Individual Support Plans
This fourth section of this
Advocacy Guide is intended to give family members and guardians detailed information
on DMR policies and procedures regarding Individual Support Plans (ISPs).
Understanding your rights and obligations regarding ISPs is critically important
to you in advocating for the best possible care and services for your family members
and wards in the DMR system.
This section is intended for
family members and guardians of persons who have been determined to be eligible
for DMR services. If your ward or family member has not yet been determined
to be eligible, please link to Section 2 on Getting Services (Determining Your Eligibility).
This section is
also intended to supplement Section 1 on
Advocating Effectively on Behalf of Your Family Members and Wards.
It should also be read in conjunction
with Section 3 on Protections
for Ricci Class Members and non-Class Members
and Section 5 on Guardianship.
NOTE:
There are numerous
DMR regulations cited throughout this guide in order to best assist you in your
advocacy efforts. Be aware, however, that regulations are subject to change
by DMR and regulatory citations can become outdated. We will strive to keep
this guide as up to date as possible.
The
full text of all DMR regulations can be found on the DMR website at
www.mass.gov/dmr/.
Defining Individual Support Plans
Individual Support Plans (ISPs) are defined
in the DMR regulations as: "written plans of services or supports for individuals,
which are developed, reviewed, and modified according to the requirements of DMR
regulations" (115 CMR 2.01).
ISPs are critical to ensuring care and
services because they serve as legally binding contracts on DMR to provide the care
and services enumerated in them. It is vital to understand what goes
into the development of your family member or ward's ISP, and how the ISP development
and appeals process works.
Know the DMR Regulations
Knowing the DMR regulations regarding ISPs
is fundamental to understanding your rights and obligations concerning them.
The regulations describe the ISP process
as an ongoing one of "establishing goals for individuals
consistent with the outcomes described in the
quality of life areas…,
and of identifying supports and strategies that will promote achievement of those goals"
(115 CMR 6.20: Introduction to Individual Support Planning). More will
be said below about the quality of life areas.
The regulations also note that "successful (ISP) support planning requires the greatest
possible involvement of the individual, his or her family, guardian, and designated
representative, if any, the
Department, and providers of supports to
the individual." Each participant, according to the regulations, is
expected to have a "continuing commitment
to learn about the individual and about his or her current goals and circumstances,
and to support the individual in particular ways to realize those goals."
In addition, 115 CMR 6.21(2) requires
the DMR to "provide reasonable assistance and accommodations to enable the individual
and other members of the ISP team to participate meaningfully in the development,
review, and modification of the ISP."
NOTE:
Your own participation in the ISP
process can be enhanced by developing a "wish list" beforehand of the most comprehensive
and appropriate services and residential settings you would like your family member
or ward to receive. Include your own goals for your family member or ward,
and your preferences for day programs, nursing services, physical and occupational
therapy, and other services that you believe would best help achieve those goals.
Be sure to discuss your wish list with your service coordinator and others involved
in the ISP process.
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