ODPANN 099-16 Adding Communication Assessment Report ... · 5. How the class member’s refusal of the accommodations was determined. Accommodations that were refused during the ISP

REISSUE DATE 12/16/2016 ODP Announcement 099-16 Page 1

AUDIENCE: Individuals and families, Supports Coordinators (SC), Supports Coordination Organizations (SCO), Administrative Entities (AEs), Providers and all interested parties. PURPOSE: The purpose of this communication is to release a guide for adding the Communication Assessment Report (CAR) recommendations to Individual Support Plans (ISP) for Harry M Class Members. DISCUSSION: The Harry M. settlement agreement (Agreement) was approved by a federal court judge on August 20, 2013. The Agreement ensures that Pennsylvanians who are deaf, have an intellectual disability, and are enrolled the Consolidated Waiver are provided with necessary communication assistance services based on their assessed needs. Among other requirements, the Agreement requires:

That all class members have initial assessments that evaluate expressive and receptive language skills and identify the preferred method of communication and make recommendations for staff skills (level of ASL fluency, visual/gestural training, etc.) needed for effective communication, specialized services and whether a fully signing environment is needed for effective communication.

That the assessment recommendations be “documented with specificity” in the class members’ ISPs, and

ODP Announcement Adding Communication Assessment Report

Recommendations to Individual Support Plans for

Harry M Class Members

ODP Communication Number

The mission of the Office of Developmental Programs is to support Pennsylvanians with developmental disabilities to

achieve greater independence, choice and opportunity in their lives.

ISSUE DATE: 12/16/2016 ODP Announcement 099-16 page 2 of 2

That the above requirements be administered and tracked by a “Deaf Services Coordinator” (DSC) who is knowledgeable about Deaf culture, has experience with Intellectual Disability and whose proficiency in ASL is at least at an Intermediate level.

Class members’ assessments are completed by Communication Assessors under contract with the Temple University Institute on Disabilities. Assessment results and recommendations are documented on a Communication Assessment Report (CAR). A standard template is used for the CARs. When CARs are completed, they are sent to the class member, the class member’s SCO, and the class member’s AE of registration. Upon receipt of the CAR, the class member’s SC must take specific steps to ensure that the recommendations are added to the ISP and that the recommended accommodations, services, and supports are acted upon. ODP has developed a Supports Coordinator Guide to Adding Communication Assessment Findings to Individual Support Plans to help SCs perform these functions; a copy of the guide is attached to this announcement. A copy of the CAR template is also attached. CONTACT Questions about this communication and/or the attached documents should be directed to the ODP Deaf Services Mailbox at [email protected] or to the appropriate ODP Regional Office.

mailto:[email protected]

Office of Developmental Programs| PO Box 2675 | Harrisburg, Pennsylvania 17105-2675

Supports Coordinator Guide to Adding Communication Assessment Findings to Individual Support Plans

December 15, 2016

Introduction As you are aware, the Individual Support Plan (ISP) contains information about an individual’s needs, desires, and outcomes. The ISP identifies what is important to individuals to enable them to lead their lives as they desire by providing supports for them to grow and develop, make their own decisions, achieve their personal desires, develop relationships, face challenges, and enjoy life as full participating members of their communities. This information is then used to link, arrange, and obtain needed medical, social, habilitation, education, or other needed community services necessary for individuals to achieve their outcomes and lead Everyday Lives. The Harry M Settlement agreement requires that all Harry M Class Members have communication assessments. Assessment results are documented on the Communication Assessment Report (CAR). The CAR is a professional assessment completed by a qualified communication assessor. The assessment findings are the most accurate analysis of the individual’s communication needs and abilities. Assessment findings supersede previous information relating to communications in the individual’s current ISP. The entire CAR must be retained in the individual’s case records maintained by the Administrative Entity (AE) and Supports Coordination Organization (SCO), and be accessible during ISP team meetings. Only the information in the “Summary and Recommendations” section is required to be added to the ISP. Other information from the CAR may be added to the ISP if desired by the ISP team. The Temple University Institute on Disabilities (Temple) performs the communication assessment and completes the CAR. Temple will contact you prior to scheduling a communication assessment. Contacts usually occur in the month before a communication assessment is scheduled. During the contact, you will be asked if you are able to attend the assessment, and if so, what dates and times you are available to do so. During the contact, you will have the opportunity to ask questions about the assessment, and may be asked to supply updated contact information for the class member to be assessed. Once the assessment is scheduled, you will be informed of the date, time, and location of the assessment and will be invited to attend. Supports Coordinator (SC) attendance at the assessment is not required.

