Update on Current Initiatives

BHDDH holds virtual DD Community Forums every three months. For the latest information about the forums, visit the Events and Forums webpage. 

The purpose of the Consent Decree is to ensure individuals receiving DD services have a choice in what services they receive and have the opportunity to be employed and to participate in integrated community activities. 

On October 2, 2023, the Court issued an order for an Addendum to the RI Consent Decree (USA v RI).  This Addendum is to continue the oversight of the Consent Decree and ensure all required actions are fully implemented by July 2024 and continue through June 2026. To review the Consent Decree Addendum, visit the Consent Decree Court Orders webpage.

The Division submitted an Implementation Plan that maps the strategies and timelines for enacting the mandated activities and to maintain the momentum of these activities through 2026 and beyond. The Implementation Plan is available for review on the Consent Decree Status Reports webpage.

BHDDH is taking steps to ensure we get all the information we need to understand the needs of those receiving DD services by using a 3-step process. When meeting with a SIS social case worker, individuals will be asked two sets of questions:

1. The Supports Intensity Scale-Adult Version (SIS-A, 2nd edition).
2. A new questionnaire called the Additional Needs and Support Questionnaire (ANSQ).

One week after completing the SIS-A and ANSQ, the individual will be invited to a second meeting with the SIS social case worker. This meeting is called the Individual Follow-up. The individual follow-up is a meeting between the individual receiving DD services, their supports, and the SIS social case worker. The purpose of this meeting is to give the individual the chance to share more details about themselves and to talk about other support needs they may have. Our goal is to make sure everyone's voice is heard. When we have more information about an individual, then we will be better able to identify everything each person needs.

The Division is still rolling out the new SIS-A, 2nd edition, assessment form. Since the SIS-A, 2nd edition is new, we need 500 assessments to be completed before we can finish the new tier scoring. If an individual receiving DD services had a SIS in the last few months or have one coming up soon, then their tier may be affected when the new scoring is complete. More information about this has been added to the SIS webpage.

BHDDH Social Caseworkers (SCW) are starting something new this year. During Individual Support Plan (ISP) meetings, a SCW will share information about any new Division resources, processes, and supports with individuals receiving DD services. The SCW will also ask the individual questions about their services, such as:

1. Did you get the services and supports that were in your ISP?
2. How happy are you with the time you spent in the community doing activities?
3. Are you working now or want to work soon?

The SCW will continue to check-in with the individual each month to see how they are doing. The SCW’s goal is to make sure the individual is getting the supports they want. The SCW will also encourage and support the individual as they get more active in their community and think about meaningful employment.

Individuals receiving DD services must sign all new Individual Support Plans (ISP) and Purchase Orders (PO). If they have a guardian, then their guardian must sign the ISP and PO. Signatures may be written on the ISP and PO, or it may be a digital signature done on a computer or tablet. The date of the individual's signature must be written on the ISP and PO. BHDDH will return any ISP or PO without the individual's signature. A returned ISP or PO may cause a delay or loss of DD services. By signing the ISP and PO, the individual is saying that they agree with and want what is in their plan.

Please note: ISP or PO changes need 45 days to be processed. BHDDH needs the 45 days to review changes to make sure everything is okay and to enter changes into the computer system. Since it takes 45 days to make changes, ISP or PO changes cannot be made if there are only 90 days left in the individual's plan year. The only exception is if the individual has an emergency situation and there are only 90 days left in their plan year. In this case, their social caseworker will work with them to make changes they need.

Most people begin talking about their new plan when there are about 90 days left in the plan year. If the individual has new things they want to add to their ISP or PO at the end of their plan year, they should add those things to their new plan.

We’re still accepting requests for the Technology Fund. More information about the Technology Fund and the online form can be found on the Technology Fund webpage. Remember, the Technology Fund can only be used once. If an individual has received funding through the Technology Fund, they can’t apply a second time.

