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Virginia Administrative Code
Title 12. Health
Agency 30. Department of Medical Assistance Services
Chapter 122. Community Waiver Services for Individuals with Developmental Disabilities
11/21/2024

12VAC30-122-200. Supports Intensity Scale® requirements; Virginia Supplemental Questions; levels of support; supports packages.

A. The Supports Intensity Scale (SIS®) requirements.

1. The SIS® is an assessment tool that identifies the practical supports required by individuals to live successfully in their communities. DBHDS shall use the SIS® Children's Version™ (SIS-C™) for individuals who are five years through 15 years of age. DBHDS shall use the SIS® Adult Version® (SIS-A®) for individuals who are 16 years of age and older. Individuals who are younger than five years of age shall be assessed using an age-appropriate standardized living skills assessment.

2. A SIS® assessment and the current version of the Virginia Supplemental Questions (VSQ), as appropriate, shall be completed with the individual and other appropriate parties who have knowledge of the individual's circumstances and needs for support:

a. At least every four years for those individuals who are 22 years of age and older.

b. At least every three years for those individuals who are 16 years of age through 21 years of age.

c. Every two years for individuals five years through 15 years of age when the individual is using a tiered service, such as group home residential, sponsored residential, supported living residential, group day, or community engagement. Another developmentally appropriate standardized living skills assessment approved by DBHDS, such as the Brigance Inventory, Vineland, or Choosing Outcomes and Accommodations for Children shall be completed every two years for service planning purposes for those in this age grouping who do not receive a SIS® assessment.

d. For a, b, and c of this subdivision A 2, when the individual's support needs have been deemed to have changed significantly for a sustained period of at least six months.

e. For children younger than five years of age, an alternative industry assessment instrument approved by DBHDS, such as the Early Learning Assessment Profile, shall be completed every two years for service planning purposes.

3. The SIS® shall be used in conjunction with VSQ, the person-centered planning process, and other assessment information to develop each individual's ISP. The SIS® shall be used to assess individuals' patterns and intensity of needed supports across life activities such as (i) home and community living activities; (ii) school activities for children; (iii) lifelong learning and employment activities for adults; (iv) health and safety activities, social activities, and advocacy activities; (v) exceptional medical and behavioral support needs; and (vi) what is important to and important for individuals who are enrolled in a waiver.

4. Scores from SIS-A® and SIS-C™ Section 1 (Exceptional Medical Needs, Exceptional Behavioral Needs), Section 2 Subsections A, B, and E and responses to Supplemental Questions shall be used to assign levels of supports (Levels 1 through 7, as defined in 12VAC30-122-250) to each individual.

5. The SIS® shall be administered and analyzed by qualified, trained interviewers designated by DBHDS.

B. The current version of the Virginia Supplemental Questions (VSQ version 10/2017) shall also be used to identify individuals who have unique needs falling outside of the needs identifiable by the SIS® instrument. The VSQ shall also be administered and analyzed by the same qualified, trained interviewers designated by DBHDS.

1. The Virginia Supplemental Questions shall address these topics:

a. Severe medical risk;

b. Severe community safety risk for people with a related legal conviction;

c. Severe community safety risk for people with no related legal conviction;

d. Severe risk of harm to self; and

e. Fall risk.

2. Specified affirmative responses to the items in subdivisions B 1 a through B 1 d of this section shall require a review of the individual's record for verification. After such review, the individual may or may not be assigned to Level 6 (exceptional medical) or Level 7 (exceptional behavioral).

C. The results of the SIS®, Virginia Supplemental Questions, and, as needed, a document review verification process shall determine the individual's required level of supports. The results of the SIS®, other assessment information, and the person-centered planning process shall establish the basis for the individual support plan.

D. Establishment of supports packages, which means a set of assumptions regarding the types and amounts of supports that an individual needs to be adequately supported in the community. It is a model that reflect reasonable services levels based on common expectations for persons who share similar characteristics.

Statutory Authority

§ 32.1-325 of the Code of Virginia; 42 USC § 1396 et seq.

Historical Notes

Derived from Virginia Register Volume 37, Issue 14, eff. March 31, 2021.

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