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Process Upon receipt of the CAR, the SC is responsible to facilitate a team meeting to add the recommendations in the CAR to the ISP. The team must review the CAR and discuss how to best implement the recommendations. Process Steps:

1. Upon completion of a class member’s assessment, the Deaf Services Coordinator (DSC) will send the CAR to the individual, the individual’s SCO, the individual’s AE of registration, and the appropriate ODP Regional Office. The individual will receive the CAR by email or traditional mail, depending on the individual’s preference. The CAR will be sent to the SCO director by email, with a copy to the ID Director of the AE of registration and the appropriate ODP Regional Office.

2. The SC will complete the following steps within 60 days of receipt of the Communication Assessment Report:

Revise and update any information relating to communications from the current ISP that is no longer accurate as a result of the assessment. Examples:

o If the “type and severity of hearing loss in both ears” recorded in Section II of the CAR is different from the type severity of hearing loss documented in the ISP, the ISP should be changed to reflect the assessed type and severity of hearing loss.

o If the current ISP indicates that an individual reads lips, but the CAR found that the individual cannot read lips, then lip-reading should be removed from the ISP.

Add the identified portion of the Summary and Recommendations to the “Know and Do” section in the ISP as specified in the CAR.

Add the identified portion of the Summary and Recommendations to the “Communications” section in the ISP as specified in the CAR.

Facilitate an ISP team meeting to discuss recommendations and to develop an action plan to implement each recommendation. The ISP team meeting will be conducted in accordance with the instructions set forth in the current version of the ODP Individual Support Plan (ISP) Manual for Individuals with an Intellectual Disability.

o Section V-G of the CAR documents the type of communication assistance needed during ISP team meetings (e.g. a certified deaf interpreter). The persons named in this section must be present at the ISP team meeting unless the individual clearly objects to their participation/assistance OR the assessment recommends that these communication supports not be introduced for the first time at an ISP meeting. For example, an assessment may find that an ISP meeting should not be a person’s initial exposure to an interpreter.

3. During the ISP team meeting, the team will:

Review the recommendations set forth in the CAR

Develop an Action Plan to implement each recommendation

Note the development of the Action Plan in the Communication Section of the ISP

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Refusal of Recommendations The recommendations in the CAR are accommodations. Accommodations give persons with nontraditional communication needs, including deafness, an equal opportunity to participate in and to benefit from their services. By providing the accommodations recommended in the CAR, class members are assured the same opportunity to communicate their wants, needs, and desires as a hearing person. Accommodations must be provided to class members. At the same time, one of ODP’s guiding principles is to promote individual choice in managing their everyday lives. ODP also respects and understands that individuals must have access to information in order to make an informed choice. Individuals who have rarely or never been provided exposure to sign language, interpreters, or other types of accommodations will need encouragement to understand the benefit of recommended accommodations. Initial resistance to recommended accommodations is to be expected. Only a class member or a class member’s surrogate1 can refuse recommended accommodations. Refusal of one or more recommended accommodations will be honored, provided that:

1. The benefits of the recommended accommodation(s) have been explained to the class member, and

2. The class member is offered the opportunity and encouraged to be gradually introduced to the recommended accommodation(s), such as through progressive exposure to interpreter services, participation in deaf social groups, or other recommendations for gradual exposure proposed in Section V-D of the CAR, and

3. Both 1 and 2 above were presented to the class member via the class member’s “preferred methods of communication” as specified in Section V-B of the CAR, and

4. If, after performing all of the above, the class member expressly refuses the accommodation(s) through actions, expressions, and other types of communication.

If a class member refuses one or more of the recommended accommodations in the CAR, the following must be clearly documented in the “Individual Preferences – Desired Activities” section of the ISP:

1. That some or all of the accommodations recommended in the Communication Assessment as documented in the “Communications” section of the ISP were refused;

2. The accommodations that were refused;

3. A description of how the benefits of the recommended accommodations were explained to the

class member consistent with the class member’s preferred methods of communication;

1 Surrogate—A person identified under State law to make decisions for a participant who is incompetent or incapacitated or a

person designated by a participant that is self-directing Home and Community-Based Services in one of the FMS Participant-Directed Services options.

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4. A description of how the class member was offered the opportunity and encouraged to be gradually introduced to the recommended accommodations consistent with the class member’s preferred methods of communication; and

5. How the class member’s refusal of the accommodations was determined.

Accommodations that were refused during the ISP meeting should continue to be offered to the class member at monitoring visits and subsequent team meetings, as the class member may be more willing to accept accommodations in the future. Efforts to obtain, offer, or provide the recommended accommodations in the CAR should be reflected in the Supports Coordinator Service Notes. Additionally, the team may not propose alternative accommodations to those recommended in the CAR, or encourage class members to accept alternative accommodations in lieu of the accommodations recommended in the CAR. Because the CAR is a professional assessment completed by a qualified communication assessor whose findings are the most accurate analysis of the individual’s communication needs, proposing alternatives to the recommended accommodations could be detrimental to the class member. Additional Information Harry M class members are identified in HCSIS via a “Harry M Indicator” checkbox in the Consumer Demographics section of the individual’s record in HCSIS. Class members have the right to refuse an assessment, but this does not mean that the indicator should be removed. For more information about the “Harry M Indicator,” please see the January 21, 2014 HCSIS Enhanced Communication Job Aid. Declining an assessment does not mean that the individual is no longer a class member. In the event that a class member refuses an assessment:

1. Temple will notify the DSC of the class member’s refusal.

2. The DSC will notify the SCO Director of the refusal by email with a copy to the AE and appropriate ODP Regional Office.