New Rates

The new rates started on July 1, 2023. These rates increase how much providers are paid for services they provide to individuals receiving DD services. With the new rates, Direct Support Professionals (DSPs) must be paid at least $20 per hour.

New Services

BHDDH made changes to the list of services we offer. Service changes include:

• Community-Based Supports now includes services that used to be called community-based day, prevocational, and overnight supports. The new Community-Based Supports can be used at any time of day or day of the week.
• Whole Life Shared Living Arrangement (WLSLA) lets individuals choose if they want to get all community-based supports, including traditional day services, from their SLA home provider. The home provider will be paid more for the additional services they provide.

BHDDH has changed how DD funding information is shown. This used to be called “Tier Packages”. The new name for DD funding is “Total Budget.” BHDDH will decide what an individual's total budget is by looking at their SIS tier, ANSQ results, and notes from their Individual Follow-up. The individual's total budget will be made of two parts, the Flexible Individual Budget and the Fixed Budget.

1. Flexible Individual Budget: This is the part of the budget that the individual can control based on their plan. They will choose how much of their funding they want to use for the DD services they want. Individuals will make these choices if they self-direct or if they use an agency for services. The services they will make choices about are:

• Community-based supports
• Center-based day supports
• Transportation
• Respite
• Assistive technology
• Professional services
• Self-directed goods and services

2. Fixed Budget: This is the part of the budget that the individual cannot change. This includes residential (group home, SLA) and fiscal Intermediary (FI) fees that must be paid. If the individual self-directs their services, their fixed budget also includes fees for the support brokerage service. They can add funding for more support brokerage, but they cannot remove the service.

There is also a new third option called the “Add On Budget”. BHDDH will provide funding above the individual's total budget for certain services that aren’t covered by the Flexible and Fixed Budgets. This includes employment, home modifications, and some new services that haven’t rolled out yet, such as vehicle modifications, and peer-to-peer and family-to-family supports.

Employment supports are no longer included in the Total Budget. Instead, employment supports will be paid for from an add-on budget. With the add-on budget, the individual receiving DD services will not have to take away from their community supports in order to get help finding and keeping a job. There are 5 employment services that can be added to the individual's add-on budget:

1. Job Development is for help finding a job. The individual will work with a certified employment specialist to find a job and get hired. Job development is short-term. This means it is not a service that will take many months or years. Instead, job development is limited to 200 hours per year. Job development is limited so the individual can reach their employment goals sooner.
2. Job Coaching is for help learning how to do a new job. It can also be used to learn new job skills if job tasks change. The individual will work with a certified employment specialist while they are at work. Job coaching is temporary, which means it will go away once they learn their job tasks. Job coaching does not include transportation to or from the individual's job.
3. Job Retention is for help keeping a job. The individual can get job retention after they finish with job coaching. The individual will work with a certified employment specialist to keep and grow in their job. The employment specialist will check in with the individual and their boss to make sure everything is going well. They will talk about any changes to the individual's job or problems they may be having.
4. Group Supported Employment can include help finding a job, learning job tasks, keeping a job, and growing in a job. The individual will work with a certified employment specialist. The individual will work in a group with two or more people receiving DD services.
5. Personal Supports in the Workplace is for help with self-care activities at work. The individual will get help with their personal care needs, like hygiene and eating, during their normal work hours. A provider will also help support their medical or behavioral needs.

More information on employment services is available on the Employment webpage.

Another helpful tool is the Guide to Employment Add-On Budget Requests found on the Brochures & Guides webpage.

BHDDH has a DD News and Updates newsletter. The newsletter has information about things that are changing at BHDDH and other helpful tips. If you would like to sign-up for the newsletter, or read past newsletters, visit the Newsletters, Forums, and Events webpage.

The Special Needs Emergency Registry helps first responders get ready for emergencies, like hurricanes, storms, and other emergencies. By signing up for the registry, you will let police, fire, and other first responders in your community know how they can best help you in an emergency. To learn more about the registry and to sign-up, visit the Rhode Island Department of Health Special Needs Emergency Registry webpage.