SIS and ICAP Assessments in North Dakota for Disability Services

What These Assessments Determine

When a young adult with an intellectual or developmental disability enrolls in North Dakota's Traditional IID/DD HCBS Waiver, two standardized assessments determine how much support they'll receive: the Supports Intensity Scale (SIS) and the Inventory for Client and Agency Planning (ICAP). The scores from these tools generate a Level of Service (LOS) rating that directly controls the funding tier and direct-care hours authorized for the individual.

Getting these assessments right matters enormously. An inaccurate assessment — one that underrepresents the person's actual daily support needs — translates directly into fewer funded hours, fewer available services, and providers who don't have the budget to staff adequate support.

How the SIS Works

The Supports Intensity Scale is a structured interview, not a test. A trained assessor sits down with the individual, their family members, and others who know the person well, and asks detailed questions across several life domains: home living, community and neighborhood activities, health and safety, social activities, employment, and lifelong learning.

For each activity, the assessor evaluates three dimensions: how frequently the person needs support (ranging from "none or less than monthly" to "at least once an hour"), the amount of daily support time required, and the type of support needed (from monitoring to full physical assistance).

The interview typically takes two to three hours. The person being assessed should participate as much as possible — their self-report matters. Family members provide context for situations the individual might not describe accurately, especially around health monitoring, nighttime needs, and behavioral support.

How the ICAP Works

The Inventory for Client and Agency Planning (ICAP) measures adaptive behavior and problem behavior. It assesses the individual's functional skills in motor development, social and communication skills, personal living skills, and community living skills. It also evaluates the frequency and severity of any challenging behaviors.

Together with the SIS, the ICAP paints a picture of both what the person can do independently and where they need support. The combined scores feed into North Dakota's Level of Service formula, which places the individual in a funding tier.

Preparing for the Assessment

The single most important thing families can do is prepare thoroughly. Assessors rely heavily on the information provided during the interview, and there's a natural tendency for families to describe their child on a good day rather than an average or difficult day.

Document a realistic week before the assessment. Note every instance where your child needed help, prompting, supervision, or physical assistance. Include:

• Morning routines (dressing, hygiene, medication)
• Meal preparation and eating
• Transportation and community navigation
• Health monitoring (seizure watches, medication timing, behavioral escalation patterns)
• Nighttime needs (sleep disturbances, repositioning, incontinence)
• Safety concerns (wandering, impulsive behavior, difficulty recognizing danger)

Bring this documentation to the assessment. When the assessor asks about home living activities, you'll have specifics instead of generalizations. "She needs full physical assistance to brush her teeth every morning and evening" paints a more accurate picture than "she needs help with hygiene."

Common Mistakes That Lead to Under-Assessment

Minimizing needs. Families who have been providing intensive support for years often normalize it. You may not think of constant supervision as "support" because it's just what you do. But if your child would be unsafe without someone present, that's a high level of support that needs to be documented.

Focusing on skills rather than needs. The SIS doesn't ask what the person can do — it asks what support they need. A young adult might be able to make a sandwich, but if they need verbal prompting for every step and someone standing nearby for safety, that's still a significant support need.

Not including all informants. Bring people who see the individual in different contexts — a teacher, a job coach, a respite worker. Each person notices different support needs. The assessor gets a more complete picture when multiple perspectives are represented.

What to Do if the Results Don't Match Reality

If the assessed Level of Service doesn't reflect your child's actual needs, you have the right to request a reassessment. North Dakota's DD system requires annual level-of-care screenings, so there are regular opportunities to update the assessment. However, you don't have to wait a full year — if circumstances change significantly (a new medical diagnosis, increased behavioral challenges, loss of a skill), you can request an updated evaluation through your DDPM.

When requesting a reassessment, bring new documentation. Medical records, behavioral data from school, incident reports, and detailed daily logs all strengthen the case for a higher support level.

The North Dakota IEP Transition to Adulthood Guide includes an Assessment Preparation Worksheet designed to help families document daily support needs in the specific categories the SIS and ICAP evaluate.

Frequently Asked Questions

How often are SIS and ICAP assessments conducted?

North Dakota requires annual level-of-care screenings to maintain waiver eligibility. The SIS is typically conducted when the individual first enters the system and may be reassessed periodically or when a significant change in support needs occurs. Ask the DDPM which reassessment schedule applies to your case.

Can I disagree with the assessment results?

Yes. If you believe the assessment underrepresents your child's needs, discuss it with your DDPM first. You can request a reassessment with additional documentation. If the issue isn't resolved through the regional Human Service Center, you can escalate through the state's complaint and appeal process.

Who conducts these assessments?

Trained assessors — typically staff at the regional Human Service Center or contracted professionals certified in SIS and ICAP administration. The individual and their family participate as informants during the interview.

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