Supports Intensity Scale®

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Overview of SIS Training Programs

Types of Training

AAIDD offers several types of SIS training to our customers based on their specific stage of implementation. These training programs are SIS Stakeholder Session/Respondent Orientation, SIS Train-the-Interviewer training, SIS Train-the-Trainer training, and SIS Quality Assurance training.  The order of these training programs also represents a general timeline from the initial steps of basic training to the more advanced, follow-up types of training.

1.  Stakeholder Session /Respondent Orientation

This training component is an intensive and interactive 1-day group session. It is designed to provide an in-depth overview of the AAIDD Supports Intensity Scale® (SIS®), and can be offered to the general public including respondents and stakeholders. Most agencies start their implementation process with an orientation session to engage and inform the public, including stakeholders and administrative staff, as well as to train potential SIS assessors. This training includes: 
- Historical and philosophical framework of SIS 
- Instrument design, including item selection, validity, and reliability 
- Item analysis 
- Scoring process 
- Interview strategies 
- Data use and management. 
- An opportunity to observe and conduct a live interview as part of a group

2.  Train-the-Interviewer program

Those who attend this training have been identified as potential SIS assessors, and typically preface a state or an agency’s implementation of SIS. This training component fully incorporates SIS knowledge and skills necessary to become confident and competent SIS interviewers. Each trainee spends approximately 5 days in classroom training, and it may take roughly a couple of months for the entire group to complete the training process. The training is designed in 3 phases (Orientation, Individual Guided Practice, and Interviewer Reliability Qualifications Review) to allow for adequate practice and self-study time. 

The Orientation Session usually takes 3-4 days, depending on the size of the class, and covers basic introduction and rationale for the SIS, administering and scoring, conducting the interview and tips for interviewing, and how SIS can inform Individualized Support Plans. The Orientation session also offers an opportunity for participants to observe and conduct a live interview as part of a group. 

The Individual Guided Practices are designed to prepare the trainees for live interview interactions with respondents and interviewer reliability review. Through live interview practices, the AAIDD SIS Trainer demonstrates the SIS interview process, including: 
- Interview set up 
- Information gathering processes 
- Information interpretation 
- Item determination and scoring 

Next, in order to be recognized by AAIDD as SIS assessors, participants complete an Interviewer Reliability Qualifications Review (IRQR) with the AAIDD Trainer. Successful candidates must obtain an interviewer reliability score of qualified or higher. This means that the AAIDD Trainer observes the participant complete an interview without comment. Based on this observation, the AAIDD Trainer determines whether the interviewer is capable of conducting the SIS independently, as indicated by interviewer techniques and decision making. Each day begins with the AAIDD Trainer clarifying any questions participants may have, including item clarification, scoring, and interviewing techniques. This is followed by the AAIDD Trainer observing the first participant conduct a full SIS interview and determining the participant’s interviewer reliability. Two interviewer qualifications reliability reviews can be completed in a day. 
(Note: Annual interviewer reliability qualifications review is required to ensure staff maintain skill level)
Prerequisites:  A minimum of 4 practice interviews before interviewer reliability qualifications review 

3.  SIS Train-the-Trainer program

The Train-the-Trainer training can only be offered after individuals’ successful completion of SIS Train-the-Interviewer training. In fact, trainer candidates are required to spend at least 1-2 months after the completion of SIS assessor training to gain adequate exposure to various SIS interview scenarios. This training ensures competent staff to train others on SIS, such as the SIS orientation course, quality assurance updates, and/or training interviewers by conducting interviewer reliability reviews. Further, the SIS Train-the-Trainer program ensures content integrity of each trainer. The trainer standing in front of a group fielding questions and comments requires more in-depth knowledge of the Supports Intensity Scale. They must know the process in a more comprehensive way than what is required to conduct an interview. The trainer must demonstrate competency in teaching others the intent of SIS, the nuances of each item on the Scale, as well as the scoring process and analysis of the information obtained.

