Each person or family participates in the development and ongoing review of a service plan that is the basis for delivery of appropriate, coordinated services and support.
NA The organization provides only legal services.
A service plan is developed with full participation of the individuals who receive services.
Interpretation: Service planning is conducted such that individuals and family members retain as much personal responsibility and self-determination as possible and desired. Individuals with limited ability in making independent choices can receive help with making decisions. When the service recipient is a minor, or an adult under the care of a guardian, the organization should follow applicable state laws or regulations requiring involvement or consent of service recipients’ legal guardians.
The service plan is based on the assessment, and includes:
Interpretation: The client should receive a copy of the signed service plan, sometimes called a service agreement, and other pertinent information. At intake or service planning an organization can also provide clients with a copy of relevant policies, including the organization’s conflict of interest policy, and use and protection of client information policy, to allay fears about providing information to service providers.
During service planning the organization explains:
The service plan addresses, as appropriate:
An expedited service-planning process is available when crisis or urgent need has been identified, and service plans are completed within timeframes established by the organization.
The worker and a supervisor, or a clinical, service, or peer team, review the case quarterly to assess:
Interpretation: Experienced workers may conduct reviews of their own cases. In such cases, the worker's supervisor reviews a sample of the worker's evaluations consistent with the requirements of the standard. Timeframes for service plan review should be adjusted depending upon issues, needs, frequency and intensity of services provided.
The worker and the family regularly review progress toward achievement of agreed upon goals, and sign revisions to service goals and plans.
Extended family members and significant others, as appropriate, and with the consent of the service recipients, may be invited to participate in case conferences and may be advised of ongoing progress.
Interpretation: The organization facilitates the participation of extended family and significant others, for example, by helping arrange transportation and involvement in scheduling decisions.