1. An Introduction to the InterRAI I/DD Assessment System
Mary L James
interRAI Fellow
Associate Research Scientist
University of Michigan
Alaska Governor’s Council on Disabilities & Special Education
July 13, 2016

2. Agenda interRAI and the interRAI “Suite” Uses of interRAI data
Frequently Asked Questions
Discussion

3. What is interRAI? Research collaborative: 87 members/35 nations
Non-profit corporation
Key interests
Science (e.g., cross-national comparisons, outcomes research)
Instrument development
Support implementation in other nations
Holds copyright to interRAI assessment instruments
Grants royalty-free licenses to governments/care providers in exchange for data
Licenses software vendors around the world

4. interRAI Members and Activities
Europe
Iceland, Norway, Sweden, Denmark, Finland,
Netherlands, Germany, UK, Switzerland,
France, Poland, Italy, Spain, Belgium,
Estonia, Lithuania, Czech Republic,
Russia, Austria, Portugal, Ireland
North America Canada, USA,
Mexico, Belize
Middle East/Asia
Israel, India, Qatar,
Lebanon, Egypt
Africa
South Africa, Ghana (WHO)
Far East/Pacific Rim
Japan, South Korea, Taiwan, Australia,
China, Hong Kong, New Zealand, Singapore
South America Chile, Brazil, Peru

5. interRAI “Suite” Wellness Community Health Home Care Assisted Living
04/03/12
interRAI “Suite”
Wellness
Community Health
Home Care
Assisted Living
LTC Facility
Post-acute Care
Palliative Care
Pediatric
Pediatric ID, MH
Acute Care
Inpatient Mental Health
Forensic supplement
Correctional Facilities
Community Mental Health
Developmental/Intellectual Disabilities
Self-Report Quality of Life
OAAS Assessment Training

6. US States Using interRAI Instruments
April 2016
Statewide:
–HC/CHA
– MDS-HC
–MH
–CMH
–SQoL
–I/DD
–Children ID/DD
–Children MH
–Children HC
Open symbol for Regional/Managed Care, shaded for planned

7. Instead of …..

8. Key Elements of interRAI Tools
Assessment, not only self-report
use all possible sources of information
Full definitions, time delimiters, examples, exclusions
Cover all relevant domains
individuals’ strengths and weaknesses
tradeoff of breadth and length
Tested decision support tools available to licensees at no cost

9. Design of Data Collection Form
“Domains”
Each domain has specific “items”
“Items” ARE NOT “questions”
Items identify specific information to be gathered
Interview with person only one possible information source
Direct observations
Staff
Family/friends
Records

10. Four “Super-Domains” Social Life/ Inclusion Cognition/ Behavior
04/03/12
Four “Super-Domains”
Social Life/
Inclusion
Community/
Social Involvement (C)
Strengths/
Relationships/
Supports
(D)
Cognition/
Behavior
Communication/
Vision (G)
Cognition (H)
Mood/
Behavior (L)
Everyday Living
Lifestyle (E)
Environment (F)
Independence in Everyday Activities (J)
Services and Supports (N)
Clinical
Health Conditions (I)
Oral/ Nutritional Status (K)
Medications (M)
OAAS Assessment Training

11. Each item has four components:
06/26/12
Item Construction
Each item has four components:
Intent: Why information is sought
Definition: What exactly is to be recorded
Process: How to collect information –
strategy/approaches
Coding: How to record
Trainer: Refer to the manual at this point: page 128, Dental in the Functional Supplement
OAAS Assessment Training

12. I/DD AC

13. interRAI HC and interRAI I/DD
121
Items ID
123
128 Core Items
69 Other Shared Items
441 Items Total

14. interRAI CMH and interRAI I/DD
108 Core Items
CMH
169 Items ID
117 Items
106 Other Shared Items
500 Items Total

15. Applications of interRAI Data

16. Applications of interRAI Data
Care Planning
Policy
Case-Mix
ASSESSMENT
Screening
Quality

17. What people want
Note: Approximately 60% of the sample responded (70% in community and 42% in institutions)

18. Scales Embedded in DD Instrument
ADL Hierarchy
Aggressive Behavior
Cognitive Performance
Communication
Depression
IADL Capacity
IADL Performance
Pain
Social Withdrawal

19. Functioning: Cognition

20. Functioning: Self-care skills

21. ID CAPs Social Relationships Meaningful Activities Communication
Continence
Injurious Behavior
Mental Illness
Abuse

22. Sample Clinical Assessment Protocols (CAPs) Manual

23. Collaborative Action Plan Triggers Source: Arkansas statewide profile, 2013
Average 3 CAPs triggered
4% triggered 0 CAPs
11% triggered 1 CAP
85% triggered 2+ CAPs
0% triggered all 7 CAPs

24. Frequently Asked Questions
Where is……..?
It’s a MINIMUM data set
Software can enable notes
Additional items can be added
Why aren’t there more items about ….?
Don’t need to “load” everything onto single item, ask many questions about particular issue
Ex: “bathing” excludes hair washing but “upper body dressing” stands in to indicate likely need for assistance with hair
What are you supposed to do if………?
Separate assessor skills from the data collection form
What is your agency’s current standard practice?

25. What DD Tool Does Not Do
Harm the relationship between the provider agency, the person, and his/her support network
Dictate what must be addressed
Dictate how needs should be addressed
Negate the importance of individual choice

26. What interRAI DD Does Helps guide planning process
Highlights potential areas of need
Highlights strengths – person and network
Helps with planning supports and services:
Individual items inform on what supports and services may be needed
Scales inform on:
The person’s current status
The rate of change in status over time (person or group)
Outcomes of supports or interventions