The Oregon ISP process includes standardized forms which are to be used whenever Medicaid-funded I/DD services are delivered.
2017 VersionsReader PDF: SDS 4115 Pro PDF: SDS 4115P Alternate Microsoft Word versions Purple text won’t show up in Microsoft Word? Follow these instructions to view “hidden text” on your computer. Translated versions available. |
Person Centered Information is the foundation of the planning process. The purpose of the form is to carefully and respectfully record the person’s perspective about a wide range of areas in his/her life. There is space for additional information to be added, when needed, and space at the end to note who contributed to this document.
Beginning in 2017, the document is provided in Adult and Youth versions.
The complete Person Centered Information form(s) is filed with the ISP at the CDDP or Brokerage.
Family members, as directed by the person, are encouraged to contribute information to this form. Providers that serve a person who lives in a Residential setting have a responsibility to update information on this form and share it with the SC/PA prior to the ISP meeting. See Person Centered Information in the ISP Manual.
2018 VersionsReader PDF: SDS 4116 Pro PDF: SDS 4116P |
2015 Versions – still valid for useStandard: 2-Risk_Identification_Tool_6-18-2015 |
This form is currently only available in English.
This tool is used to identify known, serious risks in the person’s life. Risks which are marked with a “Yes” response are recorded on the ISP Risk Management Plan along with the strategy to address the risk. This document is best completed or reviewed near the time of the Needs Assessment as similar information is covered.
The complete Risk Identification Tool is filed with the ISP at the CDDP or Brokerage.
Providers that serve a person who lives in a Residential setting have a responsibility to communicate any known changes in serious risks with the SC/PA in a timely manner.
2021 VersionsThe current version of the ISP form is dated 2/2021. Review the list of valid versions here. Reader PDF: SDS 4118 Pro PDF: SDS 4118P Translated versions available. |
The ISP begins with at least one One Page Profile, a positive introduction to the person, which can be customized to reflect the person’s personality and preferences.
The ISP reflects the person’s desired outcomes, career development plan, risk management plan, and chosen services. It has space to record any differences of opinion as well as any legal relationships present in the person’s life.
The complete ISP is filed at the CDDP or Brokerage. A copy of the ISP is provided to the person, his/her guardian or designated representative and any others directed by the person. Providers must receive a copy of the plan or a detailed service agreement or job description.
2017 VersionsReader PDF: SDS 4119 Pro PDF: SDS 4119P Having trouble viewing or downloading forms? Learn more about the PDF versions. |
2015 Versions – still valid for useStandard: 5-Change_Form_1-20-2015 This form is also available in the following languages: Arabic, Somali, Russian, Spanish, Vietnamese. |
A change form is used to document any agreed changes to the ISP or related materials. It may be initiated by the person, guardian, family, provider, or SC/PA. To streamline the change process, some changes may be made immediately by notifying ISP team members. Other changes, such as adding or discontinuing services, require approval. The change form provides documentation of what was changed, when it was changed, and who was notified or gave approval for the change.
Completed change forms are filed with the ISP at the CDDP or Brokerage. Providers must be notified of changes which impact the services they are expected to deliver, by providing a copy of the change form, changed document, or updated job description or service agreement.
For complete instructions, see the chapter called Making Changes in the ISP Instruction Manual.
Tools for implementing the ISP
Action Plans
- Basic example Action Plan format (Word, unlocked) (PDF)
- More detailed example Action Plan format (Word, unlocked) (PDF)
- Personal Action Plan This is an example of a simple action plan that could be used by anyone. It provides a framework for thinking through and recording specific steps they can take toward accomplishing a desired outcome. (Word)
Provider organizations are expected to develop implementation strategies, such as Action Plans, to train their staff how to support the person toward his/her Desired Outcomes. Provider organizations and foster providers are also free to create their own action plan templates.
Provider Risk Management Strategies
- Provider Risk Management Strategies form (Word) updated 5/14/2021
This form is prepared by provider organizations and foster providers who maintain written instructions such as protocols, safety plans, and other support documents for their staff or substitute caregivers to follow. This form is typically not used with PSWs or Independent Contractors, unless specifically directed by the SC/PA.
The ISP Risk Management Plan or the provider’s service agreement details the specific risks which are to be addressed in that setting. The provider organization or foster provider completes this form listing each identified risk and the document(s) that are in place to address it. The form includes space to list the title, date, and location where each document is kept.
Providers share an updated copy of this form with the SC/PA prior to the ISP meeting and anytime it is updated.
For more information about this topic, please visit our Support Documents page.
Other available forms
These additional materials are provided to support development and implementation of the ISP.
Who do you want involved in planning your life?
- Who do you want involved in planning your life? (Word)
Supporting Questions for Person Centered Information
- Supporting Questions for YOUTH (Supporting-Questions-Youth_5-1-17)
- Supporting Questions for ADULTS (Supporting-Questions-Adult-5-1-17)
These questions are provided as an additional, optional tool to assist you in gathering more meaningful Person Centered Information.
2017 Versions (available by 5/1/2017)Reader PDF: SDS 4117 Pro PDF: SDS 4117P Having trouble viewing or downloading forms? Learn more about the PDF versions. |
2015 Version – currently valid for useDownload form: 3-Agenda_1-20-2015 Other available languages: Arabic, Somali, Russian, Spanish, Vietnamese. |
This document serves as a record of the key topics discussed at the ISP meeting and the outcome of the discussion. It includes a number of topics to consider for discussion.
The complete ISP Meeting Agenda, if used, is filed with the ISP at the CDDP or Brokerage.
The person receiving services, his/her invited friends and family members, and providers may contribute discussion topics to the ISP meeting agenda.
Note that as of June 2016, a Discussion Record is also available. See elsewhere on this page.
Discussion Record
- Discussion Record (Word)
- Discussion Record instructions (ISP-Discussion-Record-Instructions-6-16-16)
A Discussion Record is an optional tool that ISP teams can use to record issues they have discussed and the outcome of their discussion. When referenced within the ISP or when accompanied by an ISP Change Form, the Discussion Record serves as a part of the person’s ISP.
Required Software
For best experience opening any of the PDF forms, please save the form to your desktop. Then open it in the free software “Adobe Acrobat Reader.” You may also use Internet Explorer 10+ if your Adobe Acrobat Reader plugin is up-to-date. You can download the latest version of Adobe Acrobat Reader at https://get.adobe.com/reader. Still need help? Contact us!
Other forms are provided in Microsoft Word version. They are intended for use with Microsoft Word 2007 and later, though they may also be used with earlier versions of Word with more limited functionality.