type of support is needed in advocacy?
• How often is it needed?
• How much daily support time is needed?
37

38. Section 3: Exceptional Medical
and Behavioral Supports
Exceptional Exceptional Behavioral
Medical Support Support Needs
Needs • Externally directed
• Respiratory Care destructiveness - Injury to
Others
• Feeding Assistance
• Self-directed destructiveness
• Skin Care
- Injury to Self
• Other Exceptional
Medical Care • Sexual Issues
• Other Exceptional Behavioral
Support
38

39. Example: In Exceptional
Medical Supports, a question
you will be asked about is:
Skin Care:
(Turning or positioning: is assistance needed
to reposition in chair or bed?)
If “YES” What is the level of support needed?
The scale changes to:
• No Support
• Some Support
• Extensive Support
39

40. Example: In Exceptional Behavior
Supports, a question you will be
asked about is:
Externally-Directed Destructiveness:
(Aggression against others, stealing, arson, etc.)
If “YES” What is the level of support needed?
The scale changes to:
• No Support
• Some Support
• Extensive Support 40

41. ReBAR Assessment
Supplemental Questions
Oregon has added selected additional
questions to the assessment to obtain more
information about specific support needs
related to:
Exceptional Medical Support Needs
• Exceptional Behavioral Support Needs
The interviewer will ask these questions if
indicated.
41

42. Now let’s practice by meeting a real
consumer and see how the Questions and
Ratings work!
Meet Carolyn.
42

43. We will use an example from the
Home Living Domain:
• Item: Eating Food:
(ingesting food, chewing, swallowing)
43

44. The interviewer will ask Carolyn:
Question: What type of support
do you need when you eat?
.. . and then he or she will ask YOU
to provide this information also.
44

45. Answer: During meals, Carolyn
needs someone to stay close by to
observe and make sure she does not
eat too fast.
45

46. Which of the following ratings
fit Carolyn’s Type of Support ?
0 None
1 Monitoring
2 Verbal/Gesture Prompting
3 Partial Physical Assist
4 Full Physical Assist
Answer: “Staying Close By & Observing”
#1 = Monitoring
46

47. The interviewer will also ask
Carolyn:
Question: How Often do you need
support when you eat ?
. . . and then he or she will ask YOU
to provide this information also.
47

48. Answer: Carolyn
eats 4 meals each
day and needs to be
observed every time
she eats.
48

49. Which of the following ratings fit
Carolyn’s Frequency of Support?
0 None to less than 1 time per month
1 at least 1 time per month, but not 1 time per week
2 at least 1 time per week, but not 1 time per day
3 at least 1 time per day, but not 1 time per hour
4 hourly or more frequently
Answer: “4 meals a day”
#3 = at least 1 time per day, but not 1 time
per hour
49

50. The interviewer will ask Carolyn:
Question: How much support time
do you need when you eat?
. . and then he or she will ask YOU to
provide this information also.
50

51. Answer: Carolyn spends about 30
minutes eating each meal.
•
51

52. 4 half-hour meals totals 2 hours each
day.
52

53. Which of the following ratings fit
Carolyn’s Daily Support Time ?
0 None
1 less than 30 minutes
2 30 minutes to < 2 hours
3 2 hours to < 4 hours
4 4 hours or more
Answer:
“4 meals x 30 minutes each totals 2 hours”
#3 = 2 hours to < 4 hours 53

54. The interviewer will enter the
following into the computer for
Carolyn:
Type of Support: 1 = monitoring
Frequency of Support: 3 = at least 1 x day but
not 1 x per hour
Daily Support Time: 3 = 2 hours to < 4 hours
54

55. If the interview
sounds hard
Remember,
it’s not a test. There
are no right or wrong
answers
. . . and YOU are there
because YOU know this
consumer well. 55

56. What happens to the SIS
Information?
56

57. SPD will use what is learned about the
consumer from the assessment to:
Match the consumer’s needs to a level of
support, from lowest (called “Tier 1”) to
highest (called “Tier 6”).
 Set an “Individual Budget Amount” (IBA)
designed to support that level of need.
57

58. The Individual Budget Amount (IBA)
• The “Individual Budget Amount” (IBA) is
the amount of funding authorized by SPD
for the consumer for a service.
• Right now, only DD50 residential services
will be affected. However, the
information from this same SIS
assessment will be used later for DD54
employment/day services. That is why it
is important for day program staff to
participate now.
58

59. Counties, Providers, Guardians,
and Consumers will get:
.
 A Summary of the SIS results with
information helpful for person-centered
planning and the ISP.
 Notification of the designated funding
Tier and IBA
59

60. OK- What more can I do to get
ready for an interview?
60

61. Be Prepared !
• Review information about the consumer
Know, (but don’t bring) essential information
• Individual Support Plan (ISP)
• Risk Tracking Record (RTR)
• Behavior Support Plan or Nursing Care Plan
• Talk about the consumer with other staff who
may have a different perspective on specific
support needs based on their work on other days
or shifts.
• Learn more about the SIS through websites
listed at the end of this power point
61

62. Watch a Video called
“Conducting the Assessment”
Review the
video on the
ReBAR Website
* Produced by Washington Division of Developmental Disabilities
62

63. Go to Websites to Learn More
• SIS: General SIS reading, information, and
completed SIS samples
http://www.siswebsite.org/cs/root/main/supports_and_sis.
• ReBAR Program
http://www.oregon.gov/dhs/dd/rebar/
• Oregon Council on Developmental
Disabilities for SIS Consumer and Family Orientation
Information l www.ocdd.org/SISorientation.htm
63

64. This presentation was developed using :
• A presentation designed by self advocates at the
Pennsylvania Training Partnership for People with
Disabilities and their Families at Temple University
• Picture Communication Symbols ©1981-2009 by
DynaVox Mayer-Johnson. All Rights Reserved
Worldwide. Used with permission
Adapted for Oregon:
 for consumers and families by the Oregon Council
on Developmental Disabilities
 for counties and providers, by ReBAR Program staff in
the SPD, Office of DD Services
64

65. Thank you!
For being a part of
these important
Assessment Interviews !!
The ReBAR Team