3. During the next ISP meeting, regardless of when it is to be held, the SC will remind the

individual that (s)he has the right to receive an assessment.

4. If the individual continues to decline an assessment, the SC will, when developing the ISP in HCSIS, include the phrase “[Individual Name] is a Harry M class member, but declined to receive a Communication Assessment” in the “Communications” section of the ISP.

5. Class members who decline an assessment will be offered the opportunity to be assessed

during each subsequent ISP team meeting. The offer and the individual’s response must be documented in the SC notes as well as the “Communications” section of the ISP.

o If the individual requests an assessment, the SC will notify the DSC of the request so an assessment can be scheduled.

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Paying for Communication Assistance during ISP Team Meetings AEs should use Waiver Administration funds for interpreters and may authorize the Assistive Technology service for Waiver-eligible communication devices. The county may also authorize base funds if desired or when necessary to cover a service that is not eligible for waiver funding. Contact Questions about this document or requests for assistance in adding CAR recommendations to a class member’s ISP should be directed to the ODP Deaf Services Mailbox at [email protected] or to the appropriate ODP Regional Office.

mailto:[email protected]

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Office of Developmental Programs

Communication Assessment

Report and

Recommendations

for

[Individual Name] Purpose

The mission of the Office of Developmental Programs is to support Pennsylvanians with developmental

disabilities to achieve greater independence, choice and opportunity in their lives. This document

evaluates the communication abilities of the above-named individual and makes recommendations for

services and supports that may improve the individual’s quality of care and quality of life through

effective communication. The recommendations in this report will be included with specificity in

[Individual Name]’s Individual Support Plan (ISP) and reviewed at ISP Team Meetings.


Section I – Demographic and Assessment Information

Demographic Information

Individual:

Master Client Index Number (MCI):

Date of Birth:

Age at Time of Assessment:

Assessment Information

Date of Assessment:

Location of Assessment:

☐ Private Home ☐ Lifesharing (Family Living Home)

☐ Community Home for Individuals with ID

☐ Other (Describe):

Location Address:

People Present at Assessment

Name Relationship Title / Position How Long has Person Known Individual?

Individual NA NA


Section II – Communication History Communication History (Note: record “unknown” in any area where the information is not known)

Age of Onset – Hearing Loss:

Age of Hearing Loss Diagnosis:

Etiology:

Date of Most Recent Audiologist Visit:

Hearing Level

1. Describe type and severity of hearing loss in both ears.

2. Describe any recommendations for hearing technology and individual’s history for using

prescribed hearing technology across settings.

3. Describe unaided and aided speech discrimination testing results in quiet and noise if available

from within the past five years.

4. Describe what audiological information is available and source of information.

Additional Observations Related to Communication Ability

1. Motor Functioning

2. Vision Status

3. Medical History

4. Psychiatric and Behavioral History

5. Social/Family History


6. History of Abuse, Neglect, or Trauma

Communication over Individual’s Lifetime

Describe the individual’s communication with family and staff at home over his/her/her lifetime here. Include

the individual’s early exposure to language from birth throughout their entire lifetime.

Residential History

Residence Type Years Individual Lived at Residence

Communication Partners at Residence

Communication Partners’ Communication Methods and Reported Skill Levels

Educational History

Time Period

School Name and Address Type(s) of Communication to which Individual was Exposed

Birth – 4 Years

5 – 13 Years

14 – 18 Years

Post-secondary Education


Section III – Communication Details at Time of Assessment

A. Communication in Current Living Arrangement

Describe the individual’s communication with the people the individual currently lives with. Provide an

estimated fluency level of peers and providers with the individual based on SLPI standards, if you have

the opportunity to observe communication between the individual and providers/peers. Remember that

this may not be the actual fluency level but rather what you are able to conclude based on the

assessment. If you interview a professional who has known and worked with the individual over a long

period of time, report information provided in this section.

B. Social Activities

List all current social activities in which the individuals participates and enjoys in a typical year except

those provided in the individual’s home or place of employment. Describe the how and with whom the

individual communicates with others at the listed activities.

