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Improving Quality of Life for those with Intellectual and Developmental Disabilities

Primary Functions of the HRST and SIS

Since the last newsletter we received a lot of interest regarding the use of the HRST and the SIS. We have included some information below about how these two tools work together.


The HRST is a reliable web-based rating instrument developed to screen for health risks associated with a wide variety of disabilities, including developmental disabilities, physical disabilities, disabilities associated with aging, and many other conditions, which specifically affect systems of the body and the person’s ability to engage in functional activities. It is designed to primarily detect destabilization EARLY and PREVENT preventable illness and even death. It has the ability to detect health risk that can lead to illness and death. It accomplishes this by having the interviewer rate 22 rating items that span over 5 categories: Functional Status, Behavior, Physiological, Safety, and Frequency of Services. Once scoring is complete the HRST produces an overall Health Care Level (HCL) that corresponds to the person’s risk level. The HRST also produces a set of Considerations that assist the team in identifying other professional services and training that may be needed for the person based off the scoring of the 22 items. The HRST has been shown to reduce morbidity, reduce costs related to service delivery, lead to more accurate parallel of supports/services to needs of the person, better staffing alignment based off of identified needs, greater identification of at-risk individuals, and improved quality of life for the person due to better overall health.


Developed, tested, and normed by the American Association on Intellectual and Developmental Disabilities (AAIDD), the Supports Intensity Scale is a unique supports identifying tool for ages 16 and older. It primarily seeks to assess and measure the support needs for persons with intellectual and developmental disabilities to engage in a given activity at the same level of involvement as anyone without a disability of relative age in his or her community (also defined as, Success). The SIS covers a number of life activities some of which have historically been unassociated with, or participated in, by people with disabilities. The interviewer is tasked with exploring a number of activities in the sections of Home Living, Community Living, Lifelong Learning, Employment, Health and Safety, Social and Protection/Advocacy. The interviewer then works with the team to identify what Type of Support, Frequencyof Support, and Daily Support Time would be needed to ensure success. The majority of the tool is scored in this manner. The SIS helps identify the supports needed for maximum contribution in everyday tasks. It also addresses stereotypical norms by refocusing, not on the deficits of the person, but rather on accurate supports to engage in life like others do.

Using HRST and SIS

Due to the intended nature and purpose of the HRST and the SIS, users may find that these two tools work well together in a number of ways. Each tool takes a different approach when evaluating the person.

Both tools can be used to:

  • Develop Individualized Support Plans.
  • Allocate fiscal resources based of identified risk and support level.
  • Allocate staff and personnel.
  • Qualify for advanced funding and supports.
  • Identify quality of life dynamics.
  • Trend data.
  • Assist in continuity of care.
  • Aid in transition efforts from higher levels of care.
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