Person-Centered Thinking,
Planning, and Practice:
Representative Examples of
State Definitions
Prepared by Jane Lawrence for NCAPPS
September 2020
1
Introduction
The purpose of this document is to identify state- or agency-specific, clearly stated
definitions of person-centered thinking, planning, or practice. The premise is that if
an agency has a clear definition, shared internally and embraced by multiple
stakeholders, the likelihood of person-centered practices being implemented would
be increased. Thoughtful and consistent implementation of person-centered
approaches can then result in positive outcomes for individuals receiving support,
with increased opportunities for choice and meaningful participation in the
community.
This document is one in a series of environmental scans to support National Center
on Advancing Person-Centered Practices and Systems (NCAPPS) technical assistance
and may serve as a useful tool for other human service agencies interested in
enhancing person-centered thinking, planning, and practice. The 2019 NCAPPS
resource
Person-Centered Thinking, Planning, and Practice: A National
Environmental Scan of Definitions and Principles includes definitions from federal
agencies, such as the Administration for Community Living (ACL) and the Centers for
Medicare and Medicaid Services (CMS), as well as federal legislation, including the
Affordable Care Act and the Americans with Disabilities Act, and definitions used by
other national organizations. In 2020, the National Quality Forum issued its
Person-
Centered Planning and Practice Final Report containing a definition developed by a
multi-stakeholder committee of people with lived and professional experience in long-
term services and supports across health and disability systems.
Although there are now a range of strong national definitions of person-centered
thinking, planning, and practice, many state human service agencies find it important
to develop their own local definitions for use in policy statements and implementation
protocols. This environmental scan serves as a starting point for state, tribal, and
territory human service agencies as they operationalize person-centered approaches
in their local contexts. This document extends our national environmental scan and
the work of the National Quality Forum by providing representative examples of
definitions used by state human service agencies throughout the nation.
Method
This resource is an environmental scan of publicly available information from state
agencies typically responsible for home and community-based services. The
definitions selected were uncovered through internet searches for each state, using
the terms “person-centered” or “person-centered planning.” Recognizing that state-
specific definitions would be useful for a variety of stakeholders, including people
with lived experience, we used popular consumer search sites such as Google and
Yahoo to conduct the searches. Most of the definitions were available on the websites
of state agencies responsible for administering long-term services and supports, such
as the state Medicaid agency or the state’s Department of Human Services. In
addition, the search function on each state’s website was used to identify other
Representative Examples of State Definitions
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resources and information. Some state websites included links to educational
institutions, advocacy groups, and University Centers on Disabilities. There were a
significant number of links to slide presentations focusing on person-centered
thinking, planning, or practices. Many of these materials could be useful in
developing definitions and implementation protocols; however, when there was no
author, date, or other source information provided, they were not included in this
document.
Representative Examples of State Definitions
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Themes
In reviewing definitions from all 50 states and the District of Columbia, a number of
common themes emerged that are outlined here.
Revising Existing Policies to Emphasize Person-
Centered Approaches
One approach a number of states have taken is to re-frame required service planning
within the context of person-centered planning. In so doing, policy manuals and
protocols reflected a substantive change from deficit-focused assessment and
individual plans. A number of state policy manuals and implementation guidelines
clearly reflect the core values and principles of person-centered thinking, including a
focus on the person’s strengths, capabilities, and preferences. This is sometimes done
by drawing a contrast between a traditional or status quo deficit-based orientation
and a newer person-centered orientation. For example, the Alaska Division of Senior
and Disabilities Services published the
Alaska Aging and Disability Resource Center
(ADRC) Person Centered Intake Training Guide. Although this is primarily a technical
document related to their intake process, the section “Introduction of Person-
Centered Thinking and Goals” provides a succinct comparison of traditional planning
and person-centered approaches.
However, in some instances, the term “person-centered” appeared to be simply
replacing “individualized” in service planning guides and other policy statements. It is
unclear if these states have also invested in training on the fundamentals of person-
centered work, or if thoughtful consideration of the effort required to transform a
system has occurred. Clearly, renaming service and program planning as “person-
centered” does not guarantee that person-centered thinking and practices are being
implemented.