C. Communication with Supports Coordinators (SC)

Identify the people who are the best communication partners with the individual here. Describe how the

individual communicates with the SC. Describe all communication skills, strategies, tools, services and

technology used to facilitate communication currently with the individual in these encounters.

D. Communication at Work/Day Program

Describe how the individual communicates with provider staff, workplace supervisors, coworkers, and

peers at the individual’s place of employment.

E. Communication with Current Medical Providers

Describe how the individual communicates symptoms when they are not feeling well to their family or

support staff. Describe how the individual reports pain location and severity. Describe how the

individual currently communicates with each of his/her medical providers.


F. Assistive Technology and Services Experience

Hearing Assistive Technology (HAT) and Services Type

Response Comments

Does the individual understand the role of the interpreter?

☐Yes

☐No

☐Unknown

Is the individual comfortable using an interpreter?

☐Yes

☐No

☐Unknown

Has the individual used a Deaf Interpreter (CDI/DI) before?

☐Yes

☐No

☐Unknown

Does the individual understand the role of the deaf interpreter?

☐Yes

☐No

☐Unknown

Does the individual know how to obtain an interpreter?

☐Yes

☐No

☐Unknown

Has the individual used a Communication Specialist before?

☐Yes

☐No

☐Unknown

Does the individual know the role of a Communication Specialist?

☐Yes

☐No

☐Unknown

Does the individual have or use a videophone or TTY?

☐Yes

☐No

☐Unknown

Does the individual have or use hearing aids or cochlear implants?

☐Yes

☐No

☐Unknown

Does the individual use closed captioning on TV, computer or other mobile device?

☐Yes

☐No

☐Unknown

Does the individual use any alerting devices? If yes, list the type(s) of devices.

☐Yes

☐No

☐Unknown

Does the individual use amplified or captioned telephone?

☐Yes

☐No

☐Unknown

Does the individual have or use a hearing dog?

☐Yes

☐No

☐Unknown

Does the individual use a cell or smart phone? If so, document how the individual uses the device.

☐Yes

☐No

☐Unknown

Does the individual use other assistive communication devices? If yes, list the type(s) of devices.

☐Yes

☐No

☐Unknown


Additional Assistive Technology Comments:

Describe the individual’s use of ANY assistive technology including computers, Ipads, Dynavox type devices,

smart phones for texting, videophone, hearing technology, etc. Describe your assessment of the individual’s

ability to use the device independently or with support and what the individual uses the AT for.

Section IV – Assessment of Communication Abilities Assessment Components and Tools (Check all that Apply)

☐ Interview with individual and observation of communicative interactions with others

☐

Record review (Please list what records were reviewed)

☐

Communication Skills Assessment The Communication Skills Assessment (CSA) evaluates an individual’s relative strengths and weaknesses across a spectrum of communication modalities. It is designed to identify individual strengths, weaknesses and assist in identifying communication strategies. The test is structured so to permit those with severe language deficits to demonstrate skills, thus the definition of competence does not necessarily reflect a high degree of fluency or skill. This/her assessment is designed for individuals with a wide range of communication skills and therefore has a relatively low “ceiling” with an upper testing limit of approximately 6

th grade

competence. Unfortunately, there are no more appropriate cross modality assessment tools available. It does not allow for meaningful comparisons between individuals, nor does it compare one individual to a group norm. Attempts to interpret scores in these ways represent invalid applications of this/her instrument.

☐

Home Sign Battery This 92-item test was developed by the Nicaraguan Sign Language Project for use in eliciting and evaluating understanding of signs or gesture relating to everyday needs and activities. This test helps us know whether an individual knows and uses American Sign Language signs, home signs or a gestural equivalent. Home signs are sign language signs that are “made up” and known to the people who use them on a regular basis, and often are not understood fully by others who are not familiar with the use the home sign. This test can assess general breadth of vocabulary when there is a concern about sufficient vocabulary, where are the gaps, are there sufficient verbs to support word combinations, and would assistive technology provide additional benefit to the person. The pictures gradually become more complex by including more than one noun, prompting for adjectives, prepositions, interactions between the nouns in the picture.

☐

Obler-Albert Action Naming Task This test is designed to specifically elicit verbs or action labels. It examines whether the individual has sufficient verbs or action labels to support everyday interactions and whether the individual differentiates between nouns and verbs. Only the first 17 items of this/her test are used in this assessment.

☐

Grammaticas This test also developed by the Nicaraguan Sign Language Project, is a series of video vignettes describing events from simple single clauses (a man cries, a woman drinks), to slight complexity requiring spatial referents to establish verbs (the man throws the ball to the woman, the man in the middle gives a drink to the person on his/her left), to more complex linguistic structures employing classifiers are used to elicit phrases and sentences from the client. Twelve items ranging from simple to complex were presented for this/her assessment.

