Or. Admin. R. 411-328-0750 - Personalized Plans
(1) The
following information must be collected and summarized by the provider prior to
any ISP meeting:
(a) One page profile
reflecting, at a minimum, information gathered by the site where the individual
receives services;
(b)
Person-centered information reflecting, at a minimum, information gathered by
the site where the individual receives services; and
(c) Information about known, identified
serious risks.
(2) The
following information must be developed by the provider and shared with the
case manager and the individual, or if applicable the legal or designated
representative of the individual, as directed by the ISP or Service Agreement.
(a) Implementation strategies, such as action
plans, for desired outcomes or goals.
(b) Necessary protocols or plans that address
health, behavioral, safety, and financial supports.
(c) A summary of the provider risk management
strategies in place, including title of document, date, and where it is kept.
(d) A Nursing Service Plan, if
applicable.
(e) Other documents
required by the ISP team.
(3) The provider must maintain a copy of the
ISP or Service Agreement provided the case management entity and signed by the
provider.
(4) The provider must
participate in ISP team meetings as requested by the individual or the legal or
designated representative of the individual (if applicable).
(5) The provider must maintain documentation
of implementation of each support and services specified in sections (2)(a) to
(2)(e) of this rule in the ISP or Service Agreement for the individual. This
documentation must be kept current and be available for review by the
individual, the legal representative of the individual, the case management
entity, and Department representatives.
(6) INDIVIDUAL PROFILE.
(a) The provider must develop a written
profile within 90 days of entry. The profile is used to train new staff. The
profile must include information related to the history or personal highlights,
lifestyle and activity choices and preferences, social network and significant
relationships, and other information that helps describe an individual.
(b) The profile must be composed
of written information generated by the provider. The profile may include:
(A) Reports of assessments or consultations;
(B) Historical or current
materials developed by the case management entity or nursing facility;
(C) Material and pictures from the
family and friends of the individual;
(D) Newspaper articles; and
(E) Other relevant information.
(c) The profile must be maintained
at the service site and updated as significant changes occur.
Notes
Stat. Auth.: ORS 409.050 & 430.662
Stats. Implemented: ORS 430.610, 430.630 & 430.670
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