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Why Do We Use an Individual Service Plan?

Written by: Michael S. True, M.Ed and Linda MacDougall, M.A.



This article is copy protected and should only be reproduced by permission of the author. For information contact me at: mstrue1@hotmail.com .

Note: If you are seeking a much more in-depth analysis of any of the basic Individualized Program Plans, (I.P.P., I.H.P., I.S.P., etc., including teacher/administrator guidelines contact me at: mstrue1@hotmail.com. A transcript or CD MSWord file version is available for purchase for a nominal fee.



     As a direct-care provider on any level, you will most likely need to become familiar with a document called the Individual Service Plan. (Depending on your program this might also be called an Individual Program Plan, Habilitation Plan, or Education Plan.) This document will contain, perhaps the most important information about your consumer that you will need to know. It is a history, a list of things to do, and a plan for making future hopes and dreams a reality.

THE INDIVIDUAL SERVICE PLAN IS THE KEY TO QUALITY PROGRAMS AND SERVICES!

The Individual Service Plan is:

     UNIQUE to the individual. The person and those important to him/her design it for the documentation of needs, concerns, and to emphasize the personal priorities of the individual.

     GOAL oriented. It encompasses a persons major life components and goals, empowering and improving the individuals' decision-making abilities. Major areas of focus are cognitive, communicative, social/emotional, physical/medical, and adaptive development.

     STRUCTURED for success. It begins with assessments to insure that the roadmap to the individual's goals begins where the person currently is. Assessments inform the team of possible roadblocks as well as how best to assist the individual in reaching their goals. The goals are broken down into short-term goals or objectives that, as accomplished, provide skills needed to achieve the goal.

     SUPPORTED by the team and the staff that work with the person. Individual Service Plans promote independence by supporting the person, the family and the agencies involved. Family, agencies and all team members learn and work together to assist the consumer in achieving his or her desired goals.

     OUTCOME oriented. Accountability is built into the plan so each team member knows where, why, how, and what they are expected to do and by when to support the individual in meeting their goals. The team is also responsible for evaluating and revising the plan, as necessary.

     REINFORCED across domains. This means that the goals are worked on and carried to the individual's various environments so there is uniformity of expectations wherever the person may find themselves, (home, school, or community.

     PROVIDING the supports to make the difficult possible. For example, an augmentative communication devise takes ongoing training for the individual and those that work with him/her. Giving a device, but not supporting its use and mastery belittle everyone's efforts. Working toward the possible takes time, repetition and patience.

     Planning for any person's unique level of independence takes knowledge of that person's history and behavioral adaptations to circumstances. It takes knowing what medical hurdles interfere with optimum performance, including the individual's medications and side effects. A diagnosis is just words if we are unaware of what that means to the individual and their family. Planning takes empathy. It takes a desire to explore options, to find alternative paths.

A Brief History

     In the mid 1970s, a grass-roots movement arose amongst people with disabilities and the families of those individuals. Prior to this time, many disabled persons were treated as though they had an illness. They were often placed in state hospitals commonly called institutions. A medical professional would write orders and prescriptions to establish the "patient's" treatment. This system for providing care rarely included input from the person with the disability or their family. Doctors and psychologists evaluated the medical needs of the individual and prescribed treatment. This approach to case management became known as the medical model. This was the standard of care used in most institutional settings since the middle ages! It was time for a change.

     As persons with disabilities desired to have more control over their personal living conditions, care, and treatment, they began calling for a new design for support services. Parents also wanted to have more influence within the existing system of care, training, and treatment. Together they organized to lobby representatives at both the state and federal level to change the approach used to determine where an individual was placed and what opportunities could be made available to them. At this time, legislators, especially on a federal level began to respond to these concerns. Vocational training and public education were two of the first areas to be changed.

     The term, "Least Restrictive Environment, "began to be used to move individuals out of institutional settings and into community based programs. The public schools were now expected to provide a "free and appropriate education" to all children, including those with the most severe disabilities. This was a time of transition. Educators, physical therapists, occupational therapists, speech clinicians, vocational training specialists, and other non-medical personnel needed to be able to have more direct input into the planning process.

     The coordination needed to allow the individual consumer, his or her family, and each of the professionals involved the opportunity to contribute to planning efforts would need a new organizational model. By the late 1970s the new model, known as the interdisciplinary team approach, began to be used in many public schools, as well as, state sponsored and new community based nonprofit programs for the developmentally disabled.

     This team approach made possible three very significant changes. First, it made the person being served a key player in the planning process. This person-centered focus would reduce the previous stereotype of the individual being sick or having some disease. If the individual, now a consumer of services, were unable to participate, a court-appointed guardian, usually a family member, became actively involved in the process. This insured that much more attention would be given to optimizing personal development and that all consumer Human Rights issues would be looked at more closely.

     Second, a different team could be created in each program setting. This meant that only the persons who were directly involved in providing services in a given program would participate in the planning process at that program. This allowed the public school system, vocational training and placement programs, residential programs, and adult day programs to become separate and distinct community resources. Each would provide its own team of specialists. This gave the consumer and/or his or her family more choices. It also reduced the chances of being forced into a program that was not appropriate.

     Third, the planning and prioritizing of goals would now become a group effort. The decision to change a program plan could no longer be made by one individual. By discussing the strengths and needs of the consumer and presenting proposals for goals, agreements could be made which would allow everyone to work together in a cooperative manner. This greatly increased the chances of goals being met and skills being learned. It also created a situation in which program placement changes could be considered based on increases in consumer skills.

     By the 1980s many states were seeking federal funding, specifically through Medicaid to establish what were commonly referred to as group homes. These Intermediate Care Facilities, or ICFs provided supervised housing for up to six individuals, with medical support as needed.

     In order to justify activities within these homes for reimbursement of expenses, the ISP evolved to be a comprehensive document that gave a thorough overview of the consumer and the care and training he or she was receiving. The document allowed information to be presented by each member of the interdisciplinary team. It provided for a history of previous care and treatment, the prioritization of goals in the planning process, and the establishment of methods and timelines for implementation.

     Today the core of this document is used in thousands of social service programs throughout the United states.







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