Example Core Standardized Assessment Instruments (Level II)

The Balancing Incentive Program requires states to use a Core Standardized Assessment (CSA) instrument(s) to 1) determine eligibility for Medicaid-funded community long-term services and supports (LTSS), 2) identify individuals’ support needs, and 3) inform their service and support planning (e.g., plan of care).

The CSA instrument(s) and assessment process should be uniform for a given population across the state. In addition, the CSA instrument(s) should capture a Core Dataset (CDS). The CDS contains five domains: activities of daily living (ADLs), instrumental activities of daily living (IADLs), medical conditions/diagnoses, cognitive functioning/memory, and behavior concerns. Four of these domains (ADLs, IADLs, cognitive functioning/memory, and behavior concerns) contain topics (sub-domains) that are also required components of the CDS.

Many Balancing Incentive Program states use tools that are proprietary. Therefore, copies cannot be posted on the website. Please see vendor websites for more information:

See the attachments below for examples and descriptions of states' CSA instuments.

Comprehensive List of Instruments Used by BIP and Non-BIP States