Home and Community-Based Services (HCBS) Final
Rule
1
1
- CFR 42 §441.301(c)(1) and CFR 42 §441.301(c)(2);
https://www.medicaid.gov/medicaid/hcbs/downloads/final-rule-slides-01292014.pdf
Compliance
In several states, the revision of policy and procedure manuals was tied to the state
agency’s efforts to comply with the HCBS Final Rule. State websites included links to
presentations outlining the requirements of the rule, and an overview of person-
centered planning was typically included. For example, this presentation
from the
West Virginia Department of Health and Human Resources includes a definition of
person-centered planning in its detailed description of the HCBS requirements. The
presentation
“Nothing About Me, Without Me” from the Kansas Department for
Representative Examples of State Definitions
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Aging and Disability Services highlights Centers for Medicare and Medicaid Services
(CMS) guidelines, the role of care coordination, and integrates key characteristics of
person-centered thinking and planning throughout. The Michigan Department of
Health and Human Services Behavioral Health and Developmental Disabilities
Administration cites both state law and federal regulations in their
Person-Centered
Planning Policy. Notably, leading with the HCBS Final Rule in overview documents
and definitions risks placing an overemphasis on compliance rather than the
principles of person-centered thinking, planning, and practice that underpin the
HCBS Final Rule.
Adopting Established Approaches and Resources
Over the last 30 years, person-centered planning methodologies have evolved to guide
conversations with people and families about their plans for the future. Commonly
used planning approaches include definitions of person-centeredness or person-
centered planning. In reviewing state definitions, the influence of well-established
approaches was clear in the way several states defined person-centered thinking,
planning, and practices. Some states specifically identified the resource that guided
the development of their definitions; in other states, the influence was implicit, but
just as clear to someone familiar with the approach.
For example, Michael Smull and Susan Burke-Harrison at the University of Maryland
developed Essential Lifestyle Planning to guide planning for people moving out of
institutional settings.
2
2
From The Learning Community website, accessed 8.30.20.
As this and other planning methods became more widely
known, state agencies and community organizations looked to leaders in the
movement for training and resources. Informal networks of leaders and practitioners
shared their experiences as the body of knowledge around person-centered
approaches grew. Today, The Learning Community for Person Centered Practices
is a
formal network of people who provide training and technical assistance on person-
centered thinking and planning. The impact of their work was evident in reviewing
state definitions. For example, the Massachusetts Department of Developmental
Services website includes a
video of Michael Smull discussing the definitions of
person-centered approaches. The Oregon Department of Human Services includes a
link to The Learning Community on its website. The concepts of what is “important
to” and “important for” a person, as well as planning tools such as the One Page
Profile and Good Day/Bad Day, were frequently included in state training materials,
policy manuals, and forms. Their influence was present in a number of state
definitions, resources, and policies, even when no specific reference was made to The
Learning Community.
Charting the LifeCourse is another approach to person-centered work that influenced
several state’s definitions and planning resources. The LifeCourse framework is used
to support the development of a person’s vision of a good life; it was developed at the
Institute for Human Development at the University of Missouri-Kansas City in
partnership with numerous stakeholders. Indiana has adopted Charting the
Representative Examples of State Definitions
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LifeCourse as the basis of its conceptual framework for the development of support
plans. Their Person-Centered Individualized Support (PCISP) Guide
includes a
description of the life domains of the LifeCourse framework, and various elements of
it are integrated into the protocols for case managers to develop support plans.
Hawaii is another state that has incorporated the LifeCourse framework into their
planning process for services for people with developmental disabilities.
Plain Language Resources
Several states provided information about person-centered planning using plain
language and written in the second person; for example, Michigan’s Behavioral
Health and Developmental Disabilities Administration developed
“How Person-
Centered Planning Works for You.” This resource uses a question and answer format
and includes a glossary of terms used throughout the booklet. A search of the New
Mexico Department of Health website resulted in a link to a similar
fact sheet on
person-centered planning.
Collaboration within States
In reviewing each state’s available information on person-centered practices, an
attempt was made to determine if similar definitions were used across disciplines
within state agencies. For example, most definitions were identified in the context of
planning for services for people with intellectual or developmental disabilities. Some
examples were specific to behavioral health supports. Occasionally, the only result
from the internet search was to a definition used in the state’s educational system,
often specific to transition planning for students with disabilities. Although evidence
of coordination across state agencies was rare, there were a number of examples of
states collaborating with other institutions or organizations to develop definitions,
training, and other resources. The Center for Discovery, Integration and
Transformation at The University of Southern Mississippi
collaborated with the
Mississippi Division of Medicaid on their Person-Centered Practice Initiative. The
webpage of the Pennsylvania Department of Human Services that
defines person-
centered planning was based on a document developed by the Pennsylvania Self-
Determination Consumer and Family Group and the Pennsylvania Office of
Developmental Programs. And a
fact sheet on Person Centered Planning was
developed by the Georgia Department of Education and Parent to Parent of Georgia.
