Building Bridges of Support Gent 2018 Use of the SIS by the Flemish Agency responsible for resource allocation Catherine Molleman (Researcher VAPH) Vlaams Agentschap voor Personen met een Handicap

Goal of research: More objective resource allocation (2004) Search for instruments that can measure ‘objectively’ supports intensity Vlaams Agentschap voor Personen met een Handicap

SIS in experimental Dutch translation What was available? ADL-scales (Barthel, Elida) scales that measure behavior problems, (para)medical needs… SIS in experimental Dutch translation Vlaams Agentschap voor Personen met een Handicap

SIS as a part of a VAPH instrument (ZZI) ZZI has been validated (2012 version actually in use) for persons with intellectual disabilities Method : algorithms to rank people in 6 categories of intensity of ‘care’ , 7 intensities of need of ‘surveillance’ (from less then once a week to permanently) and 4 categories of night surveillance Vlaams Agentschap voor Personen met een Handicap

ZZI Scales ≠ SIS Results = Quantitative input Ranking (care intensity and surveillance) algorithms output Vlaams Agentschap voor Personen met een Handicap

Adds up to 19.160 SIS-results (within ZZI) VAPH research unit in collaboration with Dr. W.Buntinx monitored and guided the SIS-programme in Flanders : 2005-2006 : 16.860 included for simulation. Iters : services 2010 : 319 used for validation and direct payment allocation Interviewers: trained and independent (multi-disciplinairy teams) 2010-2012 : 1.981 subjects for personnel allocation Adds up to 19.160 SIS-results (within ZZI) Vlaams Agentschap voor Personen met een Handicap

ZZI has been implemented for the allocation of cash-budget and vouchers 1. people have to make an individual support plan and ask the agency for support 2. ZZI is (mandatorily) used to make a differentiation in the highest budget-categories (defines maximum of possible budget ) Vlaams Agentschap voor Personen met een Handicap

Improves predictive value of algorithms in ZZI Benefits of the SIS ? An excellent explorative tool for individual supports planning as confirmed by the working field Improves predictive value of algorithms in ZZI Vlaams Agentschap voor Personen met een Handicap

Ongoing : more validation studies of the ZZI In the past: inter-interviewer reliability study including 80 subjects, 54 with intellectual disability (2012) Vlaams Agentschap voor Personen met een Handicap

Inter-interviewer SIS-reliability interval between 2 ratings: 4,6 months (median) n=57 Pearson corr. coeff. n=80 Pearson SIS-index 0,72 SIS1A 0,90 !!! SIS-indexplus (=+SIS 2) SIS1B 0,78 SIS1C 0,33 ! SIS-index min C&D 0,82 SIS1D 0,32 SIS-indexplus min C&D SIS1E 0,75 SIS1F 0,70   SIS2 0,60 SIS 3A (Med) 0,68 SIS 3B (Behav) 0,86 !! !!! The interval between two ratings was 4.6 months, the Pearson correlation coefficients were 0.72 for both Sis-index and indexplus. These coefficients were higher for S1 A,B,E and F then for C and D. When excluding C and D correlation index was …. In addition we obtained a very high correlation for SIS3B and somewhat lower for SIS2 and 3B Vlaams Agentschap voor Personen met een Handicap

Ongoing : analysis of the link between the subscales of the SIS and the theoretical amount of the maximum budget as measured with the ZZI Vlaams Agentschap voor Personen met een Handicap

Correlation of SIS index and subscale SIS-scores with budget-categories Pearson corr. coeff. n=4.889 SIS-index 0,800 SIS1A 0,881 SIS-indexplus (=+SIS 2) 0,783 SIS1B 0,811 SIS1E 0,812 n=3.344 SIS1F 0,660 SIS-index min C&D 0,892 SIS2 0,600 SIS-indexplus min C&D 0,878 SIS 3A (Med) -0,041 SIS 3B (Behav) 0,254 SIS1C 0,563 SIS1D 0,335 The interval between two ratings was 4.6 months, the Pearson correlation coefficients were 0.72 for both Sis-index and indexplus. These coefficients were higher for S1 A,B,E and F then for C and D. When excluding C and D correlation index was …. In addition we obtained a very high correlation for SIS3B and somewhat lower for SIS2 and 3B Vlaams Agentschap voor Personen met een Handicap

Correlation of SIS index and subscale SIS-scores with budget-categories for persons with and without ID With ID Without ID SIS-index 0,870 N=3.415 0,826 N=633 SIS-indexplus (=+SIS 2) 0,857 0,805 SIS1A 0,890 N=3.811 0,863 N=730 SIS1B 0,814 0,775 SIS1E 0,809 0,799 SIS1F 0,677 0,541 SIS2 0,596 0,547 SIS 3A (Med) 0,387 0,007 SIS 3B (Behav) 0,272 0,144 SIS1C 0,575 N=1.061 0,488 N=313 SIS1D 0,265 N=720 0,317 N=220 The interval between two ratings was 4.6 months, the Pearson correlation coefficients were 0.72 for both Sis-index and indexplus. These coefficients were higher for S1 A,B,E and F then for C and D. When excluding C and D correlation index was …. In addition we obtained a very high correlation for SIS3B and somewhat lower for SIS2 and 3B Vlaams Agentschap voor Personen met een Handicap

Challenge: when we ‘know’ the support need of an individual: Which other factors could be taken into account for resource allocation by the state to avoid long waiting-lists? Availability of : Family members (and willingness of them to help)? Material aids and adaptations? Non-handicap (= regular) particular home help? Income? Work situation? Disability specific factors ? … ? Vlaams Agentschap voor Personen met een Handicap

Questions ? Vlaams Agentschap voor Personen met een Handicap

Questions later? Catherine Molleman Flemish Agency for Persons with a Disability Zenithgebouw Koning Albert II-laan 37 B-1030 Brussel BELGIUM Contact: catherine.molleman@vaph.be www.vaph.be Vlaams Agentschap voor Personen met een Handicap