Submit the completed Person-Centered Service Plan Template to the relevant care manager or service provider as directed. The submission can typically be done via email, fax, or an online submission form. Always ensure that contact details and submission instructions are followed accurately to avoid delays.

This template should be reviewed and updated periodically, especially during the annual reassessment of the service plan, or any time there are significant changes in the individual's condition or circumstances.

The purpose of the Person-Centered Service Plan Template is to provide a structured and organized format for documenting an individual's preferences, strengths, and goals. This enables care managers, healthcare providers, and social workers to create effective and personalized service plans that meet the individual's unique needs. In addition, the template helps identify any unmet service needs and justify why they are necessary, ensuring that all aspects of the person's well-being are addressed adequately. By maintaining an up-to-date and accurate service plan, the template supports the holistic care approach and continuity of care for the individual's overall well-being.

• 1. Authorization Period: The timeframe during which the service plan is valid.
• 2. Date Issued: The date when the service plan was issued.
• 3. Personal Information: Includes the individual's name, address, phone number, email address, date of birth, and preferred language.
• 4. Care/Case Manager Info: Details about the care/case manager, including name and contact information.
• 5. Preferences and Strengths: Information about the individual's preferences and strengths based on their input and known details.
• 6. Goals/Desired Outcomes: Identification of the individual's health care and social goals, along with strategies to achieve them.
• 7. Description of Services: Details of the services the individual is currently receiving, including scope, unit and frequency, duration, and provider information.
• 8. Unmet Service Needs: Identification of any services the person needs but does not have, along with justifications and plans to address these needs.
• 9. Informal Supports: Details about unpaid supports and their relationship to the individual, including contact information, role, and frequency of service.

Failing to submit the Person-Centered Service Plan may result in gaps in service provision and unmet needs. It is crucial to submit this form on time to ensure continuity of care and support for the individual.

• Service Interruption: Failure to submit may lead to a disruption in services provided to the individual.
• Unmet Needs: The individual's needs may not be adequately addressed without a completed service plan.
• Lack of Documentation: Important information about the individual's preferences, strengths, and goals may not be properly documented.

• 1. Initial Assessment: Use the form during the initial evaluation of the individual's needs and preferences.
• 2. Annual Reassessment: Update the form annually to reflect any changes in the individual's circumstances or goals.
• 3. Significant Life Changes: Revise the form whenever there are major changes in the individual's health or living situation.
• 4. Care Plan Reviews: Utilize the form during regular reviews of the individual's care plan to ensure it remains relevant and effective.