Representative Examples of State Definitions
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Examples
As evidenced by the range of definitions identified, there is no single “correct”
definition of person-centered thinking, planning, and practice. However, several key
principles are common to most definitions, including a focus on the person, an
understanding of the importance of choice and self-determination, and a commitment
to full inclusion and access to the community. The examples included in this resource
represent a variety of descriptions of person-centeredness, often including specific
definitions included in state policy and procedures. The eleven states listed below
offer a variety of approaches to providing a clear, consistent definition.
California
Department of Developmental Services
“Person-centered individual program planning assists persons with
developmental disabilities and their families to build their capacities and capabilities.
This planning effort is not a single event or meeting, but a series of discussions or
interactions among a team of people including the person with a developmental
disability, their family (when appropriate), regional center representative(s) and
others. As part of the planning process, this team assists the individual in developing
a description that includes: a preferred place to live, favorite people with whom to
socialize, and preferred types of daily activities, including preferred jobs. This
description is called a preferred future, and is based on the individual’s strengths,
capabilities, preferences, lifestyle and cultural background. The planning team
decides what needs to be done, by whom, when, and how, if the individual is to begin
(or continue) working toward the preferred future. The document known as the
Individual Program Plan (IPP) is a record of the decisions made by the planning
team.”
Additional Resources
California Department of Developmental Services: Individual Program Planning
Resource Manual: “Person-centered planning . . . is an approach to determining,
planning for, and working toward the preferred future of a person with developmental
disabilities . . . and her or his family. The preferred future is what the person and
family want to do in the future based on their strengths, capabilities, preferences,
lifestyle and cultural background. Person-centered planning is a framework for
planning and making decisions. It is not a collection of methods or procedures.
Person-centered planning is based on an awareness of, and sensitivity to the lifestyle
and cultural background of the consumer and family.”
This 283-page manual provides a variety of useful resources, including a discussion of
values, personal stories, sample plans, planning format documents, and examples of
person-centered planning approaches.
Representative Examples of State Definitions
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California Department of Developmental Services: Person-Centered Planning—
Building Partnerships and Supporting Choices: This 8-page document includes
excerpts from the IPP Resource Manual and includes an overview of values, roles, and
responsibilities. Dated July 1, 2001.
Connecticut
Department of Developmental Services
“What Is Person Centered Planning? Person centered planning is an ongoing
individual planning process that is designed to capture your dreams and desires and
translate them into a plan of action. Person centered planning is a way to listen and
take direction from you and the people who know you best. It focuses on your
preferences, strengths and talents rather than your limitations. Person centered
planning organizes and uses natural supports like family, friends and acquaintances
and formal community supports and services to help you achieve the things that are
important to you.”
Additional Resources
Department of Mental Health and Addiction Services: Person-Centered Recovery
Planning (PCRP): This webpage includes links to a variety of resources that support
person-centered recovery planning, including a workbook for individuals to use in
preparation for their planning meeting, and a fact sheet for family members and
supporters.
Florida
Agency for Persons with Disabilities
Person-Centered Support Plan Instruction Manual
: “Person-centered planning refers
to a way of coordinating services that places the individual at the center of their
support planning process. It differs from a traditional medical model which relies on
assessments or input from professionals to describe the individual’s problems and
what needs [to be] done to fix those problems. Person-centered planning starts with
the individual’s preferences and goals and includes input from assessments
performed by [a] professional to help plan for needed services and supports. Person-
centered planning assists in identifying what is important to the individual, whereas
assessments identify what is important for the individual. For example, being able to
choose their morning routine or having access to a park may be important to the
individual, whereas taking a needed medication is important for the individual.”
Additional Resources
Florida Health Care Association: “Person-Centered Care (culture change) refers to the
national movement for the transformation of older adult services, based on person-
directed values and practices where the voices of elders and those working with them
Representative Examples of State Definitions
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are considered and respected. Core person-directed values are choice, dignity,
respect, self-determination and purposeful living.”
Georgia
Department of Behavioral Health and Developmental Disabilities
From A Life in the Community Through Person-Centered Thinking:
“What is person centered
planning? Person-centered planning is about: listening to and learning about what people
want from their lives; helping people to think about what they want now and in the future;
family, friends, professionals and services working together with the person to make this
happen.” This plain language document includes quotes from people and families, graphics
and pictures.
Additional Resources
Parent to Parent of Georgia Fact Sheet: Person Centered Planning: “What is Person-
Centered Planning? Person-Centered Planning is a process used to help families,
friends and others assist students with disabilities in preparing for their future. This
process can help students share their own interests and dreams and develop a plan to
turn them into reality.” Links to this resource are available in Arabic, Vietnamese,
Japanese, Spanish, Chinese and Korean
on the Parent to Parent of Georgia website.
