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1915(i) PERSON-CENTERED PLAN OF CARE North Dakota Department of Human Services Medical Services DivisionSUBMIT FORM THROUGH: North Dakota MMS Web Portal1915(i) Form 1Service providers must submit
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How to fill out 1915i person-centered plan of

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Step 1: Obtain a copy of the 1915i person-centered plan form.
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Step 2: Read through the instructions provided with the form to familiarize yourself with the requirements.
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Step 3: Begin by filling out the personal information section, which includes the individual's name, address, and contact details.
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Step 4: Move on to the medical history section and provide accurate information about the individual's health conditions, diagnoses, and medications.
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Step 5: Next, describe the individual's goals and preferences for care. This may include their desired living arrangements, daily activities, and support services they require.
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Step 6: Include information about the individual's support network, such as family members, friends, or caregivers who assist with their care.
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Step 7: Specify any additional support services needed, such as specialized therapies, medical equipment, or transportation assistance.
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Step 8: Review the completed form to ensure all relevant information is included and accurate.
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Step 9: Sign and date the form, indicating your agreement with the provided information.
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Step 10: Submit the filled-out 1915i person-centered plan form to the appropriate authority or agency.

Who needs 1915i person-centered plan of?

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The 1915i person-centered plan is designed for individuals who require long-term services and supports (LTSS) through Medicaid.
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These individuals may have physical or intellectual disabilities, mental health conditions, or chronic illnesses that require ongoing care and assistance.
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The plan is tailored to meet the specific needs of each individual, taking into account their preferences, goals, and community integration.
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It is particularly beneficial for individuals who wish to receive care in their own homes or community-based settings, rather than in institutionalized settings.
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The 1915i person-centered plan is a Medicaid plan that outlines how services will be provided to individuals with specific needs, ensuring their preferences and goals are centered in their care.
Service providers and support coordinators working with individuals eligible under the 1915i Medicaid option are required to file the person-centered plan.
To fill out the 1915i person-centered plan, one must gather information about the individual's needs and preferences, complete the required sections of the plan template, and ensure it is reviewed and signed by the necessary stakeholders.
The purpose of the 1915i person-centered plan is to create a tailored approach to care that aligns with the individual’s personal goals, ensuring they receive the appropriate services and support.
The report must include personal information about the individual, assessment results, identified needs, proposed services, and goals for the individual's care.
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