☐

Pragmatic Communication / Deaf Feature Checklist This method evaluates the individual’s level of functioning within established developmental norms by observing the individual in his/her environment and the degree to which they have mastered developmental milestones commensurate with the individual’s age.

☐ Visual Communication and Sign Language Checklist This method distinguishes communication difficulties caused by level of functioning from those caused by ineffective communication methods.

☐ Other (please describe) describe reason


A. Testing Results

1. Communication Skills Assessment Results (CSA)

Insert the CSA chart produced by the tool here, and provide any explanation of the results you feel

would be beneficial.

2. Home Sign Battery Results

Number of Items Reviewed (out of 92):

Number of Expressed Signs for Items Presented as Assessment:

Time to Complete Task:

Description of Observations:

3. Obler-Albert Action Naming Test (non-normed)

Number Items Presented (out of 17):

Number of Responses to Items (out of 17)



4. Grammaticas

Number of Vignettes/Videos Presented:

Number of Vignettes/Videos Described:




B. Communication Skills

1. Pragmatic Communication Features Observed (Complete Deaf Features Checklist before completing describing observations) Describe your observations from that checklist and from fluency and Dysfluency portions of CSA. Describe a naturally occurring communication between the individual and their familiar caregivers and with the evaluator that may have occurred during the introduction – such as sharing of important things in the person life (often a tour of their bedroom – to see their pictures, or favorite things – if invited). Describe an example where the individual’s caregiver makes a request of the individual and whether or not the individual can follow through with the request.

2. Visual Gestural Communication Describe here whether or not the meeting environment is a visually rich environment and useful for

communication with the individual. Describe whether the individual uses any pictures, images of actual objects or

cartoon depictions of objects/places, or actual objects to communicate. Describe whether the use of these visual

cues is helpful in clarifying communication with the individual. Describe the individual’s use of natural gestures,

pantomime and home signs. Note if you observe a difference between the individual’s receptive or expressive

capacity in visual gestural communication.

3. American Sign Language

Describe the individual’s receptive and expressive sign language skills. Be specific about the individual’s fluency

in American Sign Language, use of Signed English, fingerspelling, or another type of sign language. Note if you

observe a difference between the individual’s receptive or expressive capacity in sign language. Indicate your

observations as to whether there is a difference in the individual’s comprehension when the individual uses their

hearing technology (if any), or when sign and spoken language are used simultaneously.

4. Reading and Writing Notes Back and Forth

Describe the individual’s receptive and expressive written English or other written language skills (such as

Spanish), based upon testing and observations during the assessment. Add the highest grade level equivalent

for academic achievement in reading comprehension the individual has attained if this/her information is available

to you.

5. Speaking and Lip-reading:


Section V – Assessment Results

A. [Individual Name]’s Best Communication Partner(s). Best Communication Partners are people identified through the communication assessment as the people who have a good relationship with, and best communicate with and understand what the individual is communicating most of the time. Communication between the individual and the Best Communication Partners listed below range between very effective to minimal, yet the best an individual has with anyone based upon this evaluation. Very effective Best Communication Partners effectively use visual supports such as objects, simple written words, photographs, and images that the individual understands. Very effective Best communication partners ensure that the individual understands what is being communicated to him/her and is understood by others. Very effective Best Communication Partners’ expressive and receptive signing and visual communication skills exceed those of the individual. Best Communication Partners are identified based on the individual’s communication skills and how the individual communicates with others. In some cases, an individual may not have a Best Communication Partner. Name Relationship How Long has Person

Known Individual? Estimated SLPI Fluency or Level of Effectiveness (Very effective to minimally effective)

Comments / Notes – Section A


B. [Individual Name]’s Current and Potential Communication Types

Communication Methods (Check all that apply)

Category

Sign Language

Speaking Reading Writing Back and

Forth

Lip Reading

Visual - Gestural Communication

Assistive Technology

Current methods of communication: (How the individual communicates now)

☐ ☐ ☐ ☐ ☐ ☐ ☐

Preferred methods of communication: (How the individual prefers to communicate)

☐ ☐ ☐ ☐ ☐ ☐ ☐

Most effective methods of communication: (Communication methods that are most effective for the individual)

☐ ☐ ☐ ☐ ☐ ☐ ☐

Supplementary communication methods: (Communication methods that can be helpful but should not be used exclusively for daily communication)

☐ ☐ ☐ ☐ ☐ ☐ ☐

Communication methods that should not be used: (Communication methods that are ineffective and should not be used for daily communication)