Illinois
Department of Human Services
Person Centered Philosophy Statements: “Person Centered Planning can be described
as the balance between what is important to a person and what is important for a
person. It is a way to identify strengths, preferences, needs (both clinical and support
needs) and desired outcomes of a person. … Discovery is one component of Person
Centered Planning. The Discovery process is designed to gather information in order
to capture what is important to the person and what is important for the person. …
The Personal Plan is the single, integrated personal vision for a person's life. It
focuses on the individual's strengths, preferences, needs and desires.”
Additional Resources
Shifting to a Person-Centered System: Moving Toward Capabilities and Support. This
webpage references information provided by Support Development Associates
comparing current system characteristics and characteristics of a person-centered
system. For example, the current system has a focus on identifying and fixing what is
wrong, whereas a more person-centered system builds on existing and future
capabilities.
Representative Examples of State Definitions
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Maryland
Department of Health, Developmental Disabilities Administration
Exploration and Discovery for Development of the Person-Centered Plan
: “Person-
centered planning is a process that begins with the understanding that all people have
the right to live, love, work, play and pursue their aspirations in their community. To
that end, people have the right to figure out and pursue their good life. What defines a
good life is as individual and unique as the person being supported. Many people also
have family and others in their lives who play a meaningful role as the person
explores potential interests and opportunities not considered before.” (page 3)
Massachusetts
Department of Developmental Services
“What are Person-Centered Practices? Person-Centered Practices include both
‘person-centered thinking’ and ‘person-centered planning.’ To be person-centered
means treating individuals with dignity and respect; building on their strengths and
talents; helping people connect to their community and develop relationships;
listening and acting on what the individual communicates; taking time to know and
understand individuals and the things that make them unique. Person-centered
thinking involves a deep respect for individuals and their equality. Person-centered
planning involves a process and approach for determining, planning for and working
toward what an individual with a disability or an older adult wants for his or her
future.”
Minnesota
Department of Human Services
“What are Person-Centered Practices?”
Person-centered practices are based
on the fundamental principle that government and service providers must listen to
people about what is important to them to create or maintain a life they enjoy in the
community. When a person-centered approach is used, support and service planning
is not driven by professional opinion or limited service options. Instead, planning
looks at services and supports in the context of what it takes for a person to have the
life they want. The person along with his/her support team identifies effective support
and services that will help the person live, learn, work, and participate in preferred
communities on his/her own terms. These practices encourage professionals to see
people as unique and whole individuals with potential and gifts to share. Using these
practices, professionals and informal support people learn what is important to each
person and what contributes to each person's quality of life. “Person-centered”
services are an alternative to “system-centered” or “professionally-driven”
approaches.
Representative Examples of State Definitions
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“What is Person-Centered Planning? Person-centered planning is learning
through shared actions. People who facilitate the planning process will support a
person and their team to go through a process and then produce documentation of
their meetings and of the plan. However, planning is more than just making better
paper, it’s about enhancing people’s lives. Plans evolve as people evolve, and as we
learn through implementation.”
Additional Resources
Person-Centered, Informed Choice and Transition Protocol: “It cannot be over-stated
that a person-centered system is based on a philosophy and approach to practice. It
goes far beyond documentation in files or written plans. While documentation and
written plans are tools for communicating important information and for
accountability, they alone are not sufficient. The real proof of a person-centered
system lies in the practices of those working in our systems and in the resulting
quality of life of the people who are supported by our systems. At its heart, person-
centered practices focus on each person, and the resulting plans will vary with each
person, culture, and community. This protocol aims to provide guidance and
accountability for person-centered practices without losing individualization through
overly standardized requirements.”
New Mexico
Department of Health – Developmental Disabilities Supports Division
“Our mission is to effectively administer a system of person-centered community
supports and services that promotes positive outcomes for all stakeholders with a
primary focus on assisting individuals with developmental disabilities and their
families to exercise their right to make choices, grow and contribute to their
community.”
Service Planning and Budgets:
“Person-Centered Thinking values and supports
individuals with intellectual and developmental disabilities to make informed choices
and exercise the same basic, civil and human rights as other citizens, including dignity
of risk. Dignity of risk is defined as the right of individuals to choose to take some risk
in engaging in life experiences. Person-Centered Planning (PCP) is an ongoing
process that identifies what is important to and what is important for a person. The
individual with intellectual and/or developmental disability (IDD) is at the center of
the process and is encouraged to direct the process as much as possible. No matter
what the nature or severity of a person’s disability, there are many ways to identify a
person’s strengths, abilities, preferences, needs, and goals. ISP supports people
with IDD to exercise the same basic legal, civil and human rights as well as other
citizens. Person-Centered Practice is aligning services and resources to support
individuals to achieve individual goals and outcomes that are important to and for
them.”
