Individuals living in, or targeted to live in, 24-hour residential programs must have an assessment of their support needs to determine a tier and a service rate. The Supports Intensity Scale (SIS) is an instrument conducted by the specially trained ReBAR Program Assessment Unit. SIS scores result in a Tier 1 through 6 for the individual - the tier represents the level of support the individual needs.
When Support Needs Exceed Tiers 1-6
Sometimes unique circumstances occur where someone's support needs may appear to exceed Tiers 1-6. In these situations, the individual is referred by the ReBAR program for consideration of an exception rate or "Tier 7" service rate. For these exceptions, the "Tier 7 Committee" reviews ReBAR referrals and, based on individual circumstances, determines whether a special "Tier 7" service rate is warranted for the individual. The ReBAR program is not involved in decisions regarding these rates.
Determination of the Service Rate
Individual's service rate is determined by using their SIS Support Tier and considering the size of the home in which they live. The DD50 Residential Rate Matrix (2012) indicates the service rate that an individual receives in the home of a particular size. If an individual moves into another group home of a different size, their support tier stays the same, but a different size of the home may determine a different service rate to be paid to the provider of the home.
An individual's tier remains the same for a five-year period, until the Office of DD Services, ReBAR Assessment Unit, conducts a new assessment for the individual. If an individual's needs should change substantially within that five-year period, a new assessment can be requested to determine whether their support tier should be adjusted to another level. There are guidelines to follow when deciding whether a new assessment for an individual is warranted – Guidelines for Requesting a New Assessment
New SIS Request Process
When an adult with intellectual or developmental disabilities (I/DD) needs to move into a 24-hour group home but has not yet had an SIS assessment conducted, one can be scheduled by working with the individual's service coordinator in the county in which they currently live. An individual's circumstances must meet criteria as a "crisis" in order to be considered for this level of residential service.
The SIS Assessment is conducted using a group interview with "respondents" who know the individual's daily support needs very well. Sometimes there is not a group of people who know the individual well enough to be considered a "valid" respondent group (i.e., they have not known the individual long enough to be familiar with the details of their daily support needs, or they have not had the opportunity to observe the individual on a daily basis to know this information well enough to participate in an SIS Assessment Interview).
In very specific situations like these, there is a process called an "Early Process Assessment (EPA)," that can be used to determine a support tier for the individual. See "Guidelines for Use of an EPA."
The SIS Assessment Tool is a nationally normed, standardized assessment authored by the American Association for Intellectual and Developmental Disabilities (AAIDD). Get additional information about this instrument. Information is also available on the ReBAR Program Web page.