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Waiver Support Coordinators

Information about the QSI for. Waiver Support Coordinators. Information for Waiver Support Coordinators. What is the purpose of the QSI? The QSI is a standardized needs assessment tool. It is designed to gather information about a person’s life situation.

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Waiver Support Coordinators

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  1. Information about the QSI for Waiver Support Coordinators Questionnaire for Situational Information

  2. Information for Waiver Support Coordinators Questionnaire for Situational Information

  3. What is the purpose of the QSI? • The QSI is a standardized needs assessment tool. It is designed to gather information about a person’s life situation. • This information will be used to assist in planning for support and service needs and is only one part of a person-centered planning process. Questionnaire for Situational Information

  4. Why was the QSI developed? • Florida Statute 393.0661 and federal regulations for Medicaid waivers require a standardized needs assessment process. • A systematic and reliable instrument will be used to determine levels of services • Client characteristics and other appropriate assessment methods are used along with the QSI to develop the support plan for the individual receiving services. Questionnaire for Situational Information

  5. How was the QSI created? • Information was gathered from national experts to identify major barriers and supports for good health, safety, and quality of life • Instruments used in Florida were evaluated. • Florida Status Tracking Survey • Individual Cost Guidelines • Assessments used in other states were also reviewed • Validity and reliability tests for the QSI have been completed Questionnaire for Situational Information

  6. How is the QSI different from previous assessment tools? • The QSI gathers information for planning. • Impact of major life changes • Support needed for community inclusion and fulfillment of adult roles • The QSI includes vision, hearing, and communication in the assessment of Functional Status • The assessment of Behavioral Status focuses on the types of support and intervention needed. • The assessment of Physical Status remains focused on health and medical needs. Questionnaire for Situational Information

  7. What is assessed by the QSI? • General Information • Life Change and Adjustment;Community Inclusion andFulfillment of Valued Adult Roles • Functional Status • Behavioral Intervention and Support Status • Physical Status Questionnaire for Situational Information

  8. How will the QSI be used? • The QSI will be administered at the time of eligibility determination • The results of the QSI will be used as a part of the person-centered planning process used to develop the person’s support plan • The results of the QSI will be reviewed annually and re-administered at least every three years to identify possible changes Questionnaire for Situational Information

  9. What is person centered planning? • The person has the authority to define and pursue the goals important to them • Personal relationships and community membership are valued • All networks and systems of support must collaborate in support of the person’s goals and needs • People and families must participate as valued partners in all decision making Questionnaire for Situational Information

  10. How is the support plan developed using the QSI? • Uses information gathered from the individual, family, and friends, the QSI, and other relevant information • Reflects individually determined goals and needs and resources, including personal resources, natural supports, community resources, school systems, government programs, etc. • The scores are not as critical as the information obtained from the QSI on the types of supports and services the individual needs. Questionnaire for Situational Information

  11. Who can administer the QSI? • Qualified assessors are hired by APD area offices. They must be certified to administer the Questionnaire. • QSI assessors are required to have a bachelor’s degree and four years of related experience working with persons with developmental disabilities. • They must demonstrate competencies in conducting interviews and reliability in rating the items. Questionnaire for Situational Information

  12. How is the QSI completed? • The QSI assessor reviews the current Support Plan and other relevant records to identify general information, accomplishments, goals, health history, and service details. • Face-to-face interviews are conducted with the person with a disability and the legal representative, and others as appropriate. • The QSI assessor analyzes the information and rates the items. The ratings are recorded in QSI online application. Questionnaire for Situational Information

  13. Who gets the results? • A synopsis report is provided to the person or legal representative. A complete copy can be provided, on request. • The person or legal representative may give others a copy of the report, if they wish. • The support coordinator will review the results of the completed QSI and review the support plan to be sure it addresses all necessary supports and services. Questionnaire for Situational Information

  14. What is the QSI online tool? • All assessments are recorded and stored using the QSI online tool, available on the APD intranet • The support coordinator will be able to access the records of the persons served • The local Area Office will provide training on the online tool. • The Central Office will give the support coordinator a password and username. Questionnaire for Situational Information

