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Hear from COFAR
Voice your opinion
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During the ISP review, your service coordinator must provide any new or updated assessments of your ward or family member, and must review monitoring reports generated by the DMR and the provider. In consultation with the ward or family member, guardian, family members, and other team members, the service coordinator may make appropriate revisions to the ISP based on a review of the following:
- The satisfaction of the individual and others, including the individual's family and guardian;
- Progress toward achieving the goals identified in the ISP; and
- Any significant changes in the individual's circumstances or abilities;
- A determination "whether the goals identified in the ISP are consistent with the current desires and needs of the individual and whether the strategies and supports identified in the ISP continue to be the least restrictive, appropriate and available strategies and supports to promote achievement of those goals"; and
- The continued effectiveness and appropriateness of any authorizations given by the individual, his or her guardian, if any, a court, or other authority.
NOTE: In a stipulated agreement in December 2004 in federal court, DMR agreed that it would not use the annual ISP review to encourage or suggest transfers or relocations of persons in the DMR system from their residences. The agreement was part of litigation in the Ricci v. Okin case before U.S. District Court Judge Joseph Tauro. Judge Tauro, who had disengaged from the case in 1993, resumed hearings in 2004 after the Romney administration announced it intended to close remaining state Intermediate Care Facilities for the mentally retarded (ICFs/MR) and ultimately transfer their residents to community-based care. According to the stipulation, DMR can only discuss transfers to new locations during the ISP modification process (see below). Regulatory protections under the ISP modification process for families and guardians whose wards are facing such transfers are discussed later in this section under Transfer Regulations.
ISP modifications
DMR regulations (115 CMR 6.25) spell out requirements and timetables for making changes at any time in your ward's or family member's ISP. The regulations note that these modifications can occur when there are changes in the person's goals and needs, or if necessary to promote the quality of life issues discussed earlier, or to promote "the least restrictive, most adequate and appropriate supports consistent with the individual's desires and needs."
The ISP modification process
Under 115 CMR 6.25 (3), requests for ISP modifications must be addressed to the service coordinator and may be made by the ward or family member, the guardian, the service coordinator, a current service provider, or the person's designated representative.
After receiving a request for an ISP modification, the service coordinator must convene a meeting within 30 days to determine whether the modification should be made [115 CMR 6.25 (4)]. The meeting participants must be given at least 10 days notice of the meeting.
Within ten days after a modification meeting, the recommended modifications must be reviewed by the area or facility director or his or her designee, and approved or disapproved [115 CMR 6.25 (7)]. The service coordinator must notify the participants of the decision on the requested modification and of their right to appeal the modification under 115 CMR 6.63 or 115 CMR 6.30 through 6.34.
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