Connecticut ABI Waiver Annual Reassessments: Why Every Participant Should Have a Representative Present
Understanding One of the Most Important Decisions Affecting Your Connecticut ABI Waiver Services
Every year, participants enrolled in Connecticut's Acquired Brain Injury (ABI) Waiver program complete an annual reassessment. For many families, this process feels like another routine appointment. In reality, it is one of the most significant events of the year for an ABI Waiver participant.
The information gathered during the annual reassessment has the potential to influence an individual's level of care determination, continued waiver eligibility, service authorizations, funding levels, and the overall structure of the participant's care plan.
Because of the importance of these decisions, The Supported Living Group (SLG) strongly encourages every ABI Waiver participant to have a knowledgeable family member, legal representative, advocate, or trusted support person present throughout the reassessment whenever possible.
This recommendation is not based on distrust of Connecticut's assessment process or the professionals conducting it. Rather, it recognizes the unique characteristics of acquired brain injury and the reality that no single assessment can fully capture how a person functions across an entire year without meaningful input from those who know the participant best.
CT ABI Waiver I & II Annual Reassessment Process
What Is the Connecticut ABI Waiver Annual Reassessment?
The Connecticut ABI Waiver Annual Reassessment is conducted each year to determine whether an individual continues to meet the eligibility requirements for the ABI Waiver and to evaluate whether their current services remain appropriate.
During the reassessment, the care manager reviews a participant's:
Medical status
Cognitive functioning
Functional abilities
Activities of Daily Living (ADLs)
Instrumental Activities of Daily Living (IADLs)
Behavioral needs
Community participation
Safety concerns
Informal and formal supports
Overall need for continued waiver services
The information gathered during this process helps guide recommendations regarding:
Continued waiver eligibility
Level of care determination
Authorized waiver services
Service hours
Overall service plan
Funding allocation
Although the reassessment represents only a small portion of the year, the decisions that follow can impact every day that follows.
Why This Assessment Carries So Much Weight
Unlike many medical appointments that focus on diagnosis or treatment, the annual ABI Waiver reassessment helps determine what community supports an individual may receive over the coming year.
Recommendations resulting from the assessment may influence services such as:
Independent Living Skills Training (ILST)
Recovery Assistant Services
Recovery Assistant II Services
Personal Care Assistance
Companion Supports
Community Integration Services
Behavioral Supports
Vocational Supports
Other individualized waiver services
For many participants, these services are essential to maintaining independence within the community.
Any misunderstanding of an individual's true support needs can have significant consequences.
One Annual Assessment Cannot Tell the Entire Story
One of the greatest challenges within any annual reassessment process is that it attempts to summarize an entire year of functioning during a relatively brief appointment.
In many cases, the care manager conducting the reassessment has had limited face-to-face interaction with the participant over the preceding twelve months. While they may review documentation, communicate with providers, and complete required assessments, they may only have observed the participant for a very small fraction of the year.
This observation is not intended as a criticism of Connecticut's care management professionals. Rather, it highlights an important reality: no matter how experienced an evaluator may be, it is impossible to fully understand an individual's daily strengths and challenges through occasional visits alone.
Family members, direct support professionals, clinicians, and others who interact with the participant regularly often witness patterns that cannot be captured during a single appointment.
That is why their input is so valuable.
Acquired Brain Injury Is Often an Invisible Disability
One of the greatest misconceptions about acquired brain injury is that if someone appears physically well, they must also be functioning independently.
Unfortunately, this is rarely the case.
Many ABI survivors:
Speak fluently.
Walk independently.
Appear socially appropriate.
Answer questions accurately.
Demonstrate good long-term memory.
Yet they may simultaneously experience profound difficulties with:
Short-term memory
Executive functioning
Planning
Organization
Problem solving
Emotional regulation
Judgment
Impulse control
Cognitive fatigue
Safety awareness
Initiating tasks
These impairments are often invisible to someone meeting the individual briefly.
Without additional context, the participant may appear considerably more independent than they actually are.
Why ABI Survivors Often Underestimate Their Own Needs
One of the most challenging aspects of acquired brain injury is that many survivors genuinely do not recognize the extent of their own impairments.
Neurologists frequently refer to this reduced awareness as impaired insight or anosognosia.
This means a participant may sincerely believe they complete tasks independently because they remember completing the final step—but not the reminders, cueing, supervision, or assistance they received along the way.
For example:
A participant may say:
"I cook dinner every night."
What they may not mention is:
Staff remind them to begin cooking.
Someone assists with planning the meal.
Another person ensures food is cooked safely.
Someone prevents the stove from being left on.
Staff assist with cleanup.
Technically, the participant cooked dinner.
Functionally, they required substantial support.
Without someone present to provide this context, the assessment may not accurately reflect their daily needs.
Why Having a Representative Present Matters
Having a knowledgeable representative present is one of the simplest and most effective ways to ensure the reassessment accurately reflects the participant's everyday functioning.
A representative might be:
A parent
A spouse
An adult child
A conservator
A legal guardian
A trusted family member
A provider representative
Another individual who understands the participant's daily support needs
Their role is not to contradict the participant.
