Developmental Disabilities Administration (DDA)
Provider Implementation Plan and Person-
Centered Plan Checklist
Nicholas Burton, CMRO Regional Director
Patricia Sastoque, Director of Programs
Rhonda Workman, Director of Federal Programs
April 9, 2021
Agenda
• Opening Remarks
• Provider Implement Plan
• Policy
• Template
• Provider Person Centered Plan Checklist
• Questions
2
Opening Remarks
• The purpose of today’s webinar is to provide an opportunity for the DDA
to share some tools, policies, and information that will assist in
streamlining the Person-Centered Plan (PCPs) communications,
development, and approval processes with the Coordinators of
Community Services (CCS) and Regional Offices
• We hope that by the end of our time together you will know more about
the Program Implementation Plan and the PCP provider checklist
3
Provider Implement Plan
• DDA providers have historically created service specific implementation
plans for people they support
• Provider’s implementation plans vary in terms of scope of information,
details, and length (e.g., some a few pages and others 30+ pages)
• The DDA previously sought input for a standardized Provider
Implementation Plan (PIP) policy and form
• The PIP policy and template was created based on previous input
4
Provider Implement Plan Policy
6
• Roles:
• Person and Authorized Representative will:
• Share information about needs
• Review the PIP with the CCS and provider
• Accept or reject the PIP
• Review PIP at least annually and more frequently based on
changes
• Choose another provider when the current provider no longer
meets their needs (e.g., outcome changes, progress is not being
made, or unhappy with services)
Provider Implement Plan Policy
7
• Roles:
• CCS will:
• Coordinate with providers
• Discuss needs and share information (e.g., goals, service units and
frequency, learning style, environmental engineering)
• Assess based on person’s needs and preferences
• Review PIP with person and their representative and share
requested changes with the provider
• Upload in LTSSMaryland
Provider Implement Plan Policy
8
• Roles:
• Provider will:
• Review person’s outcome, preferences, interest, communication,
and learning styles and other tools (e.g., HRST, SIS, BP, NCP)
• Identify appropriate staff for proper discussions with the CCS for
the PIP proposed service frequency, duration, scope, and plans
• Assess and advise CCS if able to provide service that aligns with
outcome as soon as possible and prior to PCP planning meeting
• Develop PIP and share with CCS, person, and their representative
• Revise PIP
Provider Implement Plan Policy
9
• PIP must:
• Document the service delivery implementation strategy for the
requested services to support the person’s chosen outcome
• Include specific strategies for goal implementation that are specific,
measurable, achievable, relevant to the applicant's or participant’s
identified outcomes, and have clear proposed timelines for
achievement (i.e., SMART Goals)
Provider Implement Plan Policy
10
• PIP shall be created:
• Upon receipt of a LTSSMaryland service referral to address a specific
outcome listed in the person’s PCP;
• Upon request from a participant self-directing services;
• Using the DDA PIP template form
• Participants and providers may include additional information,
such as their current implementation plans, as an attachment
associated with the PIP
Provider Implement Plan Policy
11
• Services and supports outlined in the PIP must be consistent with:
• Person’s PCP (e.g., goals, important to/for, risks); and
• Comply with applicable requirements governing each Waiver program
service requested in the PCP, such as the Waiver program service’s
definition, requirements, and limitations
• DDA will not authorize payment for any Waiver program service that is
not provided in accordance with applicable requirements
Provider Implement Plan Policy
12
• PIP shall be submitted to the participant, authorized representative (as
applicable), and the Coordinator of Community Services (CCS):
• New to services - Within five (5) business days of the LTSSMaryland service
referral acceptance or sooner;
• Annual PCPs - At least five (5) business days prior to the participant’s scheduled
annual person-centered planning meeting;
• Revised PCP - Within five (5) business days or team agreed date, anytime a
revision to the strategy needs to occur; and
• Emergency Revised Plan - Within five (5) business days of an Emergency Revised
plan
Provider Implement Plan Policy
13
• PIP shall:
• Be reviewed and updated as listed in the PCP outcome section and
more frequently based on changes to circumstances
• Be approved by the applicant/participant, or their authorized
representative
• Be uploaded in the PCP Document section of LTSSMaryland by the
CCS
Provider Implement Plan Policy
14
• PIP shall:
• Be based on what is known about the person;
• Be revised based on discovery of what is important to and for the
person through the person-centered planning process and service
delivery; and
• Contain “SMART Goals” which should be developed using information
gained through person-centered planning and discovery tools,
relevant assessments, the PCP, and other information that would help
inform how to support the person to achieve their goals
Provider Implement Plan Policy
15
• PIP shall:
• Include enough information so that any direct support staff could step
