Person-Centered Care Planning

The consumer (and, as desired, the consumer’s family) should have a strong role in determining the services that the consumer receives.  The consumer or representative should be vocal in expressing preferences.  Service planning decisions should be made with input from both service providers and the consumer, with the consumer having the right to appeal a decision with which he or she disagrees.

Contents – To access the full text, please click each sub-topic.

  • MCO must ensure consumer is primary focus: Arizona a
  • MCO must adhere to person-centered approach: Florida b
  • MCO must use patient-centered, holistic, service delivery approach: Hawaii c, Tennessee d
  • MCO must maximize enrollee self-determination including choice of services, providers, and living arrangements: Minnesota e
  • MCO must make consumer the center of planning process: New Mexico f
  • MCO must ensure care provided is adequate to meet enrollee’s needs: New York g 

  • Consumer reviews own needs as part of case management process: Arizona h
  • Consumer must agree to service plan: Arizona i
  • Care planning must include face-to-face discussion with consumer, consumer’s representative, and any other consumer-approved person: Florida j
  • Care plan must be developed by service coordinator in conjunction with consumer: Hawaii k
  • MCO coordinates services with input from consumer: Minnesota l
  • Consumer must be involved and in control during development of the individual service plan: New Mexico m
  • Individual care plan must be developed in consultation with consumer: New York n
  • Consumer must be part of care planning team: Tennessee o
  • MCO must ensure that each consumer has a meaningful opportunity to participate in consumer-centered plan: Wisconsin p
  • MCO must work with consumer and consumer’s family to assess and plan for discharge from hospital or other facility: Texas q

  • Case manager must assist consumer in identifying independent living goal: Arizona r
  • MCO must provide designated experts to provide information about independent living options: Arizona s, Florida t
  • Case manager and consumer must together develop consumer-specific, measurable goals: Florida u
  • Care plan must include consumer goals, objectives, and desired outcomes: Hawaii v, Minnesota w

  • Consumer has the right to grieve or appeal consumer-centered plan: Wisconsin x
  • MCO must develop policies and procedures for when consumer refuses to sign plan of care: Tennessee y
  • Consumer must be asked to sign service plan indicating agreement or disagreement: Arizona ``, Florida aa
  • Case manager must explain enrollee’s rights including procedures for filing a grievance, appeal and fair hearing: Florida bb
  • Case manager must provide notice of right to appeal if consumer disagrees with service plan: Arizona cc
  • If consumer disagrees with assessment or authorization of services, case manager must provide written notice of rights to file appeal: Florida dd
  • Care plan must be signed by consumer or representative: Hawaii ee, Texas ff
  • Consumer must sign risk agreement: Tennessee gg
  • Consumer may request to change service coordinator: Hawaii hh, Tennessee ii

  • MCO must consider appropriate services that will enable consumer to remain in home or other community placement: Hawaii jj
  • MCO must provide information regarding nursing facility versus living at home: Tennessee kk
  • MCO must ensure that consumer, consumer’s family, and consumer’s physician are informed of all service options available to meet needs in the community: Texas ll
  • Interdisciplinary team staff must have knowledge of community alternatives: Wisconsin mm

  • Care coordination/case management: Florida nn
  • Care coordination team: Tennessee oo
  • Care coordination unit: Tennessee pp
  • Care coordinator: Tennessee qq
  • Care management: New York rr
  • Interdisciplinary team: Wisconsin ss
  • Person-centered approach: Florida tt
  • Person-centered planning: Florida uu, Wisconsin vv
  1. Ariz. Contract, pp. 14-15.  (back)
  2. Fla. Contract, Atch. II, Exh. 5, p. 35.  (back)
  3. Haw. RFP, p. 155.  (back)
  4. Tenn. Contract, p. 108.  (back)
  5. Minn. Contract, p. 109.  (back)
  6. N.M. Contract, p. 46.  (back)
  7. N.Y. Medicaid Advantage Plus Contract, Sect. 10, p. 9.  (back)
  8. Ariz. Contract, p. 39.  (back)
  9. Ariz. Contract, p. 39.  (back)
  10. Fla. Contract, Atch. II, Exh. 5, p. 36.  (back)
  11. Haw. RFP, p. 162.  (back)
  12. Minn. Contract, p. 111.  (back)
  13. N.M. Contract, p. 44.  (back)
  14. N.Y. Medicaid Advantage Plus Contract, Sect. 10, p. 10.  (back)
  15. Tenn. Contract, p. 128.  (back)
  16. Wis. Contract, p. 48.  (back)
  17. Tex. Contract, p. 8-132.  (back)
  18. Ariz. Contract, p. 40.  (back)
  19. Ariz. Contract, p. 42.  (back)
  20. Fla. Contract, Atch. II, Exh. 5, p. 30.  (back)
  21. Fla. Contract, Atch. II, Exh. 5, p. 37.  (back)
  22. Haw. RFP, pp. 161-62.  (back)
  23. Minn. Contract, p. 111.  (back)
  24. Wis. Contract, pp. 144-45.  (back)
  25. Tenn. Contract, p. 131.  (back)
  26. Ariz. Contract, pp. 40-41.  (back)
  27. Fla. Contract, Atch. II, Exh. 5, p. 42.  (back)
  28. Fla. Contract, Atch. II, Exh. 5, p. 34.  (back)
  29. Ariz. Contract, pp. 40-41.  (back)
  30. Fla. Contract, Atch. II, Exh. 5, p. 39.  (back)
  31. Haw. RFP, p. 162.  (back)
  32. Tex. Contract, p. 19.  (back)
  33. Tenn. Contract, pp. 20, 119-20, 135.  (back)
  34. Haw. RFP, p. 158.  (back)
  35. Tenn. Contract, p. 154.  (back)
  36. Haw. RFP, p. 162.  (back)
  37. Tenn. Contract, p. 119.  (back)
  38. Tex. Contract, p. 8-132.  (back)
  39. Wis. Contract, p. 49.  (back)
  40. Fla. Contract, Atch. II, p. 8.  (back)
  41. Tenn. Contract, p. 5.  (back)
  42. Tenn. Contract, p. 5.  (back)
  43. Tenn. Contract, p. 5.  (back)
  44. N.Y. Medicaid Advantage Plus Contract, Sect. 10, p. 9.  (back)
  45. Wis. Contract, p. 49.  (back)
  46. Fla. Contract, Atch. H, p. 22.  (back)
  47. Fla. Contract, Atch. H, p. 23.  (back)
  48. Wis. Contract, p. 53.  (back)

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