It is widely known that the support needs of the individuals served in our waivered programs can change quickly.  The current span of three years between SIS assessments is often not adequately meeting the need for timely re-evaluation of support needs, so moving this to four years feels like we are moving in the wrong direction.  Requests for re-evaluation in accordance with the approved criteria are difficult to obtain, even when the changes to medical/behavioral supports are significant and long-term.  Appeals are currently only allowable to the process itself and are not accepted when the team does not feel that the results of the assessment accurately reflect the needs of the individual.  

We would advocate against increasing the time span between SIS assessments to four years.  Additionally, the process for requesting re-evaluation as support needs change and the appeal process should revamped to ensure that the individuals served are able to receive proper supports, in accordance with the accurate level and tier.