Toolkit for Creating Person-Centered Care and Service Plans

Practical Ideas to Improve the Care Planning Process

These resources provide practical ideas for improving the care planning process. The first set of practice-oriented resources is for professionals who develop and write care and service plans while the Policy and Practice document provides recommendations geared toward policymakers and health plan officials.

The Person-Centered Planning and Disaster Preparedness Guide and accompanying checklists on how to develop person-centered care and service plans — with attention to disaster preparedness  — were created specifically for:

• Anyone who writes care plans for individuals with disabilities and older adults
• Individuals whose care is guided by a care or service plan
• People who provide support to a person with a disability or an older adult and want to better advocate with them during the care planning process.

The guide will help care planning teams to:

• Learn about a person-centered care or service plan and what should be included
• Successfully prepare for the care-planning appointment
• Partner with individuals to create a care plan that fits their needs and goals
• Create accessible care plans
• Strengthen disaster preparedness practices

The act of developing a care plan is only one piece of person-centered care. It is critically important to address the barriers to receiving services, including shortages of paid caregivers, the long time it can take for caregivers to get approved, and the low wages paid to caregivers. To address these and other systems-level barriers to implementing person-centered care and service plans, we have created a set of policy and practice recommendations for policymakers and health plan officials.

In addition to the PDF resources, we share two videos that provide consumer perspectives on the care planning process and the impact a care plan has on a person’s life.