I have previously described the person-centered planning process required by the new CMS rules which will go into effect in March 2019. I noted that the new rule requires that the person-centered plan for our loved one at Misericordia be developed by someone who is not associated with Misericordia. It will likely be done by someone at Community Alternatives who does not know our family member. This increases the importance that we, as the legal guardians of our family members, actively participate in the planning process. There are several places in the person-centered planning process where our participation will be particularly important.
The new rule provides that the individual receiving services should choose who will participate in the planning process. As legal guardians, we should be sure to include in the process those at Misericordia who best know our family member and his or her needs. This will ensure that the plan that is prepared for our family member is the correct one for him or her.
The person-centered planning process must offer informed choices to the individual regarding the services and supports they receive and from whom. Many of our family members are not in a position to make these types of informed choices. That is why we were appointed their legal guardians. Therefore, we are the ones who should make the informed choices about what services and supports they receive and from whom.
The rules require that the plan reflect that the setting in which our family member resides is chosen by him or her. Again, for many of us, we must make that choice for our family member. The plan must also reflect individually identified goals and desired outcomes. As the legal guardians we should help identify those goals and outcomes.
Since Misericordia owns the homes in which our family member lives, the new CMS rules contain some additional requirements for these homes. However, these requirements can be modified if necessary because of the needs of the individual. In many instances, because of medical needs or cognitive ability, we will want to be sure that these requirements in the new rule are modified in our family member’s person-centered plan.
The additional requirements include:
1. The residential units have entrance doors lockable by the individual, with only appropriate staff having keys to the doors. I know that for my daughter, I do not want her to be able to lock the door to her room. She does not have the judgment to know when it is appropriate to lock the door and I would have serious concerns for her safety. There are other, more appropriate ways, to ensure her privacy.
2. Individuals are supposed to have the freedom and support to control their own schedules and activities. My daughter needs help in establishing her schedule and choosing activities.
3. Individuals are supposed to have access to food at any time. For medical reasons it would be unhealthy for my daughter to have access to food whenever she wants. In addition, she needs supervision when she eats so that she does not choke. I will want to be sure that her person-centered plan modifies this requirement to meet my daughter’s needs.
4. Individuals must be able to have visitors of their choosing at any time. My daughter lacks the judgment to make these types of decisions. For her safety, I will need to make sure that her plan modifies this requirement.
I hope the above gives you a sense of what the new person-centered planning process will be like and where you, as legal guardians, will play an important role. If you have any questions or comments about this issue, please feel free to contact me at This email address is being protected from spambots. You need JavaScript enabled to view it.
Scott