☐ ☐ ☐ ☐ ☐ ☐ ☐

Comments / Notes – Section B


C. Communication Methods Needed to Interact with [Individual Name].

Primary Caregivers

Secondary Caregivers

Intermittent Contacts

Sign Language – ASL ☐ ☐ ☐

Sign Language – Sign-Supported Speech ☐ ☐ ☐

Sign Language – Tactile Sign ☐ ☐ ☐

Sign Language – Home Signs

☐ ☐ ☐

Visual Gestural Communication

☐ ☐ ☐

Speaking ☐ ☐ ☐

Reading ☐ ☐ ☐

Writing Back and Forth ☐ ☐ ☐

Lip Reading ☐ ☐ ☐

Assistive Technology Use ☐ ☐ ☐

Familiarity with Individual’s Video/Picture Dictionary ☐ ☐ ☐

Interpreter Required NA ☐ ☐

Other (Please Specify) ☐ ☐ ☐

Primary Caregivers are people who have daily, substantial interactions with the individual. Examples may include direct

care staff responsible for supporting the individual, or a family member in an individual’s home who provides the majority

of care and support to the individual.

Secondary Caregivers are people who have daily contact with the individual, but with minimal substantive interaction.

Examples may include the person with supervisory oversight of a community home, members of a household who interact

with the individual, program specialists, and other support professionals such as a behavioral therapist.

Intermittent Contacts are people who have interact with the individual less than daily (e.g. on a weekly or monthly basis).

Examples may include supports coordinators and physicians.


If “Sign Language” is checked for any of the contacts, specify the skill level needed to communicate

with the individual.

Primary Caregivers

Secondary Caregivers

Intermittent Contacts

Superior Plus ☐ ☐ ☐

Superior ☐ ☐ ☐

Advanced Plus ☐ ☐ ☐

Advanced ☐ ☐ ☐

Intermediate Plus ☐ ☐ ☐

Intermediate ☐ ☐ ☐

Survival Plus ☐ ☐ ☐

Survival ☐ ☐ ☐

Novice Plus ☐ ☐ ☐

Novice ☐ ☐ ☐

Comments / Notes – Section C

D. [Individual Name]’s Ability to Learn Communication Types, and Most Promising Methods to Learn Describe recommendations for the individual’s ability to learn and/or improve their communication skills if the recommendations were implemented. If a Gradual Introduction Plan is recommended, please describe how the plan is to be implemented.


E. Is a fully-signing environment appropriate for effective communication and/or improving [Individual Name]’s ability to communicate? Why or why not? “Fully-signing environment” means an environment where the primary means of communication between staff, caregivers, and housemates is American Sign Language (“ASL”); Sign Language from other countries, such as Spanish Sign Language; Signed Exact English; a mixture of ASL and signed English; tactile sign; and visual-gestural communication. F. Specialized services, Equipment, and Assistive Technology Evaluations Which of the following would improve or support the individual’s ability to communicate, if it is not already in use? (Check all that apply)

☐Doorbell Flasher

☐Alerting Device for Bedroom/Bathroom door

☐Adapted Alarm Clock

☐Wrist/Arm Waking Devices

☐Additional Mirrors in Building Layout

☐Three-Way Light Switches

☐Television Close-Captioning

☐Television Amplifiers

☐Amplified Telephone

☐T-Coil Hearing Aid Attachment

☐Specialized Telephone Equipment (Specify type)

☐Videophone / Web-Based video camera

☐Captioned Telephone

☐Personalized Sign Language Video/Image Dictionary

☐Other (Specify)

Is an evaluation for assistive technology recommended? Briefly explain why or why not? Comments / Notes – Section F G. Communication Assistance at Meetings and Appointments In general, there are three types of meetings/appointments that individuals attend where communication assistance is required. These include:

Individual Support Plan (ISP) Meetings. The ISP Meeting is the foundation for the development and implementation of the ISP, which captures information about how individuals choose to lead their lives as they desire and identifies the supports necessary for them to grow and develop, make their own decisions, achieve their personal goals, develop relationships, face challenges, and enjoy life as full participating members of their communities.


The ISP process pinpoints what is important to the individual and identifies desired outcomes based upon an individual’s ability to acquire, maintain and improve a skill, including those that increase the individual’s safety and well-being. This information is then used to link, arrange, and obtain needed medical, social, habilitation, education, or other needed community services necessary for individuals to achieve their goals. These supports may be provided formally through state and federally-funded services, services available to anyone in the community, or through natural or informal supports. ISP meetings may be attended by the individual, the individual’s family, guardian, surrogate, or advocate, the individual’s supports coordinator, service providers, and other people who are important in the individual’s life and who the individual chooses to include. ISP meetings involve a great deal of dynamic communication between team members to share ideas and discuss the individual’s needs and how to meet them.