Their role is to provide context.
For example:
Instead of simply accepting:
"Yes, I manage my medications."
A representative may clarify:
"He remembers his medication because staff organize his pill planner, provide reminders twice daily, and monitor compliance."
That single clarification completely changes the evaluator's understanding of the participant's level of independence.
Real-World Functioning Is More Important Than Best-Case Performance
One of the biggest mistakes families make during an annual reassessment is describing what their loved one can do rather than what they consistently do without assistance.
A better question is:
Can they safely perform this task every day without reminders, cueing, supervision, or assistance?
Brain injury rehabilitation is about consistency.
Not isolated successes.
An individual who successfully prepares one meal each week may still require daily supervision.
Someone who drives successfully to familiar locations may become completely disoriented when routines change.
These differences matter.
Examples Families Should Share During the Assessment
Representatives should be prepared to discuss real-life examples that illustrate the participant's daily functioning.
Topics might include:
Memory
Repeated questions
Missed appointments
Forgotten medications
Difficulty remembering conversations
Executive Functioning
Difficulty starting tasks
Inability to organize daily activities
Difficulty following multiple-step directions
Problems with planning
Safety
Leaving appliances on
Falls
Unsafe decisions
Poor judgment
Wandering
Difficulty recognizing dangerous situations
Behavioral Regulation
Emotional outbursts
Impulsivity
Poor frustration tolerance
Difficulty adapting to changes
Community Living
Difficulty managing money
Problems shopping independently
Transportation challenges
Difficulty maintaining employment
Social vulnerability
Specific examples are significantly more helpful than general statements.
The Assessment Can Influence More Than Just Services
Many people assume the reassessment only determines how many service hours they receive.
In reality, it may influence:
Continued ABI Waiver eligibility
Level of care determinations
Service authorizations
Community support recommendations
Funding allocations
Future care planning
Because these decisions affect both the participant and their support system, it is important that the assessment accurately reflects the individual's current needs.
Preparing Before the Assessment
Preparation should begin well before the reassessment appointment.
Helpful strategies include:
Keep Notes Throughout the Year
Document:
Falls
Emergency room visits
Medication issues
Behavioral changes
Memory concerns
Safety incidents
Hospitalizations
Functional declines
Small events become easy to forget after twelve months.
Review Current Services
Understand:
What services are currently authorized.
What each service accomplishes.
Which supports have been effective.
Where additional needs have emerged.
Speak With Your Providers
Direct support staff, therapists, clinicians, Program Coordinators, and family members often observe different aspects of the participant's functioning.
Combining these observations creates a much more complete picture.
Focus on Typical Days
Avoid describing only the participant's best day.
Instead, describe what a typical week looks like.
This helps ensure the assessment reflects everyday functioning rather than isolated successes.
Common Mistakes Families Should Avoid
❌ Minimizing challenges to avoid embarrassment.
❌ Assuming the evaluator already knows the participant's needs.
❌ Forgetting to discuss supervision and cueing.
❌ Describing physical independence without discussing cognitive assistance.
❌ Allowing important examples to go unmentioned.
SLG Professional Tip
Think Beyond Whether Someone Can Complete a Task.
Instead ask:
Can they complete it safely?
Can they complete it consistently?
Can they complete it without reminders?
Can they complete it without supervision?
Can they recognize when something has gone wrong?
These questions often provide a far more accurate reflection of an individual's true level of independence.
The Value of Collaborative Assessments
The most effective reassessments occur when everyone involved works together.
Participants bring their personal experiences.
Families provide historical context.
Providers contribute day-to-day observations.
Clinicians share professional expertise.
Care managers integrate all of this information into the assessment process.
When each perspective is considered, the resulting service plan is far more likely to reflect the participant's actual needs.
Final Thoughts
The Connecticut ABI Waiver Annual Reassessment is much more than an annual requirement—it is a critical opportunity to ensure that an individual's services continue to reflect their unique strengths, challenges, and support needs.
For many people living with acquired brain injuries, the greatest obstacles are not immediately visible. Memory impairments, executive dysfunction, impaired judgment, cognitive fatigue, and reduced self-awareness often emerge only through consistent observation over time. A single appointment, no matter how thorough, cannot always capture the complexities of everyday life.
By having a knowledgeable representative present throughout the reassessment, participants can help ensure that the evaluator receives a complete picture of their day-to-day functioning. This collaborative approach supports more informed decision-making and helps promote service plans that are responsive to the participant's actual needs.
At The Supported Living Group, we believe that informed participants and engaged families are among the strongest advocates for quality, person-centered care. Preparing for an annual reassessment, understanding the process, and ensuring that important information is shared can make a meaningful difference in achieving the best possible outcomes.
Need Help Preparing for Your Connecticut ABI Waiver Annual Reassessment?
If you or a loved one are preparing for an upcoming ABI Waiver I or ABI Waiver II annual reassessment, The Supported Living Group is here to help. Our experienced team works with brain injury survivors and their families throughout Connecticut, providing guidance on person-centered planning, community supports, and navigating the ABI Waiver system.
Contact SLG today to learn more about how we can support you before, during, and after your annual reassessment.