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NC Department of Health and Human Services Division of Mental Health, Developmental Disabilities, and Substance Abuse Services

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NC SNAP (NC Support Needs Assessment Profile)

Frequently Asked Questions

Below are answers to frequently asked questions about the NC-SNAP assessment: 

How will the NC-SNAP be used?

The NC-SNAP will be used as a measure of intensity of need for persons served or waiting to be served by the North Carolina developmental disabilities service system. Additionally, the NC-SNAP can be used as an initial step in the development of a person-centered support plan.

Will NC-SNAP results be used to determine what services are delivered to a client? 

No.  The NC-SNAP does not specify services.  It identifies needs, which can be met through a variety of services. Therefore, services will be neither added nor taken away solely on the basis of an NC-SNAP score. 

Will funding be tied to the NC-SNAP?  If so, will funding be tied to individual budgets or will an LME/MCO be given funding to develop aggregate budgets?

The NC-SNAP level of need criteria were used to replace non-reliable criteria formerly used to determine funding allocated to individuals in the service category Supported Living in the former CAP MR/DD waiver. Information collected from this process has been helpful to the state in determining what issues must be addressed in any broader use of level of need related to cost.

Do people living in DDA homes need an NC-SNAP? 

Yes. Persons diagnosed with a developmental disability who are currently served under the North Carolina DD service system should have an NC-SNAP administered annually. Individuals with a developmental disability should have an NC-SNAP upon initial contact with the service delivery system, annually while on the wait list for DD services, and when the individual enters the DD service.  

Do children in early intervention programs who do not have a formal diagnosis of a developmental disability need an NC-SNAP?

If the child is determined by the LME/MCO to be I/DD eligible, then he/she should receive the NC SNAP. However the SNAP is administered to children age 3 and above.

Will I need to be re-certified as an examiner if I move to another part of the state?

No, examiners may continue to use their original NC-SNAP examiner number anywhere in North Carolina. However, there are some LME/MCOs completing the NC-SNAP that do not require the NC SNAP results to be keyed into the database. If you work for this particular LME/MCO and move to an LME/MCO which will require your NC-SNAPs to be keyed into the database, your initial SNAP may be rejected due to inactivity (your examiner number has expired because none of your assessments have been keyed in the database.) If your number expires due to inactivity in the database recertification will be required. An examiners number will expire if he/she has no assessment key for 18 months. To be recertified you must attend NC-SNAP training to receive a new examiner number.  

Should I use a pencil or pen (blue or black ink) when I fill out the NC-SNAP?

Black ink should be used to complete the NC-SNAP.

Where do we get blank forms when our supply runs low?

NC-SNAP Assessment forms are available in PDF format and can be obtained by clicking the link in the forms section. These forms should not be altered in anyway. The NC SNAP maybe printed as four single pages or two front/back pages (page 1 and 2 together; 3 and 4 together).
The supplemental information sheet should always be printed as single page document, and included as a part of the NC-SNAP assessment.

Will a registration fee be charged for examiner’s training?

No. There is not a fee for the required NC-SNAP training. 

When should the NC-SNAP be re-administered?

The NC-SNAP should be re-administered at least annually or whenever there is a significant change in the individual’s need profile (e.g., the individual suffers a debilitating stroke).

Should the NC-SNAP be re-administered each time the individual obtains a new or different service?

No. The NC-SNAP does not specify services. It identifies needs, which can be met through a variety of services.

Must a person be a care coordinator, case manager or a provider be a QP to become an examiner?

The NCSNAP examiner does not necessarily have to have one of the job titles mentioned but he/she must meet at least the minimum qualifications of a Qualified Professional (QP). To meet the qualifications of QP one must have a license, provisional license, certificate, registration or permit, be a graduate of a college or university with a Masters degree in a human service field and have one year of full-time post-graduate degree experience with the population served, have a four year degree in a human service field with two years of experience post degree with the population served, or a four year non-human serviced degree with four years of experience post degree with the population served. For more details see 10A NCAC 27G .0104 titled STAFF DEFINITIONS.
Para-professionals should not be assigned responsibility for administering the NC-SNAP assessment.

If an individual has no assigned care coordinator, QP, or case manager who will be responsible for administering the NC-SNAP?

The LME/MCO should be responsible for the identification of appropriate persons to assume this responsibility. Typically a knowledgeable Qualified Professional who is responsible for the plan of care, such as a group home manager or Care Coordination Supervisor.

Will examiners be issued a certification number after successfully completing NC-SNAP training?

Yes.  Examiners should be given their certification number at the completion of examiner’s training.

What if someone fails the training?

To be certified as an NC-SNAP examiner, an individual must successfully pass an examiner’s training class. If someone does not successfully meet this certification criterion, he or she should repeat the training. If a person fails after a second training session, he or she will be ineligible to conduct NC-SNAP administrations.

