Advice for writing your plan of service
Home and Community-Based Services (HCBS) are services provided by Medicaid for people with disabilities so they can live in their own homes and communities. Gone are the days of forcing people with disabilities into nursing homes or institutions. The 1981 Omnibus Budget Reconciliation Act (Section 1915c) created Home and Community-Based Services (HCBS) that allows states to provide services as an alternative to institutional care. Through Medicaid, people with disabilities can get the support and services they need to live their life as they choose on their own terms.
People with disabilities deserve the resources to live independently.
The Individual Plan of Service is a document that lists all necessary medical services provided by the public behavioral health system. Despite different names, Individual Plan of Service (IPOS) serves the same purpose in all states. The plan enables individuals with developmental disabilities to have a say in the services and supports charged to Medicaid. It guarantees that individuals with developmental disabilities have fulfilling experiences, live where they want, and fully take part in their community. This process defines available services and supports, so it’s important to take it seriously.
If you (or a loved one) receive HCBS Waiver Services through Medicaid, then you have a plan. All states offer HCBS, but some states go beyond what is required by the federal government. HCBS includes many areas such as case management, homemaker/home health aide, personal care, adult day programs, habilitation, and respite care services. It is important to know all of your options and identify your needs before you write your plan. Your values should steer the plan you create.
Areas to consider when creating your plan
Personal– consider where you want to live and with whom. If you want to live independently, do you want roommates? Will you need help to manage your money or to make legal decisions?
Marriage– consider if you might want to marry in the future and how that might impact choices you make now.
Family– think about what support can they provide and how involved do you want them in your life.
Health– are there health issues that need to be considered in your plan? For example, will you need a nurse available if you have a tracheotomy tube or if you have seizures? How will you get to medical appointments and access therapies?
Social– how involved do you want to be in the community and how will you make and manage friendships? What organizations can help facilitate this? Do you need help to communicate?
Job– do you want to work or volunteer and what is necessary for you to do this? Do you require assistance and supervision when working in the community?
Education– do you want to work towards a degree or are you looking for training in a certain field? Do you need help with resume writing, interviewing, or job placement?
Recreation– are there hobbies that are important to you? Are there events and activities in the community that you want to access?
Think about these areas and plan. It is important for your Support Coordinator to understand what you want. If you don’t know, then they can’t help you create the best plan. Don’t worry about making a mistake, these plans can change. You want to make sure the plan makes the supports and services you need to live a full life available to you.
Tips:
- Develop a description of your best life. Make sure your Supports Coordinator (person who will be responsible for oversight of the plan) understands your wishes. If you want to live independently, make sure they know this. If you want to be involved with activities in the community, tell them this. They will ask questions and offer ideas, but you need to make your goals known.
- State your outcomes clearly. This ensures that everyone understands them. If you have a goal that says you need to try one new activity in the community a month, be sure you know what that entails. How long do you need to take part in the activity? How will you determine if you have successfully met the goal? Are you required to show that you have done this?
- Identify your safeguards. Be sure to identify what you need to stay safe while meeting your goals. Do you need someone to monitor you? Do you need help with transportation? Is it safe and practical for you to complete the activity without assistance? Consider all the scenarios you might find yourself in and plan for them.
- Understand how to change the plan. If you feel like your plan is not working for you, it needs to change. Be sure you know the process for changing your plan. Ask how many times you can change a plan each year and how often your team reviews the plan. If you have this information, you will know what to do if there are problems.
- Know that you are in charge. Supports Coordinators are helpful, but they are overworked and under-funded. Don’t let them rush you or talk you out of something you believe is important to improve your life. These services and supports are about your life, so don’t back down.