Children’s Intensive

In-Home Behavior Support

Waiver (CIIBS)

An Overview

Christie Seligman, Program Manager

Division of Developmental Disabilities
October 2009

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CIIBS Program Model

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Intensive Case Management

Steps Toward Enrollment:

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Intensive Case Management

Building a Child’s Support Team:

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Intensive Case Management

Monthly Follow-Up Visits for first 90 Days

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Intensive Case Management

30/60/90 Day Follow-Up Visits Ongoing

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Intensive Case Management

Collect Program Evaluation Data

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Program Evaluation
 Data Collection
 Collect baseline information on:
 Family stress level (using Parenting Stress Index, a

nationally normed tool)

 Child’s behaviors at home, school, and in community

 Progress data collected at 30/60/90 day follow-up visits

(intensive case management activity)
 Use information in provider Quarterly Reports; format
established by DDD
 Use data collected by schools
 Use fidelity measurements to assess implementation of the
wraparound service delivery process (e.g., Wraparound
Fidelity Index 4)
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Positive Behavior
Support Model (PBS)

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Positive Behavior
Support Model (PBS)

 Positive Behavior Support in the family home

must involve the family members in the
design as well as the implementation of
strategies. Better outcomes are achieved
when families and professionals partner
during the functional assessment and when
families direct the selection of strategies that
will work for them.

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Positive Behavior
Support Model (PBS)
Behavior specialists should take the following
into account when working with families:

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Behavior Support Providers

Behavior Specialists: PhD or MA level therapists

with expertise in Positive Behavior Support in the
family context
 Conduct Functional Assessment
 Design written Positive Behavior Support Plans
 Provide training and consultation
 Collect and review data
 Oversight – ensure ongoing efficacy of plan
Behavior Technicians: Experienced line therapists
 Implement treatment according to design
 Work alongside families in the home
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Collaboration
Working together

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Collaboration
Family Participation and Partnership with Service
Providers

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Collaboration
Collaboration between school and home

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Collaboration
Collaboration between health providers

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Services

Essential Services:

Staff/Family Training and

Consultation
Behavior
Management
and
Consultation

Planned
Respite

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Services

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Services

Total Waiver Service Package:

 Behavior Management and Consultation
 Staff/Family Training and Consultation
 Respite In-Home and Out-of-Home
 Personal Care
 Specialized Medical Equipment and Supplies

 Therapeutic Equipment and Supplies Average

 Assistive Technology cost:
 Environmental Accessibility Adaptations
$4000 per
 Vehicle Modifications
 Transportation child per
 Specialized Nutrition month
 Specialized Clothing
 Specialized Psychiatric Services
 Nurse Delegation
 Sexual Deviancy Evaluation
 Occupational Therapy
 Physical Therapy
 Communication Therapy
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CIIBS Program Eligibility

In addition to HCBS Waiver enrollment criteria, a child

must meet eligibility criteria per the DDD Assessment:

Caregiver Risk Score

Age 8-17 (served
is Medium or Higher
until 21st b-day)

High Behavior Acuity

Family Agrees to High or Severe Out-of-home

Participate in the Program Placement Risk Score

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CIIBS Program Eligibility

Algorithm:
Rules outlined in WAC
Chapter 828 (DDD
Assessment)

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CIIBS Program Eligibility
WAC 388-828-8515 How does DDD determine
your CIIBS out-of-home placement risk score?
Clients meeting criteria in 828-8505: Beginning score = 0
Eligible condition of autism in the DDD Add 40 points
determination
ADL support needs level = high, medium or Subtract 54 points
low
Most prominent behavior = assault/injury Add 14 points
AND Severity = "potentially dangerous“ or "life
threatening"
Level of monitoring required during awake Add 13 points
hours = "Line of sight/earshot"
Caregiver risk level = high or immediate Add 136 points
"No other caregiver available" Add 33 points
Mobility acuity level = high, medium or low Subtract 15 points 22
CIIBS Program Eligibility
WAC 388-828-8520 How does DDD determine if I
am eligible for the CIIBS waiver?

If your CIIBS Then your CIIBS

out-of-home eligibility is:
placement risk
score is:
96 or greater Yes - Severe

17 through 95 Yes - High

Less than 17 No - (not

eligible)

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 CIIBS Program Eligibility
Screening and Phase-In Schedule

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 CIIBS Program Eligibility
Screening and Phase-In Schedule

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For More Information

Christie Seligman, Program Manager

Division of Developmental Disabilities
(360) 725-3448
seligcl@dshs.wa.gov

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