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Not only is person-centered planning the right thing to do, it’s the law. The laws governing this process are:
- Section 2402(a) of the Affordable Care Act (PDF) requires a person-centered service plan for each person receiving Medicaid waiver services, to include long-term services and supports.
- Senate Bill 7 (83rd Texas Legislature, Regular Session, 2013) directs the Texas Health and Human Services (HHS) to promote integrated person-centered planning and person-centered services.
- The Centers for Medicare & Medicaid Services (CMS) [PDF] released updated survey guidance in April 2015 for intermediate care facility (ICF/IID) compliance, which includes person-centered planning and outcomes for people.
Who Should Have A Person-Centered Plan?
The rules in the Texas Administrative Code requires the following programs to use person-centered planning:
- 1915c waivers
- Community Living Assistance and Support Services (CLASS)
- Deaf Blind with Multiple Disabilities (DBMD)
- Home and Community-based Services (HCS)
- Medically Dependent Children Program (MDCP)
- Texas Home Living (TxHmL)
- Youth Empowerment Services (YES)
- 1915i state plan services
- Home and Community Based Services Adult Mental Health
- 1915k state plan services
- Community First Choice
- 1115 waiver
- STAR+PLUS Home and Community-based Services
- STAR Kids Home and Community-based Services
- Home and Community Based Services delivered through STAR Health
What Must Be In a Person-Centered Plan?
The final CMS Home and Community Based Services (HCBS) rule provides requirements for person-centered planning. HHS is educating people on person-centered planning and initiating changes in processes and systems to ensure that the planning process meets the HCBS settings rule.
This process will take a few years to fully implement. In the meantime, HHS is implementing policies to ensure the person-centered planning process will be:
- Driven by the person getting services and reflective of his or her perspective.
- Made up of people the client chooses.
- Conducted at a time and place convenient to the person getting services.
The plan must be reviewed and revised annually with a functional needs assessment, when circumstances or needs change, or when the client asks for a review.
Certain elements have to be included in each plan.
- It must be written using plain language.
- It must consider the person’s cultural preferences.
- It has to include strategies for solving disagreements during the planning process.
- It must provide choice regarding services and providers.
- It must have a way for clients to request an update.
- It must include risk factors and mitigation strategies.
- It must be signed, with copies given to the person getting services and her or his representatives.
The final service plan must reflect:
- The client's choice of setting and how that setting is integrated in and supports access to the community.
- Opportunities to seek competitive employment and work in integrated settings.
- Ways to engage in community life, control personal resources and receive services in the community to the same degree of access as people not receiving HCBS.
- The client's strengths and preferences.
- Clinical and support needs.
- Goals and desired outcomes, as defined by the person getting services.
- Services that will be provided, including self-directed services.
- Who will provide services and supports, including unpaid natural supports, such as family and friends.
Questions can be sent to PersonCenteredPlanning@hhsc.state.tx.us.