The Revised CDER Regional Center Train-The-Trainers 2007

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Background and Development Issues with Original CDER Resulting in inaccurate and/or incomplete data Outdated Focus on disabilities rather than abilities Not useful to IPP process Doesn’t assess health & safety, quality of life or outcomes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 McCreary Dr. Harold Stanislaw Department of Psychology California 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 the New 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

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  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 Development Revision 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 Revised Form Revised Manual Sections Under Development DSM Crosswalk

The Revised CDER Next Steps For Regional Centers

The Revised CDER Questions?

Contact Information CDER: Waiver Sue Boucher Jim Knight (916) (916)