Representative Examples of State Definitions
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Additional Resources
Person Centeredness Fact Sheet: “Person-Centered Planning: A way to help a person
plan their services and supports. It’s an ongoing process that identifies what is
important to and what is important for a person. The individual is at the center of the
process and is encouraged to direct the process as much as possible. The Centers for
Medicare and Medicaid Services (CMS) has requirements for person-centered service
plans. Best practices for person-centered planning include: 1) Listening; 2)
Empowering; 3) Encouraging; and 4) Supporting.”
Person-Centered Planning and Home and Community-Based Services: “The person-
centered plan is your plan, written in your words, and says what your goals,
preferences, and interests are. You have the final say in what goes into the plan and
have the right to have help from someone you choose when you are talking with
people from the state about what you want in your plan. This is especially important
when you are being asked to agree to something that may limit your right to make
your own decisions about your life activities.” This is a plain-language overview of the
planning process for HCBS.
Pennsylvania
Department of Human Services
“What is Person-Centered Planning? Person-centered planning can be used with all
people including those with mental health issues and people with significant
disabilities. It works for people of all ages, starting at birth and continuing throughout
the life span. Person-centered planning also works with people of all abilities. …
Person-centered planning is a way for you to say what is important to you and what is
important for you in your life. In addition, it helps you figure out how to make the
things you want in your life happen. A plan can be as simple as you having some ideas
that you tell other people. However, it helps if you write down these ideas or record
them in some way. Having a plan that is used is more important than just writing a
nice plan. Sometimes a formal planning process is used. Different tools and methods
can be used depending upon your circumstances. Sometimes you might start a
particular planning process and then it doesn't feel right. When this happens, you
need to try another way.” The Pennsylvania DHS website notes that “this information
was created as a pamphlet by a workgroup of the Pennsylvania Self Determination
Consumer and Family Group and the Pennsylvania Office of Developmental
Programs.”
Vermont
Agency of Human Services – Department of Disabilities, Aging and Independent
Living
“Person Centered Thinking: Person centered thinking is a set of principles and
core competencies that is the foundation for person centered planning. Person
Representative Examples of State Definitions
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centered planning is a guided process for learning how someone wants to live at
home, at work or in the community and developing a plan to help make it happen.
Person centered thinking tools provide practical strategies for gathering meaningful
information and facilitating conversations about goal setting, problem solving and
action planning. This process ensures that focus remains on the perspectives of
individuals affected by the issue or outcome. Person centered thinking also provides a
framework for building effective relationships and opens the door to greater
collaboration and planning in partnership. This in turn, increases the likelihood that
the individual receiving services or the employee receiving supervision will be heard,
valued and better equipped to attain the quality of life they seek at home and at work.”
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Summary
Establishing a clear definition for person-centered thinking, planning, and practice is
a fundamental first step for states moving toward transforming their systems. Clear
and consistent communication among various state agencies is essential, especially
with respect to expectations for person-centered services and supports. However,
having exemplary definitions is not enough. The challenge is solidifying a shared
understanding of what it means to be person-centered based on the lived experience
of the people receiving services. The assertion “we are person-centered” should not be
based on revisions to policies, forms, and manuals, but rather on the stories of people
who are living the lives they have chosen, in communities where they experience
belonging, and surrounded by people and friends who care about each other.
About NCAPPS
The National Center on Advancing Person-Centered Practices and Systems (NCAPPS)
is an initiative from the Administration for Community Living and the Centers for
Medicare & Medicaid Services to help States, Tribes, and Territories to implement
person-centered practices. It is administered by the Human Services Research
Institute (HSRI) and overseen by a group of national experts with lived experience
(people with personal, first-hand experience of using long-term services and
supports).
NCAPPS partners with a host of national associations to deliver knowledgeable and
targeted technical assistance.
You can find us at https://ncapps.acl.gov
This document is publicly available for use in the administration and improvement of
supports for older adults and people with long-term service and support needs. All
uses should acknowledge NCAPPS, and the developers of this content. Permission is
required if the material is to be modified in any way or used in broad distribution.
Recommended Citation:
Lawrence, J. (2020). Person-Centered Thinking, Planning, and Practice:
Representative Examples of State Definitions. Cambridge, MA: National Center on
Advancing Person-Centered Practices and Systems.
