CIIBS Overview (1)

1

Children’s Intensive In-Home Behavior Support Waiver (CIIBS)

An Overview

Christie Seligman, Program Manager

Division of Developmental Disabilities

October 2009

2

CIIBS Program Model

3

Intensive Case Management

Steps Toward Enrollment:

4

Intensive Case Management

Building a Child’s Support Team:

5

Intensive Case Management

Monthly Follow-Up Visits for first 90 Days

6

Intensive Case Management

30/60/90 Day Follow-Up Visits Ongoing

7

Intensive Case Management

Collect Program Evaluation Data

8

Program Evaluation

Data Collection Collect baseline information on:

Family stress level (using Parenting Stress Index, a nationally normed tool)

Child’s behaviors at home, school, and in community Progress data collected at 30/60/90 day follow-up visits

(intensive case management activity) Use information in provider Quarterly Reports; format

established by DDD Use data collected by schools Use fidelity measurements to assess implementation of

the wraparound service delivery process (e.g., Wraparound Fidelity Index 4)

Positive Behavior Support Model (PBS)

9

Positive Behavior Support Model (PBS)

Positive Behavior Support in the family home must involve the family members in the design as well as the implementation of strategies. Better outcomes are achieved when families and professionals partner during the functional assessment and when families direct the selection of strategies that will work for them.

10

Positive Behavior Support Model (PBS)  Behavior specialists should take the following

into account when working with families:

11

12

Behavior Support Providers

Behavior Specialists: PhD or MA level therapists with expertise in Positive Behavior Support in the family context

Conduct Functional Assessment Design written Positive Behavior Support Plans Provide training and consultation Collect and review data Oversight – ensure ongoing efficacy of plan

Behavior Technicians: Experienced line therapists Implement treatment according to design Work alongside families in the home

13

Collaboration

Working together

14

Collaboration

Family Participation and Partnership with Service Providers

15

Collaboration

Collaboration between school and home

16

Collaboration

Collaboration between health providers

17

Services

Essential Services:

Behavior Management

and Consultation

Staff/Family Training and Consultation

Staff/Family Training and Consultation

Planned Respite

18

Services

19

Services

Total Waiver Service Package: Behavior Management and Consultation Staff/Family Training and Consultation Respite In-Home and Out-of-Home Personal Care Specialized Medical Equipment and Supplies

Therapeutic Equipment and Supplies Assistive Technology Environmental Accessibility Adaptations Vehicle Modifications Transportation Specialized Nutrition Specialized Clothing Specialized Psychiatric Services Nurse Delegation Sexual Deviancy Evaluation Occupational Therapy Physical Therapy Communication Therapy

Averagecost:$4000 perchild permonth

20

CIIBS Program Eligibility

In addition to HCBS Waiver enrollment criteria, a child must meet eligibility criteria per the DDD Assessment:

Age 8-17 (served until 21st b-day)

High Behavior Acuity

Caregiver Risk Score is Medium or Higher

Family Agrees toParticipate in the Program

High or Severe Out-of-homePlacement Risk Score

21

CIIBS Program Eligibility

Algorithm:Rules outlined in WAC Chapter 828 (DDD Assessment)

22

CIIBS Program Eligibility

WAC 388-828-8515 How does DDD determine your CIIBS out-of-home placement risk score?

Clients meeting criteria in 828-8505: Beginning score = 0

Eligible condition of autism in the DDD determination

Add 40 points

ADL support needs level = high, medium or low

Subtract 54 points

Most prominent behavior = assault/injuryAND Severity = "potentially dangerous“ or "life threatening"

Add 14 points

Level of monitoring required during awake hours = "Line of sight/earshot"

Add 13 points

Caregiver risk level = high or immediate Add 136 points

"No other caregiver available" Add 33 points

Mobility acuity level = high, medium or low Subtract 15 points

23

CIIBS Program Eligibility

WAC 388-828-8520 How does DDD determine if I am eligible for the CIIBS waiver?

If your CIIBSout-of-homeplacement riskscore is:

Then your CIIBSeligibility is:

96 or greater Yes - Severe

17 through 95 Yes - High

Less than 17 No - (noteligible)

24

CIIBS Program Eligibility

Screening and Phase-In Schedule

25

CIIBS Program Eligibility

Screening and Phase-In Schedule

26

For More Information

Christie Seligman, Program ManagerDivision of Developmental Disabilities(360) [email protected]