Monday, April 22, 2013

An F

Lyn's SIS evaluation results have come back already.  The speed of the results from this evaluation have surprised us.

Lyn has received an F.  Previously, she received a B classification.  Lyn's results were shared with her and she was very upset at first to learn that she had an F.  It took considerable explanation from Mom and Lyn's support team to explain to her that she did not fail the test.  That the F just explained what group of services Lyn needs and that she did just fine.  She wasn't entirely sure, but she eventually accepted their explanations.

So what does this mean?  The New Mexico Support Intensity (SIS) Group Service Package Descriptions list eight different categories.  Based off the results from the SIS evaluation, the individual is groups into one of these eight, simply labelled NM SIS Group A through NM SIS Group H.

When Lyn was placed in group B, the description the state felt applied to her was as follows:

Adults in this group require more support than NM SIS Group A, but also receive intermittent rather than 24/7 paid supports.  Some time is spent alone, engaging independently in certain community activities and/or with unpaid natural supports.  Many of these individuals have mild intellectual disabilities, although broader ranges of intellectual disabilities do occur in this group.  The individual in this group require more support to meet personal needs than those in NM SIS Group A.  However their support needs are still generally minimal in a number of life areas.  This group has fewer general support needs (Home Life, Community, Health and Safety Support Needs) than 50% of the population with developmental disabilities.

Now that Lyn has been placed in group F, the state has applied this description to her:

Adults in this group include person with the most extensive/complex medical support needs that require frequent nurse intervention or management in order to minimize medical risk factors.  Maximum assistance with activities of daily living is required to meet their extensive physical support needs and personal hygiene, including lifting/transferring and positioning.  Feeding tubes, oxygen therapy or breathing treatments, suctioning and seizure management are common as well.  Many of these individuals may be medically unstable or are receiving hospice services.

It sounds pretty grim and in all honesty, it is.  To give a comparative, here is the explanation for Group E:

Adults in this group require many supports and maximum support relative to activities of daily living.  General support needs (Home Life, Commuity, Health and Safety Support Needs) exceed those of 75% of the population with developmental disabilities.  Most have at least one medical support need, which may include supports for aspiration risk, seizures, diabetes or other conditions which are chronic but relatively stable and do not require an amount of nursing intervention or oversight to meet criteria for NM SIS Group F.  Many individuals in NM SIS Group E require full physical supports.  Support Needs of those in Group E are associated with their level of intellectual disability which tends to be in the severe or profound range, although some may have mild/moderate intellectual disabilities with significant physical support needs.

So why does Lyn qualify for F and not E?  It is her Alzheimer's that makes the difference.  If it were not for her Alzheimer's, Lyn would probably be closer to a D than even an E.  However, she does have it and it is factored in now.

Alzheimer's is not a chronic condition.  It is a progressively degenerative and terminal condition.  As a result, Lyn cannot be left alone at all any longer.  She needs supports getting dressed.  She requires oxygen when she sleeps.  She needs assistance getting up from a seated position.  The supports she receives today continue to adjust to her increasing needs.  While she does not currently need assistance with feeding, that day will come.  

So, what does this mean in relation to her services?  That I do not yet know.  We have asked several questions of her case management team and are awaiting the answers.  What I can say, however, is that her services will not be reduced at this point and for that, we are thankful.

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