Supports Coordinator Monitoring Visits. Monitoring visits help to ensure that services and supports are being provided as indicated on the Individual’s ISP. Supports coordinator monitoring verifies that the individual is receiving the appropriate type, amount, duration, and frequency of services to address the individual’s assessed needs and desired outcomes as documented in the ISP. Monitoring visits include interaction with the individual and may include interaction with provider staff, caregivers, and other parties involved in meeting the individual’s needs. Monitoring visits may take place at the individual’s home, provider-operated day programs or prevocational work sites, or other community-based settings. For individuals enrolled in the Consolidated Waiver (as all Harry M class members are), monitoring occurs on a monthly basis or additionally as needed based on the individual’s circumstances.

Appointments Related to Routine Daily Living. Appointments of this type generally include medical appointments, but may include visits to the County Assistance Office, Social Security Administration, or similar appointments where information related to the individual’s care and services unrelated to the individual’s intellectual disability is exchanged. Inspections from licensing oversight agencies where the inspector may interview the individual are included in this category.

Assistance Required Based on Assessment Results

Type of Meeting / Appointment

Communication Assistance Required

ISP Meeting SC Monitoring

Routine Appointments

Presence of Best Communication Partner(s)

☐ ☐ ☐

Pennsylvania-Registered Hearing Interpreter

☐ ☐ ☐

Deaf Interpreter ☐ ☐ ☐ Other (Specify)

☐ ☐ ☐

Comments / Notes – Section G


Section VI - Additional Assessment Recommendations

A. In addition to the skills and skill levels identified above, are there any additional skills staff/caregivers need to help improve [Individual Name]’s ability to communicate?

B. If caregivers with the necessary skills and skill levels identified above cannot be immediately retained, what skills or training should be provided to current caregivers to allow them to communicate with [Individual Name]?

C. When should the individual receive his/her next communication assessment? Please include justification for this recommendation.

D. What if any social activities would be beneficial for [Individual Name] to participate in, and how frequently

should the individual participate in the activities?

E. Would [Individual Name] benefit from being taught ASL or another form of communication? If a caregiver

should attend the teaching sessions as well to be aware of what [Individual Name] is being taught, please

note that in your response.

F. Are Communication Specialist Services1 recommended for [Individual Name]? If so, please identify the

services to be provided:

☐ Communication Specialist Services are not recommended at this time

OR

The following Communication Specialist Services are recommended:

☐Identifying the individual’s personal communication goals

1 In general, communication specialists educate caregivers in the individual’s communication needs, create environments that

emphasize the use of visual cues and other appropriate communication methods, assists in the development and implementation of an action plan to remove communication barriers including training on assistive technology, provide direct services to the individual, evaluating the effectiveness of the plan following implementation, and modifying the plan based on the evaluation of its effectiveness, and educating Supports Coordinators, Administrative Entities (counties), and other appropriate entities on communication access, legal responsibilities and the cultural and communication needs of the individual.


☐Assisting the individual and his or her caregivers to achieve the individual’s personal communication goals

☐Creating visually rich environments, and educating staff about providing visually-rich environments

☐Creating personalized sign language video/image dictionary and a method to add new entries and providing

training on its use to the individual and others who will use it.

☐Creating an abbreviated sign language/visual gestural video and images to support communication for

healthcare appointments and other intermittent contacts.

☐Providing receptive Visual Gestural Communication staff training

☐Providing Sign Language tutoring for staff

☐Providing Individual and staff training on communication equipment and assistive technology recommended in

this report, if any.

☐Other (Describe):

G. What if any additional comments or relevant information do you have based on the assessment?


Section VII – Instructions for Summarizing Results and Including them in the Individual Support Plan

As noted above, the Individual Support Plan (ISP) contains information about individuals’ needs, desires, and goals. The ISP identifies what is important to the individual and records desired outcomes based upon an individual’s ability to acquire, maintain and improve a skill, including those that increase the individual’s safety and well-being. This information is then used to link, arrange, and obtain needed medical, social, habilitation, education, or other needed community services necessary for individuals to achieve their goals. While the information contained in this assessment report is essential to ensuring that individuals’ communication needs are met, it is neither practical nor possible to include the report in its entirety in an individual’s ISP. Therefore it is necessary for you to summarize your findings in an informative yet concise manner. Please note that the entire report will be used during the ISP process to ensure that the specific findings and recommendations are considered when developing the ISP. The following page contains a narrative passage with blank spaces to include summarized information. Please fill in the blanks or choose the most appropriate answers where prompted and reference the page number of the report where the detailed information may be found in the space provided. Words in italics are for guidance only and should be deleted once the blank is filled. Supports Coordinators will copy this passage and include it directly in the ISP.