If I am a certified examiner, may I show my assistant how to administer the NC-SNAP and let her use my examiner number?

No. Only certified examiners may administer the NC-SNAP, and only certified NC-SNAP instructors may train and certify examiners. It is fraudulent for an examiner to put their certification number on a NC SNAP assessment if they have not administered the assessment themselves. Following this practice will make your assessment invalid.

Where will the NC-SNAP be stored?

The completed NC-SNAP should be filed in the assessment section of the individual’s permanent record, which should be kept in a centralized records location, or wherever other official records are maintained. To determine how long the assessment should be kept please refer to the appropriate section of the Records Management and Documentation Manual.

Sometimes a person lives in one county but is from another county.  Which county should be listed on the Report Summary & Supplemental Information sheet (and entered into the database)?

Enter the name of the responsible county (i.e., the county with legal or financial responsibility for the individual).

Instructions for the NC-SNAP specify that the examiner should assess the individual’s needs as opposed to the supports currently delivered.  However, the Physician’s Services column under Health Care Supports suggests that the examiner should average the number of physician visits during the previous year.  Is this a contradiction?

Not really, although we can see why this might seem unclear. When gauging the intensity of need associated with an individual’s chronic health care need, it is helpful to assess the frequency of required physician intervention. If, however, the examiner feels that the previous year’s average does not accurately reflect the individual’s most current needs (e.g., due to a recent significant change in medical status), the score that best represents the most current needs should be marked.

Does Equipment Supports refer to the purchase of equipment?

No. Score this item based on the amount of support that is required to maintain or service an individual’s equipment.  The purchase of the equipment should not be considered. For instance, some communication devices are very costly to purchase, but they may not require frequent repair or service. If the individual’s prescribed equipment does not require frequent (i.e., less often than once per month) repair or service, score Level 1.

How is the NC-SNAP used as part of a personal plan for support?

Page four of the NC-SNAP provides a worksheet for developing a personal support plan.

Will the SIS replace the NC-SNAP?

The Supports Intensity Scale (SIS) is in the process of being implemented for NC Innovations recipients. Individuals receiving state funding will continue to receive the NC-SNAP. For more information on the SIS refer to the Division of Medical Assistance (DMA) web site:

The Supports Intensity Scale (SIS) is in the process of being implemented for NC Innovations recipients.

Those currently receiving NC Innovations will continue to receive the NC-SNAP until advised otherwise. IDD individuals receiving state funding will continue to receive the NC-SNAP. For more information on the SIS refer to the Division of Medical Assistance (DMA) web site:

Why doesn’t the NC-SNAP include a category specifically for vocation or communication supports?

TheNC-SNAP is designed to functionally assess an individual’s level of intensity of need for supports and services. Some areas such as vocation and communication, while extremely important aspects of an individual’s life, do not easily fit into need levels. During field-testing of the NC-SNAP, the authors found that including some of these categories actually hurt the predictive validity of the instrument.   

How do I score psychiatric supports on the NC-SNAP?

Because a psychiatrist is an MD, medical services supplied by a licensed psychiatrist are scored under Physician Services (e.g., psychotropic medication monitoring). However, if a service being supplied by a psychiatrist could be provided by a psychologist or other mental health professional (e.g., counseling), the service should be scored under Mental Health Services (i.e., score the domain that reflects the individual’s true need). 

If an individual receives 24-hour awake supervision because the residential program’s policy requires it, should the individual be scored as requiring 24-hour awake supervision if their true need is only 24-hours without awake staff overnight?

No, if the individual would be adequately supported without awake staff overnight, score the individual accordingly.

If an individual’s only participation in self-care is to lift his arms to assist someone put on his shirt and walk to the bathroom with assistance, would this individual’s Assistance Needed score be Level 4 (Partial to Complete Assistance) or Level 5 (Extreme Need)?

Because the individual can participate, although in a very limited way, in self-care, the individual would not be scored at Level 5. Level 5 in Assistance Needed is reserved for those individuals who are completely and totally dependent on others for all of their care. The appropriate Assistance Needed score for this individual would be Level 4. 

Level 5 under Supervision in the Daily Living Supports section of the NC-SNAP refers to continuous monitoring. What constitutes continuous monitoring?

Continuous monitoring means without interruption and refers to nonstop monitoring either by direct observation or direct electronic monitoring (e.g., a medical alarm that is constantly on, equipped to sound an alarm as required, and staff are awake while monitoring the alarm). A good rule of thumb is to ask if the monitoring staff can briefly leave the room to get a cup of coffee. If so, continuous monitoring does not apply and Level 5 should not be scored. If the staff member must be replaced by another staff member before leaving the room, continuous monitoring does apply and Level 5 should be scored. If the alarm has to sound to wake sleeping staff, continuous monitoring does not apply and Level 5 should not be scored.


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