The Train-the Trainer component also has three phases (an Advanced Theory session, Teaching the Orientation session, and an Interviewer Reliability Review tutorial). Areas covered during a SIS Train-the-Trainer program include: 

- Understanding of the overall intent and supports-oriented philosophy of SIS as well as the meaning of each line-item on the Scale. 
- Mechanics/style: Communicate the intent of SIS effectively using respectful language and examples that the person with disability understands and with which s/he can easily relate. Demonstrate flexibility as an interviewer using a conversational style to complete SIS subscales and not necessarily go in the order in which SIS is organized 
- Suitable interviewing techniques: Use verbal and non-verbal cues; set a scene for each subscale; tackle sensitive issues such as using people first language and dealing with difficult topics; and keep interview on track 
- Scoring and interpreting data: Explain reasoning for scores chosen; learn to properly calculate scores; and obtain consistent results 

Throughout the training, the AAIDD Trainer provides in-depth feedback and guidance to the trainee and also observes the instructors ability to appropriately conduct an interviewer reliability review with participants. 

Length of Training: About 1 week, depending on the training agenda and size of the class.

Prerequisites: SIS orientation course; interviewer reliability of .85 or higher, and completion of at least 10 additional practice interviews 

Guidelines for choosing staff for a SIS Train-the-Trainer program

If you choose the AAIDD Train-the-Trainer program, how do you choose who becomes the SIS trainer for your organization? In one regard, the selection process is fairly straight forward. The desired attributes for a trainer are listed below. However, a significant attribute required for a SIS Trainer is the willingness to understand and implement a new, progressive supports-oriented assessment process. The ability to transition from a skills focus while conducting assessments to a needs and supports orientation is a must. A SIS interviewer must be willing to listen to the respondents and gather feedback, rather than recording a perception of what s/he thinks the person requires as supports and services. 

AAIDD highly recommends that instead of preselecting candidates to become SIS trainers, agencies work closely with AAIDD trainers to select individuals showing most promise through their training. 

Some skills required include: 
- Effective communication skills 
- Public speaking skills 
- Ability to relate well to groups.
- Ability to work well with people with various backgrounds 
- Effective audience management skills 
- Availability to work when needed, including commitment to completing work within designated timeframes. 
- Willingness and eagerness to participate as an internal trainer 
- Analytical skills to address difficult questions or problematic participants 
- Ability to effectively use audio-visual equipment 
- Effective time management skills 
- Flexibility to modify presentation based on audience 
- Strong organizational skills 
- Practical knowledge of adult learning strategies 

The selection process may offer other challenges as well. This includes gauging the spirit of the person. While difficult to assess, the following attributes contribute significantly to the overall process: 

- Ability to deal with ambiguity (the rules will not always be clear or multiple changes may need to occur). 
- As ambassadors of the SIS implementation strategy, the person selected should present a positive view of the process and have a solid understanding of the SIS process and the tool. 
- Always seek to improve effectiveness and achieve greater efficiencies in the implementation strategy. 
- Demonstrating a sense of humor and the ability to promote humor in a training session is essential.

4. Quality Assurance Training

Following the completion of SIS Interviewer training and Train-the-Trainer training, SIS Quality Assurance training occurs at a later stage of the training process. An agency’s team of SIS assessors and trainers need on-going support and review to ensure that they are meeting the quality standards and following best practices. AAIDD requires training customers to include annual quality assurance training components in their SIS implementation plan.  It should cover refresher training for assessors and/or trainers, data quality review for individual assessors, and annual IRQR reviews at a minimum. The key to SIS quality assurance training is in the long-term strategic planning so as to maintain and strengthen quality performance by the agency’s team of SIS assessors and trainers. Length of the training is determined by the agency’s specific training needs.  