  15. What is required of the support coordinator? • The support coordinator will provide access to the records for the QSI assessor. • Temporarily transfer records • Follow protocol in Central Records Policy to secure records, including copies • Provide records to the QSI assessor within three business days. Questionnaire for Situational Information

  16. What else is required of the support coordinator? • Participate in interviews when requested. • Use the results of the QSI and other relevant information to develop the person’s support plan. • Responsible for noting changes in Life Changes and Community Inclusion. Questionnaire for Situational Information

  17. You have completed the first session. Go the second session to learn more about the content of the QSI. Questionnaire for Situational Information

  18. Content of the QSI Questionnaire for Situational Information

  19. General Information/ Demographic Information Questionnaire for Situational Information

  20. General/Demographic Information • The information is pre-filled from the ABC database. • The support coordinator is responsible for ensuring that the ABC database is accurate and up-to-date. • The support coordinator should immediately update ABC when changes or errors are identified. See pages 5-6 Questionnaire for Situational Information

  21. Life Change and Adjustment Information Questionnaire for Situational Information

  22. Life Change and Adjustment Information • Keep track of any changes that occur • Include a description in your case notes for that day. • Notify the QSI assessor if there is a significant change in condition • Keep the ABC demographic information up to date Questionnaire for Situational Information

  23. 8a. Life Changes (examples) • No life changes experienced • Death or loss of a long-term caregiver • Survivor of a major physical assault • Gaining a new family member • Major change in living conditions • Major change in daytime activities • Major change in eating habits See page 7 Questionnaire for Situational Information

  24. Levels of Life Change Stress Low Moderate Significant To follow-up, you may want to let caregivers know about the particular life changes and observe the person for any health or behavioral changes. Referrals for medical or behavioral support may be required if problems arise. See page 7 Questionnaire for Situational Information

  25. 8b. Signs and Symptoms of Emotional or Behavioral Distress (examples) • Avoidance of favorite activities and friends • Suicidal thoughts, plans or suicide attempts • Property destruction (major, repeated) • Self-injurious behaviors (pica, head banging, etc.) 8c. Was this person screened by a qualified professional for any of the conditions? See page 8 Questionnaire for Situational Information

  26. 8d. Life Changes that this Person is Likely to Experience (examples) • Loss/change of significant long-term primary caregiver • Major surgery requiring hospitalization • Change in place of residence • Major change in work or daytime activities See page 8 Questionnaire for Situational Information

  27. 9a. Does the Person Plan to Move in the Next 12 Months? (examples) • Chooses to remain in current home • Chooses to remain in current home, but cannot do so without additional help • Must move for reasons of health and safety • Is unsure about moving See page 9 Questionnaire for Situational Information

  28. 10. Legal Status (examples) • Person is an adult with no pre-need directives or any form of guardianships. • Person has a partial or full guardian advocate. • Person is an adult and has a guardian ad litem. • Person is a minor child See page 9 Questionnaire for Situational Information

  29. 11. Language Spoken or Understood The primary language that is spoken or understood by the person: English, Spanish, Sign Language, Does Not Apply or Other See page 9 Questionnaire for Situational Information

  30. Community Inclusion & Valued Adult Roles • These items are only required for individuals 18 years or older. Community Inclusion Valued Adult Roles Employment • The rating is based on the level of personal support required by the person to complete tasks now and for the next year. Questionnaire for Situational Information

  31. Community Inclusion & Valued Adult Roles Level 1: The individual does not need any personal support. Level 2: The individual needs personal support and it is limited to occasional reminders or verbal prompts and/or physical assistance. Level 3: The individual needs personal support and requires daily reminders, verbal and/or physical prompts. Levels 4/5: The individual needs personal support from someone and requires supervisionto complete See page 10 Questionnaire for Situational Information