Summary and Recommendations

For inclusion in the “Know and Do” Section in the ISP: TIP: For this section, the available options are Sign Language, Speaking, Reading, Writing Back and Forth, Lip-Reading, Visual-Gestural Communication, and/or Assistive Technology. A Communication Assessment Report (CAR) was completed for [Individual Name] on [Date of Assessment]. The CAR is a hard copy document that is maintained in the individual’s file and accessible to all ISP team members. The assessment found that [Individual Name]’s current method(s) of communication include ___________. His/her preferred method(s) of communication are ____________. The most effective methods of communication for him/her are _____________. Supplementary methods of communication to be used in conjunction with the most effective methods of communication include _____________. Communication methods that should NOT be used to communicate with [Individual Name] include ________. See Section V-B of the CAR for more information.

For inclusion in the “Communications” Section in the ISP: A Communication Assessment Report (CAR) was completed for [Individual Name] on [Date of Assessment]. The CAR is a hard copy document that is maintained in the individual’s file and accessible to all ISP team members. All staff working with [Individual Name] should read Sections V and VI of the CAR before providing assistance to [Individual Name]. Staff working with [Individual Name] should also review the ODP Harry M Online Training within 45 days of receiving the assessment report. Assessment findings included the following: [Individual Name]’s best communication partner is Name, Relationship OR [Individual Name] does not have a best communication partner at this time. See Section V-A of the CAR for more information. TIP: The available options for the following questions are Sign Language, Speaking, Reading, Writing Back and Forth, Lip-Reading, Visual-Gestural Communication, and/or Assistive Technology. If sign language is one of the identified methods, include the necessary skill level. At least one primary caregiver in all settings at all times must be able to communicate using ____________. Signing caregivers must have documented sign fluency at the _________ level. If a primary caregiver with the required communication ability is temporarily unavailable, a secondary caregiver or an interpreter who is able to communicate using ____________ must be available to communicate with [Individual Name]. Secondary caregivers or interpreters who sign must have documented sign fluency at the _________ level. In general, “temporarily unavailable” means a period not to exceed a consecutive 3-hour period. If primary caregivers with the required communication ability are not available for a period exceeding 3 hours, [choose: hearing interpreters or deaf interpreters] must be used daily for at least ________ number of hours. See Section V-C of the CAR for more information. *** A Gradual Introduction Plan IS / IS NOT recommended for [Individual Name]. See Section V-D of the CAR for more information.


*** A fully-signing environment IS / IS NOT recommended for [Individual Name]. See Section V-E of the CAR for more information. *** TIP: The available options for the following questions are Doorbell Flasher, Alerting Device for Bedroom/Bathroom, Adapted Alarm Clock, Wrist/Arm Waking Devices, Additional Mirrors in Building Layout, Three-Way Light Switches, Television Close-Captioning, Television Amplifiers, Amplified Telephone, T-Coil Hearing Aid Attachment, Specialized Telephone Equipment (Specify type), Videophone / Web-Based Camera, Text-Based Telephonic Equipment, Personalized Sign Language Video/Image Dictionary, and/or Other (Specify) [Individual Name] would benefit from the following equipment and training in its use to improve communication ability: ___________. An evaluation for assistive technology IS / IS NOT recommended for [Individual Name]. See Section V-F of the CAR for more information ***

TIP: The available options for the following questions are Best Communication Partner, “Pennsylvania-registered interpreter,” “deaf interpreter,” or “other” as specified in Section V-G of the CAR. The following persons should be included at: [Individual Name]’s Individual Support Plan meetings: _________________. [Individual Name]’s routine appointments: _________________. [Individual Name]’s Supports Coordination monitoring visits: _____________________. [Individual Name] should be offered the opportunity to communicate privately with his/her Supports Coordinator through an independent interpreter. [choose: Hearing interpreters or Deaf interpreters] must be available during licensing visits and incident investigations. See Section V-G of the CAR for more information *** [Individual Name]’s next communication assessment should occur no later than __________. See Section VI-C of the CAR for more information TIP: Include the following only if you have made recommendations in these areas in Section IV of the CAR Specific recommendations are made for staff to improve their communication ability with the individual. See Section VI-A of the CAR for more information *** Recommendations for skills or training are made for current caregivers to allow them to communicate with [Individual Name] if caregivers with the necessary skills and skill levels cannot be immediately retained. See Section VI-B of the CAR for more information *** [Individual Name] would benefit from participation in specific social activities to enrich his/her communication ability.


See Section VI-D of the CAR for more information *** [Individual Name] would benefit from being taught ASL or another form of communication. See Section VI-E of the CAR for more information *** [Individual Name] would benefit from Communication Specialist Services. See Section VI-F of the CAR for more information *** There are additional factors to be considered when providing assistance and support to [Individual Name]. See Section VI-G of the CAR for more information

Documents

ODPANN 099-16 Adding Communication Assessment Report ... · 5. How the class member’s refusal of the accommodations was determined. Accommodations that were refused during the ISP