5. AAIDD SIS Assessment Services

AAIDD can provide trained, reliable and experienced SIS interviewers to states interested in seeking help in conducting SIS assessments with clients. As an integral part of this service, comprehensive “look-behind” supports are offered by AAIDD through its senior SIS trainers. This component facilitates data collection; ensures data integrity particularly data reliability; and effective, open communication between state officials, stakeholders, respondents including the individual with an intellectual and developmental disability, field staff, and SIS interviewers. This service may also include help with logistics of interview arrangements as well as data entry. AAIDD provides a final report to the state after completion of the project.


AAIDD Supports Intensity Scale Interviewer Services

Pilot projects are a modest foray into judging the effectiveness of the Supports Intensity Scale (SIS) for its multiple uses in specific settings. Since the Supports Intensity Scale tool calls for a new way of thinking of supports and service delivery, states/provinces often need advice in planning a roll out of SIS, whether it is collecting reliable SIS interview data, engaging and communicating with stake holders, conducting training on SIS interviews, customizing the SISOnline system, or determining strategies to integrate SIS with other existing assessment information. 

When planning a SIS roll-out, states and provider agencies need to decide whether to develop internal resources to carry out the various steps or to contract part, or all of such services to an outside entity. Often times, they seek the expert advice and technical assistance from AAIDD’s SIS team at the onset of their planning, adoption, and eventual implementation of SIS.
The AAIDD SIS team consists of expert SIS trainers, a cadre of well-trained SIS assessors, a technical manager, and government relations partners, and works with states/provinces to customize SIS implementation efforts in varying settings and timelines.

Specifically, the following AAIDD services are available to assist states/provinces successfully define and achieve their pilot goals:

- provide reliable, experienced AAIDD interviewers to conduct SIS assessments
- provide AAIDD SIS trainers to administer interviewer reliability tests to ensure the reliability of assessment data
- provide a project lead trainer for overall project administration to include technical assistance and supports, logistical coordination and management for the duration of the pilot project
- assist the state/province in its communication with stakeholders on the philosophy and value-base of SIS, goals of the project, roles and responsibilities of the respondents, and address common stakeholders’ concerns
- communicate with state officials on project progress and problem solve concerns/issues that ensue
- introduce SIS respondents to the SIS instrument
- provide reports summarizing key facts of the assessment data and important issues/trends to emerge during the interview project
- provide integrated training solutions to optimize pilot outcome
- administer and supervise AAIDD/State SIS-scheduler(s) to facilitate effective SIS interview arrangements that maximize interviewer availability and scheduling outcomes

Why engage AAIDD’s interviewer services?

Here are some benefits to consider:
It ensures quality data – AAIDD’s SIS assessors are selected by AAIDD’s trainers, and all receive rigorous training and are current with their quality assurance training requirements.  Furthermore, AAIDD trainers perform Interviewer Reliability Reviews on a percentage of the overall assessments as additional quality measure. 

AAIDD’s standard of quality is not just in the data, but also in the communication surrounding the SIS tool. In fact, we call our assessors “AAIDD SIS Ambassadors”, because not only are they skilled at conducting assessments, they are also proficient in communicating the supports-oriented SIS philosophy to the public and all involved in the interview process.  

It saves time – Instead of spending months training your internal staff at the front end of the pilot, you have a team of quality assessors readily available to conduct SIS. This is attractive especially when states have budgetary constraints or a limited workforce. While newly trained assessors experience a learning curve getting used to the multi-faceted aspects of conducting SIS interviews as part of their regular work routine, AAIDD assessors routinely conduct a minimum of 3 assessments a day, 5 days a week. 

It is efficient – AAIDD’s SIS team is experienced in handling the various aspects of running interview projects. The rich experiences and lessons gleaned from other states by our team will help better position your state/province in strategic planning and day-to-day administrative tasks.

It helps craft the message – A typical precursor to a pilot project is communication. AAIDD often plays a role in the state or the agency’s communication activities with its key stakeholders.  Whether it is participating in stakeholder meetings, respondent orientations, or through SIS assessor’s communication with providers and respondents, such involvement helps reinforce the true intent and values of the SIS. 

