Emerging Threat: Use of the Supports Intensity Scale Assessment Tool for ICF/MR Discharge

The Supports Intensity Scale (SIS) is a needs assessment tool developed and sold by the American Association on Intellectual and Developmental Disabilities(AAIDD). SIS is designed to evaluate the practical support requirements of a person with an intellectual disability.

To date, SIS has been used most predominantly in the assessment of individuals served in non-ICF/MR settings. It is sometimes used in combination with other assessment tools, such as psychological assessments, and risk assessments to assist individuals receiving services and their support teams in developing person-centered plans that focus on strengths and abilities. Where used in ICFs/MR, an “add on” to the SIS assessment has been necessary.

Reports of the use (or proposed use) of SIS as an assessment tool for the purpose of re-assessment or discharge assessment in several states, including Louisiana, Kentucky, Tennessee, Virginia, and California is of significant concern. In Louisiana, the most dramatic example to date, every public ICF/MR resident was re-assessed with 20% of current residents being found ineligible for public ICF/MR placement regardless of how long they had called the ICF/MR home.

According to the Centers for Medicare & Medicaid Services (CMS), SIS does not meet the federal ICF/MR regulation standard for Active Treatment, which includes a requirement that each ICF/MR resident receive an “individual program plan” (IPP).

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