Connecticut DDS Level of Need Assessment

What the LON Assessment Actually Measures

The Level of Need (LON) assessment is Connecticut DDS's primary tool for determining how much support an individual requires — and by extension, how much waiver funding they receive. The score ranges from 1 (least support needed) to 8 (most intensive support), and it directly controls the annual budget allocated under the Individual and Family Supports (IFS) waiver.

A common misunderstanding: the LON is not an IQ test or a clinical diagnosis. It's a functional assessment. It measures what your young adult actually needs in daily life, not what condition they have. Two people with the same diagnosis can receive very different LON scores based on their practical support requirements.

The Five Assessment Domains

The LON evaluator scores the individual across five functional domains:

Medical complexity: Does the individual require ongoing medical interventions, nursing care, medication management, or specialized health monitoring? This covers physical health conditions that go beyond standard primary care.

Behavioral risks: Does the individual engage in behaviors that pose risks to themselves or others — self-injury, aggression, property destruction, elopement? The severity, frequency, and current management of these behaviors are all assessed.

Psychiatric needs: Does the individual require psychiatric treatment, crisis intervention, or mental health supports beyond standard counseling? Co-occurring psychiatric diagnoses are evaluated for their impact on daily functioning and safety.

Safety and supervision: How much oversight does the individual need to remain safe? Can they be left alone for any period? Do they understand environmental dangers? Can they respond to emergencies?

Personal care: What level of assistance does the individual need for activities of daily living — eating, bathing, dressing, toileting, mobility, and hygiene?

Each domain is scored independently, and the composite produces the overall LON score. Higher needs in more domains push the score upward.

How the LON Score Affects Waiver Funding

For the IFS waiver, the LON score maps directly to an annual funding allocation within the waiver's approximately $59,000 cap. A higher score can support a larger allocation, but the actual budget depends on the assessed needs and the waiver plan.

For the Comprehensive Supports waiver, the LON score determines placement intensity — whether the individual qualifies for a standard group home, an intensive behavioral group home, or individualized 24-hour staffing. Higher LON scores open access to more resource-intensive (and more expensive) residential options.

The practical consequence: an inaccurately low LON score doesn't just mean fewer services. It means a smaller budget, less provider flexibility, and potentially being placed in a less supportive environment than your young adult actually needs.

Preparing for the Assessment

The LON assessment is typically conducted by a DDS case manager or a qualified assessor, often through an interview with the individual and their family. Here's how to prepare:

Document the typical day, not the best day. Families naturally want to showcase their young adult's abilities. In a LON assessment, this works against you. The assessor needs to understand the full scope of support required. If your young adult can make a sandwich independently but only because you pre-set every ingredient, label containers, and verbally prompt each step — describe the full process, not just the outcome.

Bring records. The assessor's observations during a single interview may not capture the full picture. Bring:

• Behavioral incident logs (dates, descriptions, responses)
• Medical records documenting ongoing conditions and treatments
• Psychiatric evaluations and current medication lists
• School-based assessments that describe functional limitations
• Any emergency room visits or crisis intervention records

Describe overnight needs. If your young adult requires checks during the night, has sleep-related behavioral issues, or needs assistance with nighttime toileting, these count toward the safety/supervision and personal care domains but are easy to forget during a daytime interview.

Be specific about prompting levels. There's a significant difference between "can do it independently," "can do it with verbal prompting," "can do it with physical assistance," and "cannot do it at all." For each daily living task, specify exactly how much support is required.

Requesting a Reassessment

The LON score isn't permanent. If your young adult's support needs change — due to a new medical diagnosis, behavioral regression, loss of a caregiver, or age-related changes — you can request a reassessment through your DDS case manager.

Common triggers for reassessment:

• A new psychiatric diagnosis or medication change that affects functioning
• An increase in behavioral incidents, particularly those requiring emergency intervention
• A change in living situation (moving out of the family home, losing a roommate or caregiver)
• Medical changes that increase personal care or nursing needs
• Any hospitalization or emergency service utilization

When requesting a reassessment, submit a written summary to your case manager documenting what has changed since the last assessment. Include dates, incident reports, and any new clinical evaluations. The written record ensures the assessor reviews current information, not just the previous score.

What to Do if You Disagree With the Score

If you believe the LON score doesn't accurately reflect your young adult's needs, you have options:

1. Request a conference with the case manager. Sometimes the score reflects incomplete information — additional documentation can justify an adjustment without a full reassessment.

2. Request a formal reassessment. Provide the documentation that supports a higher score and ask for the assessment to be repeated.

3. Contact your regional DDS director. If you've exhausted the case manager channel, escalating to regional leadership can initiate an independent review of the scoring.

4. Seek advocacy support. Disability Rights Connecticut (DRCT) and the Connecticut Parent Advocacy Center (CPAC) can provide guidance on challenging a LON score that seems inaccurate.

The LON assessment is one piece of the larger waiver access puzzle. The Connecticut SSI at 18 & Adult Disability Benefits Guide includes LON preparation worksheets that help you organize documentation across all five assessment domains before the evaluation, maximizing the accuracy of the score.

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