What is an Individual Support Plan (ISP)?
An Individual Support Plan (ISP) is the foundation of care under the Supports Waiver Program. It is a person-centered roadmap designed to outline a participant’s goals, services, and supports, ensuring their needs and preferences are met. The ISP focuses on enhancing independence, community integration, and overall well-being.
This guide explains the essential components of an ISP, the budget development process, emergency planning, and the approval steps required to implement it successfully.
Key Components of the Individual Support Plan
Each ISP is tailored to address a participant’s unique needs and goals, ensuring their care aligns with their lifestyle and preferences. The primary components include:
1. Personal Care
The ISP identifies support needed for daily living activities, such as hygiene, meal preparation, and mobility. These services ensure participants can remain safely in their homes.
2. Community Membership
This section focuses on promoting social and community engagement through activities like employment, volunteering, or joining community groups. Supports may include Supported Employment and Customized Community Supports.
3. Health and Wellness
Health-related goals are addressed through services like Behavior Support Consultation and Assistive Technology. This ensures participants have access to tools and resources that enhance their physical and mental well-being.
4. Other Supports
Supports like Non-Medical Transportation, Respite Care, and Environmental Modifications are included to enhance participants’ independence and quality of life.
5. Emergency Back-Up Planning
Every ISP includes a mandatory emergency back-up plan that outlines who will provide services if primary providers are unavailable. This ensures care continuity during unexpected situations.
Budget Development and Management
A critical part of the ISP process is developing a budget that aligns with the participant’s annual allocation and needs. The budget is created collaboratively by the participant and their Community Support Coordinator (CSC).
Key considerations in budget development:
- Reasonableness: All expenses must be necessary, cost-effective, and directly related to the participant’s disability.
- Transparency: Each service or support is clearly outlined with costs, frequency, and duration.
- Flexibility: Budgets can be adjusted as participants’ needs change, ensuring their care remains effective and person-centered.
Participants are encouraged to work closely with their CSC and Fiscal Management Agent (FMA) to monitor expenditures and ensure compliance with Supports Waiver guidelines.
Emergency Back-Up Planning
Emergencies can arise at any time, making a robust back-up plan essential for every ISP. This plan includes:
- Identified Contacts: Trusted individuals or agencies who can step in if primary caregivers are unavailable.
- Action Steps: Clear instructions for accessing services in an emergency.
- Provider Responsibilities: Agencies listed in the plan must ensure back-up employees are available to avoid service interruptions.
The back-up plan is reviewed regularly by the participant and CSC to confirm its effectiveness and accuracy.
ISP Review and Approval Process
Before services outlined in an ISP can begin, the plan must be submitted to the Third-Party Assessor (TPA) for review and approval. This process ensures that all services and supports comply with Medicaid regulations and meet the participant’s needs.
Steps in the Approval Process:
- Initial Submission: The CSC submits the completed ISP, including the budget, to the TPA.
- Documentation Review: The TPA verifies that all requested services are necessary, reasonable, and align with the participant’s goals.
- Approval or Revisions: If approved, services can begin immediately. If revisions are needed, the CSC assists the participant in addressing any issues.
Participants should ensure their ISP is submitted at least 30 days before their current plan expires to avoid interruptions in care.
How the New Mexico Support Network Can Assist
The New Mexico Support Network is an invaluable resource for participants creating or updating their ISPs. Their services include:
- Expert Guidance: Helping participants identify goals and supports that align with their needs.
- Budget Assistance: Ensuring budgets are clear, reasonable, and within the annual allocation.
- Approval Support: Navigating the TPA review process and addressing any required revisions.
- Workshops and Training: Providing tools and information to help participants take an active role in their care planning.
With the help of the New Mexico Support Network, participants can create ISPs that maximize their independence and quality of life.
Why ISPs Are Essential for Participants
An effective ISP is more than a document—it’s a dynamic tool that empowers participants to live independently, engage with their community, and achieve their personal goals. With proper planning and support, ISPs ensure every participant receives the care and services they deserve.
