Page 217 - QAP Manual 2020

NCI™ ADULT IN-PERSON SURVEY (IPS) 2020-21

Now I am going to ask you about your IPP. An IPP is sometimes called a Care
Plan, or an ISP. An IPP talks about the supports and services you need to do the
things you want to do.

(Instructions to surveyor: Please replace “service plan” with the terminology
used in the state, such as “care plan,” “ISP,” “IPP.” )

47. Do you have an IPP plan? (Do you have a list of services your case
manager/service coordinator will help you get?)
□ 2. Yes
□ 3. Maybe, not sure

□ 1. No →Code CA-8 and 48-50 as ‘Not applicable’
□ 99. Don’t know, no response, unclear response →Code CA-8 and 48-50
as ‘Don’t know, no response, unclear response’

CA-8. Did you get a copy of your IPP in your preferred language?

□ 98. Not Applicable – no IPP
□ 2. Yes
□ 1. No
□ 99. Don’t know, no response, unclear response

48. Do you remember what is in your IPP?

□ 98. Not applicable – no IPP
□ 2. Yes

□ 3. In between
□ 1. No →Code 49 as ‘Not applicable’
□ 99. Don’t know, no response, unclear response →Code 49 as ‘Don’t
know, no response, unclear response’

49. Does your IPP include things that are important to you?

□ 98. Not applicable – no IPP or person doesn’t remember what is in the
IPP
□ 2. Yes
□ 3. In-between
□ 1. No

□ 99. Don’t know, no response, unclear response

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