The Revised CDER

The Revised CDER

Regional Center Train-The-Trainers2007

Today’s Training Objectives

Train-the-trainer’s session to provide:

Training resources

Background on revision process

Details about the new CDER

Instructions for completing the new CDER

Presentation Order

1. Revised Evaluation Element and New Personal Outcomes Element

2. Waiver Level of Care Eligibility

3. Revisions to the Diagnostic Element

Evaluation and Personal Outcomes Elements

Assessing Consumer Abilities and

Outcomes

Background and Development

Evaluation and Personal Outcomes Elements

Background and Development

Issues with Original CDERResulting in inaccurate and/or incomplete data

Outdated Focus on disabilities rather than abilities Not useful to IPP process Doesn’t assess health & safety, quality of

life or outcomes

Background and Development

Project Consultants

Dr. Jamie McCrearyDr. Harold Stanislaw

Department of PsychologyCalifornia State University, Stanislaus

Goals for revision

Requirements for the New CDER Focus on consumer abilities

Useful for program planning

Shorter and easier to use

Continuity with existing CDER data

Improve ability to provide reliable data

Background and Development

Revision Process

User Surveys Identified items to retain, delete, add and reword

Analysis of Data Requests Identified type of information most frequently

requested to ensure continued availability of data

Background and Development

Revision Process

Scientific Literature Review Identified published studies based on CDER data to

ensure continued availability of data needed for scientific research

Field Testing To confirm the validity and reliability of the new

CDER

Evaluation and Personal Outcomes Elements

Comparison of “Old CDER” to “New

CDER”

The Revised CDER Evaluation and Personal Outcomes Elements

New CDER: 46 Items

2 Major Sections Evaluation Element Personal Outcomes

Element

Consistent Number of Response Options Per Section

Original CDER: 66 Items

7 Domains

Responses Range From 3 to 9 Options Throughout

Rate consumer abilities vs. categorizing them Use of informed sources to obtain information Snapshot at a particular point in time Items applicable to all consumers regardless of

age or challenges Response options to address when a question

can’t be answered

Highlights

The Revised CDER Evaluation Element

Revised Evaluation Element

Content

The Evaluation Element:Provides information for identifying services and supports

2 Sections

Skills Demonstrated in Living (14 items) Challenging Behaviors (6 items)

The Revised CDER Evaluation Element

The Evaluation Element Information provided by a person directly

involved with consumer on a daily basis during a specified time period

Skills Demonstrated in Daily Living At least 1 week of the preceding 6 months

Challenging Behaviors At least 2 months of the preceding 12 months

The Revised CDER Evaluation Element

New Personal Outcomes Element

Content

The Personal Outcomes Element:Provides information about quality of life and well being

3 Sections Physical and Social Environment (13 items)

Health and Safety (3 items)

Consumer Survey (10 items)

The New CDER Personal Outcomes Element

The Personal Outcomes Element Information provided by knowledgeable person

involved with the consumer Physical & Social Environment = Sufficiently

knowledgeable to provide accurate, unbiased picture of consumer’s current situation

Health & Safety = Sufficiently knowledgeable to provide accurate, unbiased picture of consumer’s situation during the preceding 12 months

The New CDER Personal Outcomes Element

The Personal Outcomes Element

Consumer Quality of Life Survey = Only the consumer can respond to these items

Items designed to capture consumers own feelings

Consumers provide the information without someone else interpreting responses

The New CDER Personal Outcomes Element

Completing theNew CDER

Evaluation and Personal Outcomes Elements

Conducting Interviews Present items conversationally Do not read response items Change order of items as needed

Completing the New CDER

Completing the New CDER

Consumer Survey Interviews Build rapport and create neutral

environment Paraphrase and personalize items Use the keywords or phrases included in

the items Translation vs. Interpretation of responses

Completing the New CDER

Choosing Response Options Consistent number of options in each

section 4 or 5 point scales Select options that best describe typical

behavior Additional options when items cannot be

answered

Completing the New CDER

The Consumer Survey 3 point scale

Negative Response Ambivalent Response Positive Response

Additional options when any item cannot be answered

Special options when entire survey cannot be completed

Training Resources

Evaluation and Personal Outcomes Elements

Training Resources DVD

Tutorial for group or individualized training Review questions and quizzes Designed for both initial and periodic refresher

training

Training Manual (available at www.dds.ca.gov/cder) Review questions and quizzes Glossary FAQs

Waiver Level of Care Eligibility

Evaluation and Personal Outcomes Elements

Background and Development

Revised CDER Diagnostic Element

Background and Development

Issues Resulting in inaccurate and/or incomplete data

Outdated Terminology

Does Not Reflect Current Medical Knowledge and Practices

Background and Development

Goals for Revision

Revise in Phases

Prioritize Items For Revision

Ensure Applicability For Both RCs and DCs

Background and DevelopmentRevision Process

Participants: ARCA physicians and chief counselors

DC Physicians and Clinical Staff

DDS clinical staff

The Wellness Advisory Committee

Revised Diagnostic Element

Content

Cerebral Palsy

Item 17: Presence of Cerebral Palsy

Item 19: Severity of Motor Dysfunction

Item 20: Type of Motor Dysfunction

Item 22: Condition Impact

Autism

Item 23a: Presence of Autistic Disorder

Item 23b: Presence of Other PDD

Item 26: Condition Impact

Epilepsy/Seizure Disorder

Items 27a - 29a: Type of Seizure

Items 27c - 29c: Condition Impact

Psychiatric Disorders(Previously Mental Disorders)

Specifies the use of the DSM-IV rather than the DSM-III

Items 50c - 53c: Condition Impact

Chronic Major Medical Conditions

Items 54b – 59b: Condition Impact Multiple Conditions: Only Top 6 Transmit to

DDS

Other Developmental Disability

Adds Item 33: Other Disability (Y/N)

Resources

Diagnostic Element

Resources

Available at www.dds.ca.gov/cder

Revised Form

Revised Manual Sections

Under Development

DSM Crosswalk

The Revised CDER

Next Steps For Regional Centers

The Revised CDER

Questions?

Contact InformationCDER: WaiverSue Boucher Jim Knight(916) 654-2120 (916) 653-7710sboucher@dds.ca.gov jknight1@dds.ca.gov