	Services for Individuals with Developmental Disabilities

Introduction

Administration and Management

Service Delivery Administration Standards

Service Standards

DDS 4: Person-Centered Service Planning and Monitoring

Person-centered service planning engages persons with developmental disabilities and their team as primary decision makers regarding the services and supports they receive.

Interpretation: Generally, all decisions are made with the informed consent of the individual or guardian. Unless otherwise noted, informed consent is not necessarily written. However, the fact that consent was given should be noted in the individual's case record.

Research Note: Portable funding, also known as “individual budgets,” is becoming increasingly commonplace as a mechanism for funding flexible, consumer-directed services. Portable funding provides the individual with a sum of money and the individual can choose the services they need.

DDS 4.01

The organization works in partnership with the individual, and his or her team according to the wishes of the individual, to develop and implement a plan that enables the fullest and most independent life possible in the community and promotes self-determination.

DDS 4.02

Individuals with limited ability to make independent decisions receive help from the team in making choices and/or assuming responsibility for making decisions.

DDS 4.03

The service planning process includes a means for resolving conflicts between the individual and his/her family, advocate, or others that may be involved in establishing and implementing the individual's plan.

DDS 4.04

The service plan is based on the assessment, and includes:

agreed upon goals, desired outcomes, and timeframes for achieving them;
services and supports to be provided, and by whom; and
the written, informed consent of the individual.

DDS 4.05

During the service planning process the organization explains to the individual or guardian:

available options;
how it can support the achievement of desired outcomes; and
the benefits, alternatives, and any risks or consequences of planned services.

DDS 4.06

Service planning for persons with developmental disabilities can address, as appropriate to the individual:

health and safety issues;
degree of supervision needed;
independent living, social, and daily living skills;
nutritional and dietary needs;
leisure and vocational interests, aptitudes, and need for greater social inclusion;
screening and treatment for co-occurring psychiatric disorders or substance use conditions;
the need for assistive technology, auxiliary aids, and other special accommodations;
positive behavior support planning;
medication needs;
issues related to adaptive, behavior, and cognitive functioning, including concrete and abstract reasoning;
specialized supports such as physical, speech, and occupational therapy;
ancillary services;
end of life planning; and
the need for hospice or palliative care.

Research Note: Research suggests that the prevalence of mental illness among individuals with intellectual disabilities is higher than among the general population.

Research Note: Research suggests that persons with intellectual disabilities are less healthy, have more specialized healthcare needs, and have greater difficulty gaining access to health and dental services than the general population.

Research Note: Positive behavioral support (PBS) has been shown to be effective at reducing problem behavior and enhancing the overall quality of life and lifestyle of the individual.

DDS 4.07

The worker, the individual, and members of his/her team, as appropriate, review progress quarterly to assess achievement of service goals and desired outcomes, and the continuing appropriateness of these goals.

Interpretation: Timeframes for the review should be adjusted depending upon the specific needs of the individual and the frequency, intensity, and type of services provided. Revisions to service goals and plans are signed by the individual in the case record.

QUICK JUMP TO


	PURPOSE: Children, youth, and adults who participate in Services for Individuals with Developmental Disabilities achieve full integration and inclusion in the mainstream, make choices, exert control over their lives, and fully participate in, and contribute to, their communities.

RELATED FILES


	SERVICE One or more organization-operated programs or activities that have a common general objective and deploy the organization's material and human resources in a planned and systematic manner. An organization that publicly promotes or identifies itself in writing as offering a service, is licensed to deliver a service, assigns personnel and/or space to a service, or allocates financial resources to a service is considered to offer that service.


	PLANNING The process of specifying objectives, evaluating the means for their achievement, and exercising deliberate decision making about appropriate courses of action.


	INFORMED CONSENT The explicit granting of permission by a consumer or his/her legal guardian to the service provider and organization to use a specific intervention or participate in research. The consent is predicated on full disclosure of the facts to enable the consumer to make a decision based on knowledge of the risks and alternatives.


	CASE RECORD A written compilation that describes the client and the services delivered. Records can be in hard copy and/or electronic format. The case record can be used as a source of information for quality improvement or other evaluation activities, for research purposes, or to demonstrate accountability to funding bodies.


	CONSUMER The individual, family, group, or community that seeks or receives services.


	COMMUNITY A specific group of people living in the same locality and who may share a common culture, values, and norms. Communities can also be defined by race, religion, ethnicity, age, occupation, political status, tribal affiliation, interest in particular problems or outcomes, or other common bonds. The term "community" encompasses worksites, schools, tribes, residential neighborhoods, business districts, recreational areas, and health and human service sites.


	FAMILY Two or more people who consider themselves family and who assume obligations, functions, and responsibilities generally essential to healthy family life. Child care and child socialization, income support, long-term care, and other caregiving are among the functions of family life. The definition of "family" will rest with an individual's indication of who plays a family member role, including current or former foster family, adoptive family, extended family members, fictive kin, or significant others. Organizations that believe family is the central constellation in a child's life, and that family attachments are of primary importance for human development, will strive to work with professional staff to develop a common understanding of "family."


	SERVICE PLAN A written plan of action based on the assessment of consumer needs and strengths that identifies problems, sets goals, and describes a strategy for achieving those goals and engaging in joint problem solving with the consumer. Also known as a "treatment plan".


	ASSESSMENT An evaluation, which utilizes professional expertise and skills in the collection and analysis of data to understand and describe the nature of service needs of an individual, family, or group. Assessment, as in needs assessment, is also used to determine priorities of program planning and service development for the organization as a whole. See also DIAGNOSIS.


	SUPERVISION Assumption of responsibility for directly overseeing and evaluating the work or work products of personnel within an organization. Also includes inspecting the act or process of accomplishing a function or activity.


	ASSISTIVE TECHNOLOGY The commercial or custom-designed devices, modifications, accommodation strategies, and/or related technical services that help persons with disabilities increase, maintain, or improve their functional capabilities.


	MEDICATION A prescribed or over-the-counter drug that is injected, taken orally, applied topically, or otherwise administered.


	RESEARCH For purposes of COA accreditation, all forms of internal or external research involving persons served except internal program evaluation and outcomes research, or educational projects performed by students and interns that are part of their professional training.


	QUALITY In this context, the extent to which contemporary and generally recognized standards for professional practice are met and exceeded, and desirable service outcomes achieved.


	SERVICE GOALS Broad, issue-oriented statements that reflect the realistic achievements to be accomplished in the short or long term. Goals are achieved through the accomplishment of specific quantifiable objectives.


	APPROPRIATENESS The degree to which a particular service, placement, treatment, intervention, or activity is: best suited to an individual's needs; not excessive, unduly intrusive, or restrictive; anticipated to be effective in achieving the desired and specified outcomes; and adequate or sufficient in quantity to address the problem.