In 1989, SRS/HCP began a project to develop a reimbursement system that would link level of payment to relative level of disability. Toward that end, an assessment instrument called the Developmental Disabilities Profile (DDP), developed by the New York Office of Mental Retardation and Developmental Disabilities, was adopted. The DDP is a four-page instrument designed to collect information about adaptive functioning skills, challenging behaviors, and health factors. It yields three index scores (from which a converted score is also calculated). The higher the score, the greater (more severe) the disability.

The DDP has been used since July, 1990, as the eligibility instrument for Intermediate Care Facilities for persons with Mental Retardation (ICFs/MR) and Home and Community Based Services for persons with Mental Retardation and other Developmental Disabilities (HCBS/MRDD). One factor in reimbursement levels for ICFs/MR is their average converted DDP score. Certain HCBS/MRDD rates are also tied to reimbursement tiers which relate to ranges of DDP index scores so providers are reimbursed at rates corresponding to the relative severity of disability of the person served.