Tuesday, April 22, 2008

ICAP Question/Answer related to OASIS

The FAQ for the latest OASIS forums should be posted soon on the OASIS website. In an effort to help parents understand the complexities of OASIS, Family Voices will be sharing various resources with its members. In that spirit, we are posting the Question and Answers from the 2007 OASIS presentations since ICAP (the assessment tool) was addressed in more depth and answered by Arbitre Consulting, the firm handling ICAP.

Some answers may have changed in the interim, as they continue to develop OASIS. If you have questions you would like clarification on, you can email Andrew Ranck at OASIS-ICAPhelp@fssa.in.gov or call (317) 234-5222 or 1-888-527-0008 .

Arbitre Consulting: ICAP Questions

1. The ICAP tool does not have many questions related to medical issues. How are we bringing these medical needs into the way rates are to be calculated?

Ø The ICAP will only be used as a "point in time" functional assessment to assist in determining funding needs. ICAP will only have a 3% to 15% impact on the total funding model. Some medical documentation may be gathered at the assessment if it is missing.

2. Who is hiring the staff and what qualifications to screen the number of support staff that will be needed to implement this (i.e. the ICAP)?

Ø Arbitre Consulting is responsible for conducting the ICAP throughout the state. They have a specific, regimented training program for their clinicians who administer and review the assessments. They have conducted over 20,000 assessments since 2000. Arbitre Consulting is hiring and training staff who live in Indiana to complete the assessments.

3. Is an ICAP respondent notified by mail or phone? Is the case manger notified if the respondent doesn't reply?

Ø IPMG case managers will contact the providers and family/consumer to confirm appropriate respondents and ask for recommendations. Arbitre Consulting will follow-up with the individual respondents to setup and conduct the ICAP.

4. If the ICAP determines level of service, what happens if the respondent does not respond honestly due to embarrassment?

Ø There are a minimum of three respondents required for a valid ICAP assessment. The purpose of multiple and individual interviews is to establish an accurate overall view of the consumer. If one of the respondents cannot answer a particular question properly, one or both of the other respondents should be able to fill in any gaps. The Quality Control Specialist for Arbitre Consulting reviews all completed ICAP's and will note any answers that don't align and return the ICAP assessment to the Arbitre Assessor for clarification.

5. What happens if the ICAP respondents are new to the consumer and do not know them well?

Ø A person that is new to the consumer would not be used as a valid respondent. If a consumer does not have enough respondents, their ICAP will be postponed until their new staff/guardians become better acquainted with the consumer's capabilities (This would likely be one year from first scheduled ICAP assessment.)

6. Should the three respondent interviews be done separately? What if they were done together?

Ø Each interview is done individually to ensure confidentiality and identify each respondent's own experiences with the consumer.

7. I realize you are trying to get an assessment done in a timely manner, but how are you going to get a thorough assessment in 20-30 minutes that determines the level of care?

Ø The ICAP will only be used as a "point in time" functional assessment to assist in determining funding needs. The ICAP will not currently be used as a level of care tool, but may be altered for future use as such. Arbitre Consulting has completed over 20,000 assessments. The 20-30 minutes for the specific interview is an average based on previous experience. The ICAP assessment takes approximately 30 minutes because it is a developmental assessment, each section goes from infant to adult therefore if the person is functioning at a higher level, the first several questions of each section go very quickly. Once they get several zeros in a row, the clinician moves on to the next section due to the questions getting progressively more difficult.

8. When it is time to interview for ICAP, we don't have in-home support staff, only school services; who will we find to complete the interviews?

Ø School teachers can be used as respondents with the cooperation of the school district. Family members who spend time with the consumer and know their functional abilities are also potential respondents.

9. How do the assessors rate the skills that the client can do in one setting, but refuse in another setting or cannot do in another setting?

Ø Multiple respondents are interviewed from all areas of the consumer's life. (The goal is to have three.) These include work, school, day programs and home.

10. If you already have the data why are you re-asking? What about the reliability of medical information?

Ø Medical information will be gathered from the consumer's records, but medical questions will be asked for the safety of the consumer.

11. Why does the ICAP ask for IQ? Some of the tests are 12 to 15 years old.

Ø This information is merely used as background for the consumer. The IQ is not part of the ICAP nor will it affect the scoring of the ICAP.

12. How does the ICAP take into consideration the historical facts of a client's life (for example - fluctuating health needs, seasonal changes in behavior)?

Ø The ICAP is only intended to assess a particular point in time. Additional factors that need to be considered in determining an individual's needs will be incorporated in the OASIS tool.

13. How does the ICAP ensure that all data collected is reliable and valid? Some clients appear like they know it all. Also parents and family members overrate the consumer's abilities.

Ø There are a minimum of three respondents required for a valid ICAP assessment. The purpose of multiple and individual interviews is to establish an accurate overall view of the consumer. If one of the respondents cannot answer a particular question properly, one or both of the other respondents should be able to fill in any gaps. The Quality Control Specialist from Arbitre Consulting reviews all completed ICAP's and will note any answers that don't align, and return the ICAP assessment to the Arbitre Assessor for clarification.

14. Are school teachers recommended as ICAP respondents? Do schools cooperate with this?

Ø Teachers usually make very good ICAP respondents. Permission from the school district is required for a teacher to participate in an ICAP assessment.

15. Will the ICAP report make sense to me if I request it?

Ø The actual ICAP scoring report will make very little or no sense to someone who is not trained. However, the report is available from the state upon request.

16. Can there be more than one respondent from a provider to accommodate the need for three respondents?

Ø Yes, if the potential respondent has the desired knowledge of the consumer. A respondent is someone who spends time with the consumer 3-5 times per week and has worked with the consumer for at least one year.

17. What would trigger a new ICAP reassessment?

Ø A life-altering event or significant change in health would trigger a new ICAP reassessment.

Davis Deshaies: OASIS Questions


20. Please summarize the relationship between OASIS and ICAP.

Ø The ICAP will be used as a "point in time" functional assessment to assist in determining funding needs. ICAP will only have a 3% to 15% impact on funding. Davis Deshaies will also identify additional "cost drivers" which may include such things as consumer age, predictable life events, living situation and geography, and transportation access. The ICAP fits within the OASIS program, which is the name for the entire method of determining fair and equitable funding, services and pricing.

21. We've previously been told that rates will be determined on a variety of factors/tools or assessments in addition to the ICAP. Have these other pieces been identified yet? If so, what are they and what percentage will they hold in the actual rate determination?

Ø Primary cost drivers include: age, family living situation, work situation, life events, geography and transportation. Secondary cost factors include functional abilities, behavior and health supports. Other factors being considered in the state of Indiana include: natural supports, employment, forensic and behavioral health issues. These will likely play a role in the determination of costs in Indiana, but will be evaluated using data and what is learned during the pilot. There is not yet an exact percentage breakdown of the pieces that will be used in the rate determination. This is also determined by the data analysis and what is learned during the pilot in BDDS District 4.


27. I like my child with severe disabilities to be involved and an active participant in the community. Are my son's services going to be compared to children with similar disabilities whose parents don't care if they just sit all day doing nothing?

Ø All consumers will be evaluated on an individual basis, and their person centered plan will be developed based on their needs.

28. What is an outlier consumer?

Ø An outlier consumer is someone whose needs and costs are so extreme that the "best practices" level of service will not accurately predict their costs.



You can read the document, in its entirety, at the OASIS website.

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