Rhode Island Code of Regulations › Title 210 - Executive Office of Health and Human Services › Chapter 50 - Medicaid Long-Term Services and Supports › Subchapter 10 - Home and Community Based LTSS › Part 1 - "Medicaid Long-Term Services and Supports: Home and Community-Based Services (HCBS)" (210-RICR-50-10-1) › Section 210-RICR-50-10-1.5 - Person-Centered Planning

Current through June 14, 2024
A. Federal
				  regulations require states providing HCBS through Section 1915 and Section 1115
				  M edicaid waiver authorities to implement a person-centered planning process
				  (PCPP) that is driven by the Medicaid beneficiary. The PCPP serves as the basis
				  for the authorization of the Medicaid HCBS.
B. The person-centered planning process is
				  directed by a Medicaid LTSS applicant/beneficiary (or family members) for the
				  purposes of identifying the strengths, capacities, preferences, needs and
				  desired outcomes that become the core of an individualized plan of LTSS care.
				  The applicant/beneficiary will lead the person-centered planning process where
				  possible. The applicant's/beneficiary's representative should have a
				  participatory role, as needed and as defined by the applicant/beneficiary,
				  unless State law confers decision-making authority to the legal representative.
C. The LTSS applicant/beneficiary
				  may invite others to participate in the PCPP who may enable or assist in
				  identifying and accessing a personalized mix of paid and unpaid services and
				  supports that will assist him or her in achieving personally defined outcomes
				  in the most inclusive community setting. The applicant/beneficiary sets the
				  planning goals for achieving these outcomes in collaboration with the other
				  PCPP participants he or she has selected. The plan of care incorporates both
				  the personally defined outcomes of the applicant/beneficiary and the training
				  supports, therapies, treatments, and or other services the individual is to
				  receive to achieve those outcomes.
1.5.1
Principles of Person-Centered
				  Planning
A. State agencies that
				  administer programs that provide Medicaid LTSS in the home and community-based
				  settings adhere to the principles of the PCPP to the full extent feasible
				  pending full implementation of the process EOHHS-wide.
1. General principles -- The PCPP must be led
				  by applicant/beneficiary and include participants chosen by the
				  applicant/beneficiary. The PCPP strives to:
a. Inform and support. Provide the
				  information and support necessary for the applicant/beneficiary to direct the
				  process to the maximum extent possible;
b. Avert service delays. at times and
				  locations of convenience to the applicant/beneficiary;
c. Reflect personal values and preferences.
				  Be conducted in a manner that respects the values and prioritizes the
				  preferences of the applicant/beneficiary and in plain language;
d. Facilitate person-centered
				  consensus-building. Includes strategies for solving disagreements in a manner
				  that supports the interests and informed choices of the
				  applicant/beneficiary;
e. Offer
				  informed choice. Describes the full range of HCBS service options within the
				  applicable level of care tier or classification;
f. Promote community participation and
				  integration. Identifies how the outcomes and goals of the applicant/beneficiary
				  are strengthened and supported by social relationships, community
				  participation, employment, income and savings, healthcare and wellness,
				  education and others.
g. Encourage
				  independence. Identifies what services are self-directed.
h. Manage risks. Potential risks and
				  strategies for mitigating them, including back-up plans and providers.