016-06-17 Ark. Code R. § 14
Arkansas will build upon the MnCHOICES comprehensive functional assessment developed by the State of Minnesota to customize an Independent Assessment and algorithms and tiering criteria used across two Arkansas Divisions: the Division of Behavioral Health Services (DBHS) and the Division of Developmental Disabilities Services (DDS). These two Divisions will use the MnCHOICES assessment and developmental screening tool, as well as the IT platform upon which they sit for eligibility determinations for long-term service and supports (LTSS), behavioral health services and developmental disabilities day treatment to support Arkansas' goal of consistency and efficiency in processes. This assessment provides compatibility across persons of all ages, abilities, and financial background, offering a person-centered, modular approach to support a streamlined, statewide strategy for determining eligibility for publicly funded LTSS and behavioral health services.
The MnCHOICES assessment will serve as the basis for an independent functional assessment and data collection tool across all populations and fulfills the Arkansas goal of implementing an assessment strategy and process across the two Divisions to support the creation of a sustainable, person-centered system that:
The assessment focuses on individuals, not programs, gathering standardized information necessary to determine level of need and support individuals in making their own choices across a diversity of publicly-funded services. The tool will incorporate built-in algorithms customized for Arkansas that align individuals with program eligibility.
By implementing a single automated tool with supporting modules, Arkansas will realize efficiencies through reduced paperwork and avoidance of redundant data entry for individuals as they move across programs and services as they age, or as conditions change. The diverse and robust MnCHOICES assessment supports eligibility determination and support/care planning.
The table below outlines the assessment instrument and supplemental forms by Division.
Division of Behavioral Health Services | Division of Behavioral Health Services |
INSTRUMENT: MnCHOICES | INSTRUMENT: MnCHOICES |
Supplemental Form for Individuals under age 18 | Supplemental Form for Individuals under age 18 |
DEVELOPMENTAL SCREENING TOOL: Battelle Developmental InventoryT, 2nd Edition Normative Update or similar tool |
The following Domains comprise the MnCHOICES assessment:
Person Information | Sensory and Communication |
Quality of Life | Safety and Self-Preservation |
Activities of Daily Living (ADLs) | Employment, Volunteering and Training |
Instrumental Activities of Daily Living (lADLs) | Housing and Environment |
Health | Self-Direction |
Psychosocial | Caregiver |
Memory and Cognition | Assessor Conclusion |
Both of the two Divisions: DBHS and DDS, will identify the individuals in need of an Independent Assessment and provide contact information to Optum. Physicians will refer children with identified developmental delays and diagnoses to Optum for a developmental screen. Optum schedulers will schedule the interviews/assessment or screen with the individual and/or any other necessary and/or desired parties (e.g. legal guardian, representative, or desired family member). Prior to conducting the interview, the assessor will review any and all available information shared by the State, providers, or individual/families in order to pre-populate the assessment with demographic and historical data.
The assessor will conduct the interview/assessment and enter the findings into the IT platform. Upon completion, the assessor will review any additional notes documented during the assessment to more accurately confirm responses and gather additional information made available by the State, providers and individuals/families before finalizing the assessment.
Once completed, the IT platform automatically calculates a Tier determination based upon the algorithms built into the platform. The assessor will share the Tier determination with the appropriate State Division. Optum will also transmit the independent assessment report to the appropriate State Division. Based upon the needs identified during the independent assessment, the appropriate State Division will authorize services within the tier determined.
The State or Designated Entity can then use all of the information in the MnCHOICES assessment to build a robust, person-centered plan outlining the desired and needed services based on the Tier recommendation of the individual's functional needs.
Each Division has developed and defined Division-specific Tiers of services to address needs of the beneficiary. The need for these services drives the algorithms built within the IT platform in support of the Tier determination. This will result in an objective and unbiased Tier determination based solely on the assessor's input of responses provided during the Independent Assessment. Below outlines each Division's tiers of services:
Division of Behavioral Health Services
Time-limited behavioral health services provided by qualified licensed practitioners in an outpatient based setting for the purpose of assessing and treating mental health and/or substance abuse conditions. Tier 1 Services settings mean a behavioral health clinic/office, healthcare center, physician office, and/or school. |
At this level of need, services are provided in a Tier 1 services setting but the level of need requires a broader array of services. |
Eligibility for this level of need will be identified by additional criteria, which could lead to inpatient admission or residential placement. |
Division of Developmental Disabilities Services
Individual receives services in a center-based clinic such as Developmental Day Treatment Clinic Services (DDTCS) or Child Health Management Services (CHMS) or successor program or receives services such as personal care, occupational therapy, physical therapy or speech therapy due to th developmental disability or delay. |
The individual meets the institutional level of care criteria but does not currently require 24 hours a day of paid support and services to maintain his or her current placement. |
The individual meets the institutional level of care criteria and does require 24 hours a day of paid support and services to maintain his or her current placement. |
Example of Tiering Process
Trained and qualified assessors will administer the Arkansas assessment tool. Assessors will have the following qualifications:
* At least one year experience working directly with the population with whom they will administer the assessment * Have the ability to request and verify information from individuals being assessed * Culturally sensitive to individuals assessed * Have the necessary knowledge, skills and abilities to successfully perform and manage Independent Assessments including organization, time management, ability to address difficult questions and problematic individuals, effective communication, and knowledge of adult learning strategies * Linguistically competent in the language of the individual being assessed or in American Sign Language or with the assistance of non-verbal forms of communication, including assistive technology and other auxiliary aids, as appropriate to the individual assessed or use the services of a telephonic interpreter service or other equivalent means to conduct assessments |
* Verify the information received from the individual and the individual's family members, caregivers, and/or guardians by cross-referencing all available information * Assessors SHALL NOT be related by blood or marriage to the individual or to any paid caregiver of the individual, financially responsible for the individual empowered to make financial or health-related decision on behalf of the individual, and would not benefit financially from the provision of assessed needs. | |
DBHS | Four-year Bachelor's degree or Registered Nurse, both with at least one year of mental health experience |
Two years' experience with the l/DD population and meet the qualifications of a Qualified Developmental Disability Professional (QDDP) |
More information on training - both initial and ongoing - for assessors is included in the Section V. of this document.
Assessors administering the Independent Assessment will receive classroom and instructional training, as well as hands on experience through role playing and case studies to become proficient in administering the Independent Assessment as well as use of the IT platform.
AR providers of services and DHS State staff will have available in-person group training, web-based training, and onsite coaching in the Independent Assessment System for those who have attended training and require follow-up assistance during the first year of the transition.
Assessors:
Assessors will receive the following training:
Training Module | Description |
Step 1: Foundations: Overview Foundations: Basics | Training on AR LTSS programs and services MnCHOICES background and overview Battelle Inventory |
Step 2: Application | Training and hands on experience to learn how to access and become proficient in using MnCHOICES in the following four areas: - Access and Navigation Content Practice and Certification Tiering |
016.06.17 Ark. Code R. § 014