Service Coordination

Service Coordination services establish, along with the person, a life-long, person-centered, goal-oriented process for coordinating the supports (both natural and paid), range of services, instruction and assistance needed by persons with developmental disabilities.

It is designed to ensure accessibility, accountability and continuity of support and services. This service also ensures that the maximum potential and productivity of a person is utilized in making meaningful choices with regard to their life and their inclusion in the community.

Based on assessed needs, services may include:
  • Assist the person and/or legal representative with re-determination of financial eligibility as required
    Ensure that the person is aware of their rights within the Waiver program.
  • Act as an advocate for the person.
  • Provide education, linkage and referral to community resources.
  • Promote a valuable and meaningful social role for the person in the community while recognizing the person’s unique cultural and personal value system.
  • Work with state management agencies on behalf of the person in regard to the assessment process, purchase of services and budget process.
  • Coordinate necessary evaluations to be utilized as a basis of need and recommendation for services in the development of the Individual Program Plan (IPP). Document the IPP and ensue that team members have access.
  • Convene and facilitate Individual Program Plans to determine the needs of the person.
  • Access the services, resources (Waiver and community) as detailed in the IPP.
  • Monitor that service providers implement the instructional, behavioral and service objectives of the IPP.
  • Monitor to ensure that the person’s health and safety needs are addressed.
  • Meet monthly with the person and their paid or natural supports that are present with the person the time of the visit at the person’s residence to verify that services are being delivered in a safe environment, in accordance with the IPP and appropriately documented. Check with the BMS fiscal agent monthly to verify financial eligibility.
  • Meet at least every other month with the person and their support staff at the person’s facility-based day program or pre-vocational center (if applicable).
  • Provide planning and coordination before, during and after crises.
  • Monitor any restrictive measures approved by the HRC to ensure the measures are implemented properly and reviewed at least annually by the HRC and by the IDT at every IDT meeting.