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The Revised CDER

The Revised CDER. Regional Center Train-The-Trainers 2007. Today’s Training Objectives. Train-the-trainer’s session to provide: Training resources Background on revision process Details about the new CDER Instructions for completing the new CDER. Presentation Order.

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The Revised CDER

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  1. The Revised CDER Regional Center Train-The-Trainers 2007

  2. Today’s Training Objectives Train-the-trainer’s session to provide: • Training resources • Background on revision process • Details about the new CDER • Instructions for completing the new CDER

  3. Presentation Order • Revised Evaluation Element and New Personal Outcomes Element • Waiver Level of Care Eligibility • Revisions to the Diagnostic Element

  4. Evaluation and Personal Outcomes Elements Assessing Consumer Abilities and Outcomes

  5. Background and Development Evaluation and Personal Outcomes Elements

  6. Background and Development Issues with Original CDER Resulting in inaccurate and/or incomplete data • Outdated • Focus on disabilities rather than abilities • Not useful to IPP process • Doesn’t assess health & safety, quality of life or outcomes

  7. Background and Development Project Consultants Dr. Jamie McCreary Dr. Harold Stanislaw Department of Psychology California State University, Stanislaus

  8. Goals for revision Requirements for the New CDER • Focus on consumer abilities • Useful for program planning • Shorter and easier to use • Continuity with existing CDER data • Improve ability to provide reliable data

  9. Background and Development Revision Process • User Surveys • Identified items to retain, delete, add and reword • Analysis of Data Requests • Identified type of information most frequently requested to ensure continued availability of data

  10. Background and Development Revision Process • Scientific Literature Review • Identified published studies based on CDER data to ensure continued availability of data needed for scientific research • Field Testing • To confirm the validity and reliability of the new CDER

  11. Comparison of “Old CDER” to “New CDER” Evaluation and Personal Outcomes Elements

  12. New CDER: 46 Items 2 Major Sections Evaluation Element Personal Outcomes Element Consistent Number of Response Options Per Section Original CDER: 66 Items 7 Domains Responses Range From 3 to 9 Options Throughout The Revised CDER Evaluation and Personal Outcomes Elements

  13. The Revised CDER Evaluation Element Highlights • Rate consumer abilities vs. categorizing them • Use of informed sources to obtain information • Snapshot at a particular point in time • Items applicable to all consumers regardless of age or challenges • Response options to address when a question can’t be answered

  14. Content Revised Evaluation Element

  15. The Revised CDER Evaluation Element The Evaluation Element: Provides information for identifying services and supports • 2 Sections • Skills Demonstrated in Living (14 items) • Challenging Behaviors (6 items)

  16. The Revised CDER Evaluation Element The Evaluation Element • Information provided by a person directly involved with consumer on a daily basis during a specified time period • Skills Demonstrated in Daily Living At least 1 week of the preceding 6 months • Challenging Behaviors At least 2 months of the preceding 12 months

  17. Content New Personal Outcomes Element

  18. The New CDER Personal Outcomes Element The Personal Outcomes Element: Provides information about quality of life and well being • 3 Sections • Physical and Social Environment (13 items) • Health and Safety (3 items) • Consumer Survey (10 items)

  19. The New CDER Personal Outcomes Element The Personal Outcomes Element • Information provided by knowledgeable person involved with the consumer • Physical & Social Environment = Sufficiently knowledgeable to provide accurate, unbiased picture of consumer’s current situation • Health & Safety = Sufficiently knowledgeable to provide accurate, unbiased picture of consumer’s situation during the preceding 12 months

  20. The New CDER Personal Outcomes Element The Personal Outcomes Element • Consumer Quality of Life Survey = Only the consumer can respond to these items • Items designed to capture consumers own feelings • Consumers provide the information without someone else interpreting responses

  21. Completing theNew CDER Evaluation and Personal Outcomes Elements

  22. Completing the New CDER Conducting Interviews • Present items conversationally • Do not read response items • Change order of items as needed

  23. Completing the New CDER Consumer Survey Interviews • Build rapport and create neutral environment • Paraphrase and personalize items • Use the keywords or phrases included in the items • Translation vs. Interpretation of responses

  24. Completing the New CDER Choosing Response Options • Consistent number of options in each section • 4 or 5 point scales • Select options that best describe typical behavior • Additional options when items cannot be answered

  25. Completing the New CDER The Consumer Survey • 3 point scale • Negative Response • Ambivalent Response • Positive Response • Additional options when any item cannot be answered • Special options when entire survey cannot be completed

  26. Training Resources Evaluation and Personal Outcomes Elements

  27. Training Resources • DVD • Tutorial for group or individualized training • Review questions and quizzes • Designed for both initial and periodic refresher training • Training Manual(available at www.dds.ca.gov/cder) • Review questions and quizzes • Glossary • FAQs

  28. Waiver Level of Care Eligibility Evaluation and Personal Outcomes Elements

  29. Background and Development Revised CDER Diagnostic Element

  30. Background and Development Issues Resulting in inaccurate and/or incomplete data • Outdated Terminology • Does Not Reflect Current Medical Knowledge and Practices

  31. Background and Development Goals for Revision • Revise in Phases • Prioritize Items For Revision • Ensure Applicability For Both RCs and DCs

  32. Background and Development Revision Process Participants: • ARCA physicians and chief counselors • DC Physicians and Clinical Staff • DDS clinical staff • The Wellness Advisory Committee

  33. Content Revised Diagnostic Element

  34. Cerebral Palsy • Item 17: Presence of Cerebral Palsy • Item 19: Severity of Motor Dysfunction • Item 20: Type of Motor Dysfunction • Item 22: Condition Impact

  35. Autism • Item 23a: Presence of Autistic Disorder • Item 23b: Presence of Other PDD • Item 26: Condition Impact

  36. Epilepsy/Seizure Disorder • Items 27a - 29a: Type of Seizure • Items 27c - 29c: Condition Impact

  37. Psychiatric Disorders(Previously Mental Disorders) • Specifies the use of the DSM-IV rather than the DSM-III • Items 50c - 53c: Condition Impact

  38. Chronic Major Medical Conditions • Items 54b – 59b: Condition Impact • Multiple Conditions: Only Top 6 Transmit to DDS

  39. Other Developmental Disability • Adds Item 33: Other Disability (Y/N)

  40. Resources Diagnostic Element

  41. Resources Available at www.dds.ca.gov/cder • Revised Form • Revised Manual Sections Under Development • DSM Crosswalk

  42. The Revised CDER Next Steps For Regional Centers

  43. The Revised CDER Questions?

  44. Contact Information CDER: Waiver Sue Boucher Jim Knight (916) 654-2120 (916) 653-7710 sboucher@dds.ca.govjknight1@dds.ca.gov

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