Case Management
Individual Support Planning
A plan of care is required for all Medicaid waiver participants. The Individual Support Plan (ISP) is Tennessee’s format for the federally required plan of care. The ISP is the roadmap for implementing services that meet a service recipient’s unique needs. The ISP also serves as the vehicle for justifying the service recipient’s need for services so that services can be authorized by the DMRS Regional Offices. The ISP is to clearly describe needs and the services and supports required to meet those needs.
Each ISP must be submitted for review by DMRS staff prior to its effective date. This review process ensures that the plan meets basic requirement, addresses the person’s needs, and supports the need for the services being requested.
Once this review process is completed, DMRS staff will authorize the services being requested. They may authorize all services requested, some of the services requested, or none of the services requested. Some services may be partially approved. That means that they may be approved, but for fewer hours than requested. If any service is denied or only partially approved, the person has the right to appeal this decision and have a hearing with an Administrative Law Judge.
For more information regarding the appeals process, click here. (Link to appeals information.)