in to assist the person in completing the goal such as:
• The participant’s preferred learning style and communication
method;
• Specific strategies and learning steps (i.e., direct support staff
individual actions that need to be completed for success);
• Description of how integrated supports (e.g., natural or
community supports) will be used to help the participant attain
the goal;
Provider Implement Plan Policy
16
• PIP shall include (continued):
• Description of staffing levels, type of supports (e.g., verbal prompting,
hand over hand, line of sight, etc.), types of activities, and how often
an opportunity should be given to try or practice it, and for what
duration of time;
• Reference of Nursing Care Plan and/or Behavior Plan strategies to be
utilized and circumstances (as applicable);
Behavior
Plan
Provider Implement Plan Policy
17
• PIP shall include (continued):
• The method for evaluating success (e.g., how to determine what’s
working and what’s not working);
• Location(s) of service delivery site(s), such as the community (if in the
community environment); meaningful day provider site; residential (if
at residential setting), or home (if provided at a non-licensed site);
• Exactly match the outcome description statement in the person-
centered plan;
Provider Implement Plan Policy
18
• PIP shall include (continued):
• General staff position(s) (e.g., Direct Service Professional (DSP), Job
Coach, Nurse, etc.) responsible for assisting with goals is noted (Note:
As staff may change, specific staff names are not required);
• Documented information so that the participant, if they are able, and
the direct support staff can understand how to complete the goal;
and
• Completed using the DDA’s provider implementation plan form
Provider Implement Plan Policy
19
• The activities identified in the PIP shall take place in settings that:
• Meet the Community Settings Rule (CSR) (set forth at 42 C.F.R.§ 441.301(c)(4) and
COMAR 10.09.36.03-1); or
• Be locations which are not required to meet the Community Settings Rule at this
time, have a transition plan approved by DDA which will result in compliance
Note:
• All Family Supports and Community Supports services must meet CSR requirements
• All new services and new service site approved as of January 2018 must meet the CSR
requirements regardless of waiver program
Provider Implement Plan Policy
20
• Effective July 1, 2021:
• A PCP cannot be submitted to or reviewed by DDA unless and until a
PIP is submitted addressing each service associated with a provider
• The DDA Regional Office staff shall review the PIP to ensure it aligns
with the person’s identified outcome(s) and that the service is within
the scope of the Waiver program service’s definitions, requirements,
and limitations as part of the PCP authorization process
Provider Implement Plan Policy
21
• PIP Revisions
• Revised PIP goal steps, that do not result in a modification of the
service requested, shall be shared with the CCS who will upload to the
LTSSMaryland Client attachment section. No action is needed for the
PCP
• The last uploaded PIP associated with the participant’s outcome,
whether in the PCP or Client attachment section, is considered active
until a new PIP is submitted in LTSSMaryland
Provider Implement Plan Policy
22
• PIP Revisions
• Revised PIP that result in a modification of the service requested shall
be submitted with a Revised PCP, including when the participant
seeks a change in:
• Frequency of service delivery;
• Scope of services provided;
• Ratio (i.e., 1:1 or 2:1) of direct support staff implementing service
to the participant;
• Service type; or
• Their goals because they no longer align with the outcomes the
participant seeks
Provider Implementation Plan
Takeaways
24
Questions
25
Provider Person Centered Plan Checklist
26
• DDA
recommended
optional
Provider
specific tool to
support the
development
and
authorization of
the PCP
Provider Person Centered Plan Checklist
27
When completing the
DDA Provider Application,
providers were asked to
indicate which service,
waiver program, and age
group they wanted to
provide services.
Provider Person Centered Plan Checklist
28
If either the provider or site that the participant prefers is not
available because the provider did not indicate on their application,
has not completed the ePREP process, or due to a system issue, they
should proactively follow up the RO Provider Relations staff
● CMRO - Jessica Xander (Jessica.Xander@Maryland.gov)
● SMRO - Teresa Nataline (Teresa.Nataline@Maryland.gov)
● ESRO - Andrea Jones (Andre[email protected])
● WMRO - Timothy Jenkins (Timothy.Jenkins@Maryland.gov)
Provider Person Centered Plan Checklist
31
Provider Person Centered Plan Checklist
32
Risk and Rights Restriction
• Individual Record
• Health and safety risk
and how they are being
addressed
• Restrictions noted in
Behavioral Plan or
Nursing Care Plan
• Mitigation strategies
Provider Person Centered Plan Checklist
33
Service Authorization
• Upper Pay Limits
• Dedicated hours
• Meaningful Day 1:1/2:1
• Personal Supports 2:1
• Documentation to
support assessed need
Provider Person Centered Plan Checklist
34
Guidance, Resources, & Tools
• PCP planning resources
• FAQs
• DSAT
• CDT
• Charting the LifeCourse
• SD Guidance, Forms, and
Webinar
• Guidance on Operating in
PCIS2 and LTSSMaryland
• PolicyStat
• Calculator – Hour to 15
minute
Provider PCP Checklist
Takeaways
35