  32. Community Inclusion Activities (examples) 12a. The person can find a place to live and manage leases or rent arrangements 12d. The person can shop for food, clothes, and other personal items. 12e. The person can arrange and attend social outings… 12h. The person can keep him/herself safe in the neighborhood 12j. The person can do his/her own housekeeping See page 10 Questionnaire for Situational Information

  33. Fulfillment of Valued Adult Roles in the Community 12l. The person can parent his/her minor children… 12m. The person can function as a spouse or domestic partner… 12n. The person can fulfill the role of a valued and trusted employee… 12o. The person can vote, follow community rules… See page 11 Questionnaire for Situational Information

  34. Employment Information 13a. Does the person currently have a job? 13b. Does the person need help with a job currently held? 13c. … is the person interested in getting a job? See page 12 Questionnaire for Situational Information

  35. QSI Scoring Plan Functional, Behavioral, and Physical Status Individual items are rated: 0 to 4 A status rating is calculated for each section: 1 (minimum) to 6 (maximum) QSI Overall Support Level 1 (Basic) to 5 (Intensive) Questionnaire for Situational Information

  36. Functional Status Questionnaire for Situational Information

  37. Functional Status: Sensory Functioning 14. Vision 15. Hearing See pages 13-14 Questionnaire for Situational Information

  38. Functional Status: Essential Living Skills 16. Eating 17. Ambulation 18. Transfers See pages 15-16 Questionnaire for Situational Information

  39. Functional Status: Essential Living Skills 19. Toileting 20. Hygiene 21. Dressing See pages 17-18 Questionnaire for Situational Information

  40. Functional Status: Essential Living Skills 22. Communications 23. Self-protection 24. Ability to Evacuate (place of residence) See pages 18-19 Questionnaire for Situational Information

  41. Behavioral Intervention and Support Status Questionnaire for Situational Information

  42. 0. NONE required 1. OCCASIONAL verbal prompts, instructions, or redirection from caregiver 2. FREQUENT prompts, instructions, or redirection, environmental modification, restriction from caregiver 3. Frequent, PLANNED INTERVENTION Or – Assistance from others or restrictions are frequently necessary – Uses one psychotropic medication – Was admitted to crisis stabilization unit 4. Use of physical, mechanical, or chemical restraint Or – Uses one psychotropic medication with changes or two or more medications, or intensive behavioral services – Resides in secure facility, intensive residential treatment center, or psychiatric hospital See page 21 Questionnaire for Situational Information

  43. Behavioral Status 25. Hurtful to Self/Self-injurious Behaviors 26. Aggressive/Hurtful to Others 27. Destructive to Property See pages 22-24 Questionnaire for Situational Information

  44. Behavioral Status 28. Inappropriate Sexual Behavior 29. Running Away 30. Other Behaviors That May Result in Separation from Others See pages 25-27 Questionnaire for Situational Information

  45. Guidelines for Behavior Follow-up Consultation • Need for assistance from the Area Behavior Analyst to complete the scoring of the QSI tool • Behavioral Status Rating of 3 or higher • Emergency health and safety need • Urgent need that requires a provider to complete a behavior assessment • Need for a change in behavioral services See page 28 Questionnaire for Situational Information

  46. Physical Status Questionnaire for Situational Information

  47. Physical Status 32. Injury Caused by Self-injurious Behavior 33. Injury Caused by Aggression toward Others or Property See pages 30-31 Questionnaire for Situational Information

  48. Physical Status 34. Use of Mechanical Restraints or Protective Equipment for Maladaptive Behavior 35. Use of Emergency Chemical Restraints 36. Use of Psychotropic Medications See pages 32-33 Questionnaire for Situational Information

  49. Physical Status 37. Gastrointestinal Conditions (include vomiting, reflux, heartburn, or ulcer) 38. Seizures 39. Antiepileptic Medication Use See pages 34-35 Questionnaire for Situational Information

  50. Physical Status 40.Skin Breakdown 41. Bowel Elimination 42. Nutrition See pages 36-37 Questionnaire for Situational Information

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