Coordinated Assessment System (CAS)

OPWDD is required to perform a conflict-free comprehensive needs assessment for people receiving OPWDD services.  The Coordinated Assessment System (CAS) is the comprehensive assessment that OPWDD uses for people 18 years or older to identify their strengths, needs and interests. The CAS provides information used in person-centered planning for the person’s care. Understanding of what kinds of support each person needs is the foundation of an equitable service system that focuses on providing the right amount and type of support, in the right way, to each person.

In response to requests for an assessment that provides a more complete understanding of each person, OPWDD has adopted the CAS for people with developmental disabilities in New York State. The research network interRAI created the CAS. The CAS was studied and proven to be a reliable tool for learning about a person and the kinds of support they may need. It collects information about a person’s strengths and needs and is more person-centered in its approach than prior assessment tools like the DDP-2.  The CAS is an important part of person-centered service planning and is required for everyone 18 years or older who receives or applies for OPWDD services.

The CAS is performed through a conversation with the person with a developmental disability who is the subject of the assessment. The discussion can include either family or other people who know the person well. The CAS looks at all areas of the person's life, such as living skills, health, behavior and supports.  Its purpose is to gather information to help the person and their care planning team develop a care plan that responds to their needs.

The CAS is a three-part process that includes:

• discussion/observation with the person with the developmental disability
• discussion with others who know the person well (such as family members, residential support staff, Care Managers, Consumer Advisory Board (CAB) representatives, etc.) and
• a review of supporting documents, such as medical evaluations, etc.

The assessment process is initiated following a person’s eligibility determination and repeated every two years. A CAS assessor or assessment scheduler will contact the person or their representative to set a date, time and location for a CAS interview that works for the person.

During the assessment, the trained assessor will listen to all information shared to get an idea of what the person is good at, what they need help with, what they enjoy doing and what they want from their life.

After the interview takes place, the CAS assessor will review the information gathered during this discussion, as well as any additional information provided, before the CAS process is completed. To oversee the quality of the CAS assessments, OPWDD routinely observes CAS assessors’ work. This means an OPWDD CAS Field Observer may sit in and watch the assessment meeting. The Field Observer would not actively participate in the interview but would be there to listen and observe the assessor’s process. As with any CAS assessment, the person’s private information is always protected according to OPWDD’s privacy practices.

State laws and regulations require that an assessment chosen by OPWDD must be used to review and record a person’s strengths and needs as a condition of receiving OPWDD services. OPWDD uses the CAS to conduct these required assessments for all people 18 years and older.

It is preferred that the person with a developmental disability and people who are close to the person participate in the CAS process. However, should a person choose not to participate in the CAS, there are certain circumstances where the assessment may be completed either with the help of others who know the person well and through the review of clinical, medical and program records.

The CAS assessor may interview Care Managers, Qualified Intellectual Disabilities Professionals and others responsible for providing care or developing the care plan for a person. The person with a developmental disability may also request other staff be present during their discussion with the CAS assessor. If a person lives alone and chooses an in-person interview with no one else present, the assessor will work to find a public setting (e.g., office space, library, etc.) where it is appropriate to complete the assessment.  The person can also choose to participate in their interview using remote technology if that is more convenient for them.

Within 48 hours of completing the CAS, a summary of the results will be automatically placed into the person's record in OPWDD’s computer system (called CHOICES).

Within 30 days of completing the CAS and having access to the CAS Summary, the Care Manager or Qualified Intellectual Disabilities Professional will review the CAS Summary with the person and their care planning team members.

The care planning team will use the information from the CAS Summary to create a service plan that reflects the person’s abilities, preferences and support needs.

An initial assessment is completed when the person is assessed for the first time with the CAS.

A routine reassessment is the standard reassessment that occurs at least two years after the either the initial assessment or last CAS assessment.  A CAS is repeated every two years, or more often if needed, to keep the information up to date.

A Significant Change in Condition (SCIC) reassessment is conducted when a significant improvement or decline in a person’s behavior, medical condition or functioning has occurred since the last assessment and before the scheduled reassessment. Some SCIC reassessment qualifying events include:

• Accidents or events resulting in serious personal injury 
• Major medical events or prolonged illness
• Major psychiatric events resulting in extended inpatient psychiatric hospitalization 
• Significant improvement in behavior or physical functioning that may be related to an improvement in an acute medical condition, recovery from prolonged illness or stabilization resulting from psychiatric and/or medical intervention

SCIC reassessment qualifying events will not typically be resolved without intervention by staff. These events usually impact more than one area of the person’s health or behavioral status and require professional review or revision of the person’s care plan. They often result in a newly identified need for reduced or enhanced support to maintain health and safety. If a person believes that they have had a Significant Change in Condition, they should contact their Care Manager or Qualified Intellectual Disabilities Professional to review any additional needs, including the need for a CAS reassessment.

OPWDD’s 2023-2027 Strategic Plan lays out important goals and objectives for our service system. Among these is enhancing our person-centered supports and services by making sure OPWDD services are: Needs-based, Equitable and Person-centered.

OPWDD’s service system must provide each person with the support that is right for them. While every person should not have the same services, they should have access to the services they need. Getting better information through the CAS is helping OPWDD to make this happen. Understanding each person’s needs better leads to services that better match each person (i.e., services are more person-centered, needs-based and equitable).

The CAS is providing OPWDD with important information about all of the people who use OPWDD services. By studying service use (called service utilization) data and CAS data, we can see similar service use patterns among people with similar support needs. These patterns reveal clear Service Ranges – that can guide care planners and OPWDD to understand what kind and how much each service might meet someone’s needs.

The Service Ranges support:

• Care planning - Service Range will help Care Managers and care planning teams identify the kinds and levels of service that may best meet a person’s needs.
• Service authorization - Service Ranges will help OPWDD understand what level of services may best meet a person’s needs.

However – Each person with a developmental disability is unique and has their own needs and preferences. While Service Range will help Care Managers and OPWDD understand what someone might need, more information, discussion, records review and planning with each person’s care planning team are needed before a person-centered Life Plan is developed.

OPWDD will look into concerns raised about CAS Summaries and, when warranted, determine if the summary needs to be edited.

However, when reviewing the CAS Summary, it is important to understand that the CAS is not the only source of information about a person. Many other documents provide the care planning team with information about a person and what support they need. Because not every concern raised impacts care planning, some questions or concerns may be noted in a person’s records but not require a change in the actual CAS Summary report.

How it Works -

If the person or anyone on their care planning team has questions or concerns about the CAS Summary, the Care Manager or Qualified Intellectual Disabilities Professional:

• Will discuss the CAS results with the person or their care planning team and note in their records any questions or concerns raised.
• Can help the person and their care planning team understand if there is a specific part of the CAS Summary that is critical to care planning decisions. 

If, after discussion with the Care Manager or Qualified Intellectual Disabilities Professional, someone still has concerns or questions about CAS results, the Care Manager or Qualified Intellectual Disabilities Professional can submit these concerns to OPWDD using the CAS/CANS Request for Review Form.  In addition, people or their representatives may direct questions to OPWDD at 518-473-7484.OPWDD will work with the Care Manager or Qualified Intellectual Disabilities Professional to answer questions and follow up as appropriate.

Guidance for Care Managers on how to request a CAS or CANS Assessment for someone they support is available on the Care Managers page under the Provider section of the website.