411-348-0430 Individual Support Plan (1) A program provider must collect and summarize the following information prior to a child's ISP meeting: (a) One-page profile reflecting, at a minimum, information gathered by the in-residence caregiver. (b) Person-centered information reflecting, at a minimum, information gathered by the in-residence caregiver. (c) Information about known, identified serious risks. (2) A program provider must develop and share the following information with a child's case manager, the child, and the child’s parent or guardian as directed by the child's 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 program provider's risk management strategies in place, including title of document, date, and where the document is located. (d) A Nursing Service Plan, if applicable. (e) Other documents required by the ISP team. (3) When desired by a child’s parent or guardian, the program provider, including the in-residence caregiver, must participate in the child's ISP team meetings. (4) A program provider must agree in writing to implement the portion of the ISP for which the program provider is responsible for implementing. Agreement may be recorded by a signature on the ISP or a Service Agreement. (5) A program provider must maintain a copy of the ISP or Service Agreement provided by the case management entity. (6) A program provider must maintain documentation of implementation of each support and services specified in section (2) of this rule in a child's ISP. The documentation must be kept current and be available for review by the child, the child’s parent or guardian, case management entity, and Department representatives. (7) INDIVIDUALLY-BASED LIMITATIONS. (a) A program provider, including the in-residence caregiver and staff, may implement structure and place reasonable restrictions on a child consistent with community parenting practices. The program provider is expected to collaborate with the child’s parent or guardian and ISP team in identifying reasonable limits and boundaries a child may require. (b) When a child’s individual health and safety needs necessitate a program provider to place limitations on the child’s home and community-based freedoms described in OAR 411-004-0020 that are more restrictive than community parenting practices, an individually-based limitation must be authorized and documented in the child's ISP in accordance with OAR 411-415-0070. (c) A program provider may not place any limitations on a child's freedom from restraint without an individually-based limitation, except in accordance with the standards for developmental disabilities services set forth in OAR chapter 411 or the relevant Title XIX Medicaid-funding authority. (d) When an individually-based limitation is implemented for a child, the program provider is responsible for all of the following: (A) Maintaining a copy of the completed and signed form documenting a child’s parent's or guardian's consent to the appropriate individually-based limitation. The form must be signed by the child’s parent or guardian and the case manager. (B) Regular collection and review of data to measure the ongoing effectiveness of, and the continued need for, the individually-based limitation. (C) Requesting a review of the individually-based limitation when a new individually-based limitation is indicated or change or removal of an individually-based limitation is needed. (8) TRANSITION SUPPORTS. The program provider, in coordination with the child’s ISP team, must document a plan, including specific strategies and responsibilities to support the child’s goal of returning to the family home or to an environment where the child may be successfully supported with less structured supports. Statutory/Other Authority: ORS 409.050, 427.104, 441.715, 443.450 & 443.455 Statutes/Other Implemented: ORS 427.104, 441.705-441.720, 441.740, 441.745, 443.384, 443.392, 443.400-443.445, 443.450, 443.455, 443.880, 443.881 & 443.991 History: APD 36-2019, adopt filed 10/29/2019, effective 11/01/2019