1. Page 1 DBHDS Virginia Department of Behavioral Health and Developmental Services Proposed Selection Process SEVTC Advisory Committee August 13, 2009

2. Page 2 DBHDS Virginia Department of Behavioral Health and Developmental Services Selection Principles Blind Review –No names, designations, or other identifying information Use all clinical, social, and other information available about the person –Consult ID case managers, SEVTC staff, and medical records

3. Page 3 DBHDS Virginia Department of Behavioral Health and Developmental Services Pilot Review Process Clinical Committee –Composed of SEVTC and CSB ID staff –Use medical and behavioral data only to develop profiles of each person living at SEVTC Selection Committee –Composed of SEVTC and CSB ID staff –Blind review of clinical committee profiles –Use selection criteria Oversight Committee –SEVTC director, CSB executive directors, Central Office, parents, and another training center director –Review work of clinical and selection committee to ensure blind review and objective process

4. Page 4 DBHDS Virginia Department of Behavioral Health and Developmental Services Proposed Selection Criteria (1) Significant support needs related to behavior –Intensive behavioral support due to: Aggression Property Destruction Running Away Self-injury Sexual Behavior Individual Behavior Support Considerations

5. Page 5 DBHDS Virginia Department of Behavioral Health and Developmental Services Proposed Selection Criteria (2) Significant support needs related to health and medical issues –Extensive support due to impaired functional mobility: Upper and lower extremity involvement Lower extremity involvement and non-ambulatory Lower extremity involvement and ambulatory/wheelchair –Specialized support for meals and feeding: Tube feeding as supplemental to oral Bolus-Scheduled feedings for all nutrition Continuous pump for all nutrition –High risk or specialized medical conditions

6. Page 6 DBHDS Virginia Department of Behavioral Health and Developmental Services Proposed Selection Criteria (3) Significant staffing support requirements –Support staff (1:1, Continuous, Routine/General); –Nursing – Immediate support, within 1 hour, within 1 day, within 1 week; and/or –Continuous nursing treatment, hourly treatment, daily treatment, weekly treatment Additional considerations –Age –Personal preference is an important consideration but will not be the sole basis for selection

7. Page 7 DBHDS Virginia Department of Behavioral Health and Developmental Services Use of Selection Criteria Decisions and rating would be based on: –Likert scale (1-5, minimum to maximum support needs) –Scoring for selection criteria –Scoring by consensus Recommendation for individuals to: –Continue to reside at SEVTC –Explore community ICF/MR –Explore waiver home options

8. Page 8 DBHDS Virginia Department of Behavioral Health and Developmental Services Other Information Pilot testing has yielded consistent results to date Re-assess when there are changes in health status