It helps address (the perception of) conflict of interest issues– This is especially important when states decide to use SIS for resource allocation---- having an external, independent team of reliable assessors may help avoid potential perceptions of “skewed” SIS data that can impact a person’s funding level.


Oregon Pilot:
Size: 400 assessments
Timeline: June – September, 2007
AAIDD supported the state of Oregon in different capacities, including consulting services on SIS implementation, technical support to collect assessment data, and providing interviewers to conduct SIS assessments. Further, in order to ensure the reliability of the assessment data, AAIDD senior SIS trainers administered interviewer reliability reviews on 10% of the total assessments. 

Working with its partners, AAIDD facilitated the sharing of supplemental questions from other states to include questions on additional medical, behavioral areas and protective supervision. The “Oregon Supplemental Questions” have since been widely adopted by many other states/provinces. On the information technology end, AAIDD worked with Oregon to elaborate strategies for information access and control, such as setting up levels of security and enabling locking of data for security reasons, and customizing reports to meet the needs of program managers, data analysts, and IT staff.

Upon project completion, Oregon used the data to develop Individualized Budget Amounts and standardized funding for long-term supports for people with developmental disabilities. Through this project, people with developmental disabilities have a greater degree of choice and consistency of service rates in community living and employment settings. 

What Oregon has to say about AAIDD Interviewer Services?
Jan Morgan, Manager for the Oregon Restructuring Budgets, Assessments and Rates (ReBAR) project says, “We have enjoyed a rare, and much-appreciated relationship of cooperation, flexibility, and openness with the team at AAIDD.”  

Maryland Pilot:
Size: 475 assessments 
Timeline: March 2009-December 2010
In 2009, AAIDD conducted about 100 SIS assessments for Maryland as part of the state’s efforts to close the Rosewood Center, an intermediate care facility (ICF) for individuals with intellectual disabilities. SIS assessments were conducted to gauge support needs for a majority of Rosewood’s residents who transitioned into community placements. As part of AAIDD’s interviewer services, AAIDD assessors utilized the Rosewood Forensics list to complete SIS assessments on individuals with complex or challenging medical and/or behavioral needs.
In 2010, AAIDD continued its interviewer services with the state of Maryland to complete an additional 375 assessments. This data was used as the basis to develop funding allocation algorithm. Simultaneous to the interview process, AAIDD provided training to the state to enhance its internal capacity by cultivating new SIS assessors. For both phases of the project (interview and training), interviewer reliability reviews were conducted on 10% of the assessment data. Additionally, AAIDD supported the state of Maryland in providing data entry and data report of SIS assessments using SISOnline and SIS Venture. 

New Mexico Pilot:
Pilot size and timeline: 960 assessments (April –December, 2011)
Ongoing assessment services size and timeline: Approx. 1000 assessments (2012)
In 2011, AAIDD’s SIS team assisted the state of New Mexico to gather data on about 960 SIS assessments, which were used as the basis for the State to develop a new rate setting approach and rate models. The State has continued its arrangement with AAIDD in 2012 to further collect SIS data so that the information, in addition to fine-tuning the State’s resource allocation policies, will inform the person’s Individualized Service Plans (ISP). 

AAIDD’s team of assessors has been actively engaged in the different regions within the state to accomplish the targeted number of 1900 SIS assessments. For the culturally or linguistically diverse sub-groups within the State, such as the Native American populations or Spanish-speaking populations, AAIDD assessors have consistently handled the interviews with cultural awareness, sensitivity, and respect.

Compared to the typical interview service offerings, AAIDD has offered a most comprehensive package of services during this pilot. Specific tasks include --providing reliable interviewers, conducting interviewer reliability review on a portion of the interviews, providing a lead trainer for overall project administration; communication with state officials as well as stakeholders and respondents; providing reports; providing training to the state’s team of SIS assessors, and last but not least, scheduling the interviews with NM providers, respondents and AAIDD SIS assessors.  As with most states, the state chose to use SISOnline and SIS Venture for the convenience of data input and storage.