Through an individual directed approach, each individual, with assistance from the individual's team, is the designer of the services and supports reflected in the individual plan (IP). The provision of these services and supports may be influenced by health and safety considerations or resource limitations. This chapter applies to individuals living in the community, FRCs, and SRCs. The IP is: A single plan for the provision of services and supports to the individual; Directed by the individual; Outcome oriented; and Intended to specify all needed assessments, services, and training. The IP is a written plan which includes: Strengths and needs of the individual; Preferences and desires identified by and for the individual; Services to be provided to the individual by the licensee, such as: Habilitation; Medical; Occupational therapy; Physical therapy; Social; Psychological; Audiological; Speech and language; Nursing; Assistive technology; and Additional services to support an individual in retirement; A behavior plan, if required; Specific training and staffing ratios based on the needs, preferences, and desires of the individual; Measurable goals for the completion of outcomes; Target dates for the completion of goals; Implementation strategies and dates; Documentation of progress toward the achievement of goals; Monitoring procedures; Individuals responsible for providing the supports, services, implementation, and monitoring of the plan; Documentation indicating that the individual or the individual's proponents, when applicable, have been involved in, informed of, and agree with the plan; A determination of whether the needs of the individual could be met in more integrated settings; and For individuals residing in a State residential center, the written plan of habilitation consisting of: The treating professional's recommendation on the most integrated setting appropriate to meet the individual's needs; The resource coordinator's recommendation on the most integrated setting appropriate to meet the individual's needs; A description of the services and supports, including residential, day, employment, and technology, that are required for the individual to receive services in the most integrated setting; A listing of barriers that prevent the individual from receiving supports and services in the most integrated setting, including community capacity or systems, if community services are determined to be the most integrated setting appropriate to meet the individual's needs; and An annual update on the status and progress toward addressing and resolving any identified barriers to receiving supports and services in the most integrated setting. The resource coordinator, as defined in COMAR 10.22.09, shall ensure that: Each individual, other than an individual receiving respite services in the community, has an IP that is developed not more than 30 calendar days after receiving services; The IP is developed in a manner consistent with the values and outcomes in COMAR 10.22.04, and the provisions of any other relevant State or federal laws; Each individual is provided with a range of the most integrated setting service options that may be appropriate; and The IP meetings are held at a time and place convenient to the individual. If the individual does not have a resource coordinator, the licensee, in the following priority order, shall ensure that the requirements of this chapter are met: Community residential services licensee; Vocational or day services licensee; or Family and individual support services licensee. Written Plan of Habilitation for Individuals Residing in State Residential Center. The individual, a treating professional, and a resource coordinator shall develop the written plan of habilitation. On an annual basis and any other time requested by the individual, the treating professional and the resource coordinator shall discuss with the individual: The service and support needs of the individual; A range of the most integrated setting service options licensed through the administration that may be appropriate; and Any identified community-based Medicaid waiver services and any other services and supports that may be appropriate. The treating professionals and resource coordinator shall use any communication devices and techniques, including the use of sign language, as appropriate, to facilitate the involvement of the individual in the development of the written plan of habilitation. The team shall make decisions by consensus. If the team cannot reach a consensus, the resource coordinator shall mediate and resolve the issue of concern. If the resource coordinator cannot resolve the issue or if there is not a resource coordinator on the team, the appropriate regional director shall mediate and resolve the issue of concern. For individuals residing in a State residential center: If the team cannot reach consensus, the facility director shall mediate and resolve the issue of concern; and If consensus still cannot be achieved, the regional director shall mediate and resolve the issue of concern. Each IP shall be reviewed and approved, disapproved, or modified by: The executive officer or administrative head of the licensee or a qualified developmental disability professional whom the executive officer or administrative head designates; and One other professional individual who is responsible for carrying out a major program but does not participate in the IP. Approval of an IP shall be based on the current needs of the individual. The team shall review each IP at least annually, or more often as needed, and modify each IP as required by the individual's circumstances. Any member of the team may request a review or modification of the IP at any time. The licensee shall implement the supports and services that the licensee has agreed to provide, as indicated in the IP, within 20 calendar days. Health-General Article, §§7-1002 and 7-1006, Annotated Code of Maryland Effective date: April 13, 1977 (4:8 Md. R. 643) Regulations .01 — .06 repealed effective November 14, 1988 (15:23 Md. R. 2659) Regulations .01 — .09, Individualized Habilitation Plans, adopted effective November 14, 1988 (15:23 Md. R. 2659) Chapter, Individualized Habilitation Plans, repealed and new chapter, The Individual Plan, adopted effective July 26, 1999 (26:15 Md. R. 1148) Regulation .01 amended as an emergency provision effective July 10, 2008 (35:16 Md. R. 1388); emergency status extended at 36:2 Md. R. 96; amended permanently effective January 26, 2009 (36:2 Md. R. 100) Regulation .02B amended effective May 5, 2008 (35:9 Md. R. 897) Regulation .03A amended effective May 5, 2008 (35:9 Md. R. 897) Regulation .03C adopted effective May 5, 2008 (35:9 Md. R. 897) Regulation .04D adopted effective May 5, 2008 (35:9 Md. R. 897) Regulation .05 amended effective May 5, 2008 (35:9 Md. R. 897)